Oops! Do you find yourself crossing your legs after a sneeze, cough, or laugh? Or discover that you can’t quite make it to the bathroom in time when you feel the urge to urinate?
Stress incontinence involves urine leakage when pressure is placed on your bladder. You may experience a little leakage or a lot, and the pressure on your bladder may be the result of sneezing, laughing, coughing, jumping, running, high-impact exercises, or lifting something heavy.
This type of urinary incontinence is extremely common - especially among women. An estimated 1 in 4 women regularly experience stress incontinence - and the problem gets worse with age: 75% of women who are 65 years old and older report having the condition.
Why It Occurs
Weakening of pelvic floor and urinary sphincter muscles can lead to the inadvertent leaking of urine during physical exertion. The “pelvic floor” supports organs such as your bladder, uterus, and rectum.
Factors that contribute to stress incontinence include:
- Age
- Pregnancy and childbirth
- Weight gain and obesity
- Menopause
- Anything that increases coughing, such as smoking, allergies, or other illness
- Previous pelvic surgery, such as a hysterectomy
- Pelvic organ prolapse
Other causes of urinary incontinence in women include an overactive bladder, in which you experience frequent and sudden urges to urinate that are difficult to delay, leading to urine leakage.
Diagnosing Stress Incontinence
When you visit your OB-GYN provider at EstrogenicA Health 360, you can expect a pelvic exam, which may include a cough stress test in which you are asked to cough during the exam in an attempt for your provider to visually identify urine leakage. For this reason, you may be asked to come to your appointment with a full bladder. Your EstrogenicA Health 360 may also order a urinalysis to rule out infection or other possible causes of urinary incontinence.
A post-void residual (PVR) urine test may also be conducted. This diagnostic test involves undergoing an ultrasound of the bladder after emptying your bladder to measure the amount of urine that remains in your bladder after urination.
Treating Urinary Incontinence in Women
There are a number of methods to treat urinary incontinence, depending on the cause and severity of your condition and symptoms. Your treatment options may include:
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These contract-and-release exercises can help strengthen your pelvic floor muscles. It can also allow you to regain control of your urinary sphincter muscles that control your ability to start and stop urinating.
This may include exercises designed to help you control the urge to urinate, completely empty your bladder, and to urinate on a schedule to help eliminate accidents.
Your provider may prescribe medication to be used in conjunction with Kegel or bladder exercises. The most common medications for urinary incontinence include antidepressants, anticholinergics, and topical estrogen.
Botox is FDA-approved to treat an overactive bladder (frequent urges to urinate) that can lead to urinary incontinence. The Botox is administered via a catheter threaded through your urethra to your bladder muscles.
If you wish to avoid surgery, there are a number of insertable devices to help relieve urinary incontinence in women. These nonsurgical treatments include:
- Bladder support – Urethral inserts are tampon-like devices that are inserted into the vagina to support and lift the urethra or the group of muscles that connect the bladder to the urethra (known as the “bladder neck”). They are disposable and help to stop involuntary urinary incontinence. These temporary bladder support devices are meant to be worn before specific activity that tends to cause stress incontinence. They can be safely used for up to 8 hours at a time.
- Vaginal pessary – These soft, insertable devices come in a variety of forms, such as a ring, doughnut, and Gellhorn. They can address organ prolapse, as well as stress incontinence. When used to treat urinary incontinence alone, the devices can be left in for up to six months at a time. A pessary will be customized to fit you, and should not interfere with your ability to urinate.
There are a variety of sling and suspension procedures that can help support the urethra and keep it closed until you urinate.