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The Emotional Toll of Female Incontinence

Female incontinence is physical, but it can also have a psychological impact.

Female Urge Incontinence

While all types of female incontinence can cause emotional distress, urge incontinence is far more distressing, says Halina Zyczynski, MD, associate professor of obstetrics and gynecology at the University of Pittsburgh School of Medicine and a specialist in female incontinence at the Magee-Womens Hospital.

It's the unpredictable nature of urge incontinence that makes it so distressing, she says. Urge incontinence isn't totally understood, but experts think the bladder muscle may give the wrong messages to the brain, with the bladder feeling fuller than it really is. As a result, a person with urge incontinence feels the urgent need to go to the bathroom, even if they have just done so.

Stress incontinence, which causes urine to leak when lifting objects, laughing, coughing, or sneezing because of weakened pelvic floor muscles, is less emotionally draining, Zyczynski says. "Women can learn which positions or situations predispose them to stress incontinence [and avoid them]."

"If you know, for instance, that doing the Stairmaster makes you leak [urine], you can avoid it," she says. "If you know that sneezing [makes you leak urine], as your sneeze comes on, you can cross your legs or squeeze your pelvic floor muscles."

But, unlike stress incontinence, urge incontinence occurs without warning and is especially upsetting. "Before a woman has a chance to respond to that urge to go [to the bathroom], urine is already running down her leg," says Zyczynski.

The sheer volume of leaking urine associate with urge incontinence is another reason why this condition is so distressing. Women with stress incontinence tend to leak urine in small amounts, perhaps a teaspoon or a tablespoon, says Zyczynski. But with urge incontinence, a woman can leak a cup or two of urine, saturating an absorbent pad and soaking through their clothing.

What Can You Do About Female Incontinence?

Whatever form of female incontinence you have (and some women have both urge incontinence and stress incontinence - called mixed incontinence), it is crucial to seek help before the condition leads to social isolation, Zyczynski tells WebMD. Once women stop socializing, she says, it's easy to see how the withdrawal can lead to depression.

If you notice symptoms of incontinence, such as leaking urine, tell your doctor. He or she may recommend you see a specialist, such as a urogynecologist -- an obstetrician-gynecologist who specializes in the treatment of women with pelvic floor problems, which includes female incontinence - or a urologist with experience treating female incontinence.

Treatment Options for Female Incontinence

Some medications may aggravate female incontinence, such as high blood pressure drugs and antihistamines. If you have female incontinence and are taking these medications, your doctor may switch you to a different drug in hopes of alleviating the problem.

Simple remedies, such as the use of protective garments like pads or adult-size protective panties, may lessen the problem, says Zyczynski. Strengthening the muscles that control the bladder by doing Kegel exercises may also help, she says.

Biofeedback may also improve female incontinence. In one study of 26 women with urge incontinence, presented at the 2006 meeting of the American Geriatrics Society, biofeedback helped the women learn to control their bladder muscles and reduce the number of overactive bladder episodes.

If urinary incontinence is not helped by these remedies and is significantly interfering with your life and activities, your doctor may suggest medications or surgery. In one surgical procedure, surgical threads are used to help lift the bladder up to a normal position. This allows the muscles that help hold urine in to work better.

Another procedure, called a "sling," uses strips of material, either natural or synthetic tissue, to support the bladder neck and prevent urinary incontinence.

Reviewed on January 17, 2007

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