The Facts About Incontinence

About 25 million American adults suffer from some form of urinary incontinence, and 3 in 4 sufferers are women.

Urinary incontinence, or the loss of bladder control, is a widespread and stressful problem. The two primary types are stress urinary incontinence (SUI) and urge incontinence, also known as urgency incontinence. The stress form is a physical issue, typically spurred on by childbirth, pregnancy or aging. Hormonal changes or neurological diseases are the cause of urge incontinence.

You can determine which type you have based on symptoms. If leaks happen when you cough or laugh, it's likely the stress type, and if leaks occur even after you urinate, it's the urgency type.

Incontinence can occur in all ages and genders but is more common in women. Risk increases with age, affecting 28 percent of women 30 to 39 years old, and increases to 55 percent for women 80 to 90 years old.

Exercises that target the pelvic floor muscles can help women manage stress urinary incontinence. It's best to see a pelvic floor physical therapist who can create an exercise program for you, but the regimen generally consists of Kegel exercises, hip and spine exercises, and routines to strengthen the gluteal muscles.

Women can use products such as leak-proof underwear, incontinence pads, disposable underwear and panty liners to help prevent embarrassing leaks in public.

Urine leakage can affect men but at a much lower overall rate, 3 percent to 11 percent, than in women. Urge incontinence makes up 40 percent to 80 percent of male cases with causes including aging, a prostate injury or surgery, or reconditioning because of disease.

One method of treating incontinence is Kegels, which can help men who struggle with premature ejaculation and erectile dysfunction (ED), because tightening the pelvic floor muscles increases blood flow to the penis.

Most people experience minor leakage now and then. Other people may experience urine leakage in moderate amounts more frequently.

The types of urinary incontinence include:

• Functional incontinence. When you can't get to the bathroom in time because of environmental factors and/or aging.
• Overflow incontinence. Urinary retention caused by being unable to empty the bladder fully.
• Stress incontinence. A weakened pelvic floor that causes involuntary urination when you laugh or cough.
• Urge incontinence. An overactive bladder that causes leaks even after you've gone to the bathroom.

Mixed incontinence. A mix of stress and urge incontinence.

Incontinence is very common. For example, about 50 percent of American women experience incontinence at some point in their lives, according to a 2005 study published by JAMA Internal Medicine.

Many experts think the cause of urinary incontinence is hormone fluctuations caused by aging, but there are many causes, including:

• Cancers such as multiple myeloma and lymphoma
• Complicated delivery
• Diabetes
• Neurological diseases
• Prolapse or a drop of the pelvic organs

Doctors are better suited to effectively treat incontinence when they understand the root cause.

The causes and risk factors depend on the type of incontinence someone is experiencing. For example, stress incontinence risk factors include vaginal delivery, pelvic surgery, aging and menopause.

Risk factors for urge incontinence or an overactive bladder include benign prostatic hyperplasia (BPH) in men, cystitis or bladder inflammation, high body mass index (BMI) and increasing age.

Doctors use clinical diagnosis, which is when they look at possible symptoms and risk factors of the patient. They also check medications and carry out urinalysis to check for urinary tract infections (UTIs) that may be causing incontinence.

Treatment can include lifestyle changes such as weight loss, Kegel exercises, physical therapy and pharmacological medications.

Kegel exercises can help people strengthen their pelvic muscles and control incontinence.

Here's a quick guide to Kegels:

1. Clench the muscles around your urethra and anus as if you are trying to stop urinating midstream.
2. Flex these muscles for three to five seconds, then relax for five seconds.
3. Do this exercise 10 times each session with three to four sessions per day, and you should see results within a few weeks or months.

Other preventive measures are abstaining from fluids two to three hours before bed and having a bedside urinal close by to prevent evening accidents.

Certain exercises can cause stress urinary incontinence, but that doesn't mean you need to halt these workout routines completely. Exercises such as running are intense on the pelvic girdle, which can cause bladder leaks. Gymnastics, cross-country skiing and other exercises with hard, vertical-hitting movements can also cause incontinence.

If you're having problems with SUI, it's important to consult a doctor with the goal of determining its root cause. You can continue exercising, but use Kegels to help control leaks. When it comes to your sexual health, you can wear panty liners or pads on dates, empty your bladder before having sex and avoid vertical bouncing, as in the cowgirl position.

As they age, many men experience bladder control problems that can be related to prostate issues. Your prostate is a gland in the pelvis that secretes fluid to help sperm travel. As men age, their prostate grows and may press against the bladder and urethra, leading to incontinence.

You can get a test to check and see if you have any prostate issues. Your doctor may recommend a digital rectal exam (DRE)—in which they feel for lumps or abnormalities in your prostate—or a prostate-specific antigen (PSA) test. Your doctor can help you decide which test is best for you.

As women age, they experience menopause and its dramatic hormonal changes. These can lead to incontinence, especially in women who have had children. Hormonal changes can cause the pelvic muscles to loosen and lose control, which can cause stress urinary incontinence. Menopause can also cause depression and anxiety, which can also cause SUI.

Some natural remedies can help ease the symptoms of menopause and incontinence. Try exercising and eating foods rich in magnesium and tryptophan, which may help reduce the menopausal symptoms of depression and anxiety.

What causes incontinence?

There are a few different factors that can cause incontinence. One of the most common is low muscle strength in the pelvic muscles caused by age and childbirth. Another cause is neurological disorders, such as Parkinson's disease, multiple sclerosis (MS) and stroke.

Some medications, including antidepressants and blood pressure meds, can cause incontinence.

How do I stop incontinence?

The best way to treat incontinence is prevention in the form of exercise, healthy diet and the maintenance of a healthy weight. Avoid bladder irritants such as caffeine and alcohol, and try different lifestyle changes or remedies to help strengthen your pelvic floor and prevent incontinence. These approaches may include Kegel exercises, pelvic muscle exercises, biofeedback, pelvic floor therapy, pelvic slings and surgery, if needed.

What are the most common treatment options?

One common treatment to prevent incontinence is to strengthen your pelvic floor muscles. Another option is to use products that can help control incontinence. These include absorbent underwear, extra-absorbent pads and alarms that go off when there is a leak.