stress incontinence when jumping
Incontinence

Stress Incontinence: Everything You Need To Know

Do you know any moms who jump on their kids’ trampoline? I don’t. Most of us avoid it like the plague. If sneezing, coughing, laughing, or jumping brings on unexpected leaks, you’re in the right place. We’ve got everything you need to know about the symptoms, causes, and treatments for stress incontinence.

What Is Stress Incontinence, You Say?

If you’re wondering, “what is stress incontinence?” then you’re in the right place. Stress incontinence is one of several types of incontinence. It’s the kind where a little bit of pressure on the bladder from laughing or jumping on a trampoline can cause an unexpected spritz. It’s like a random person who pops up to say hello and then scurries away before you can say, “hey, how’s it going” back. Kind of awkward, right?

While the situation itself might stress you out, the term “stress” actually refers to physical pressure put on the bladder. When the pelvic floor muscles or urinary sphincter has been weakened or stretched, the bladder has a more challenging time holding in pee. So even if you feel like you don’t have to go, a cough, sneeze, or picking up a toddler could cause you to pee a little.

Stress Incontinence Causes

Wondering about what can weaken your pelvic floor and cause stress incontinence? Well, plenty of things can weaken your pelvic floor muscles or even cause pelvic prolapse. Have you ever been pregnant? Have you birthed a baby (or three)? Are you a bit heavier than the average person? What about going through menopause? All of these things can cause our pelvic floor muscles to get a little loosey-goosey over time.

Don’t have kids? Don’t think you’re off the hook. Plenty of kid-free women still experience stress incontinence. According to the National Institute of Diabetes and Digestive and Kidney Disease, some women even suffer from stress incontinence during the week before their periods. Our estrogen levels tank around that time and in the process, our muscles start to loosen up a bit. And that’s why leaks often crop up during menopause, too.

Other Causes to Consider

Outside of pregnancy, childbirth, and menopause, age is a factor with stress incontinence too. As we get older, gravity starts to really hit us. Everything starts to droop a little, including things we can’t see. The hammock-like structure of our pelvic floor doesn’t cradle our bladder like it once did, and that’s when stress incontinence can pop up. The following health changes can also cause stress incontinence:

  • Bladder and kidney infections
  • Diabetes
  • Constipation, especially being chronically stopped up
  • Blocked urinary tract (e.g. tumor, kidney stones)
  • Nerve damage
  • Chronic coughing, and
  • Anxiety

Stress Incontinence Symptoms

In a nutshell, the main stress incontinence symptom is when you experience an unexpected, unpredictable urine leak without having felt the urge to go. It’s most common that this happens when you cough, sneeze, laugh, lift something heavy, jump up and down, or exercise. But you may not leak each time you laugh or every time you exercise with stress incontinence. It’s sporadic, which is what makes it so stressful.

Stress Incontinence Treatment Options

If you’re dealing with stress incontinence, then you’re probably wondering what your options are. Some women make lifestyle changes, some try medication or surgery, and a lot of us opt for disposable underwear or pads. (Psst…if that’s the route you’re thinking, Lily Bird has you covered.)

Here’s the rundown on your options.

Lifestyle Changes

It turns out that there’s a lot that makes most bladders unhappy. Spicy foods, alcohol, caffeine, and sugar are just a few of the most common bladder irritants. So Wine Down Wednesdays may have to take a back seat for a bit. We know, it’s a bummer. Oh yeah, tobacco products don’t help either. Cutting back on some of these things may actually strengthen your bladder and reduce the frequency of unexpected leaks. To see if cutting out certain items is making a difference, use a handy-dandy bladder diary.

Another thing you can do to combat stress incontinence is exercise. Pilates and Kegel’s can do wonders for your pelvic floor. Give ‘em a try and see if you notice a difference after six weeks. Worried that you’ll unexpectedly leak while doing those exercises above? Not to fret. There are pads out there made just for leaks so you can exercise, laugh, sneeze, and more with confidence.

Disposable Pads & Underwear

A lot of women opt for disposable underwear or pads to help manage bladder leaks caused by stress incontinence. Why? Well, for starters, a lot of women feel that the lifestyle changes needed to eliminate leaks are too restrictive. Cutting out coffee and alcohol all or even most of the time isn’t realistic for most of us. And  other women find that lifestyle changes (read: endless Kegels) don’t necessarily do the trick.

Pads and disposable undies are also a convenient option because they’re fairly inexpensive and avoid the more drastic approach of surgery or medication, which can have side effects. Plus, you can get pads and disposable underwear delivered to your door.

A word of caution: you’ll definitely want to find a product designed specifically for bladder leaks. Don’t just reach under your sink for a pantyliner or menstrual product. Why? Menstrual products aren’t designed to absorb urine so you may find that your leaks leak out, your skin gets irritated, or that odor is a problem.

Stress Incontinence Medication & Devices

If you’ve tried all of the above but are still having issues, then talk with your doctor to see about other solutions. To date, there are no approved medications that specifically treat stress incontinence in the United States. However, in Europe, they use the anti-depressant, Cymbalta. Apparently, the boost of serotonin (happy hormone) from Cymbalta helps control the contraction of the urinary sphincter. Remember, when the sphincter is loose it leads to leaks, so Cymbalta helps in keeping the sphincter, or urinary door, shut. Unfortunately, the benefits may not outweigh the side effects. Women have reported nausea and increased suicidal thoughts.

If you’re not excited about pill popping, then consider a pessary. It’s a ring-shaped device that’s inserted by a healthcare professional and can reduce sneaky leaks during activities.

Another option is a urethral insert. They’re shaped like a tampon and can be inserted by you for one-time use. Once inside, a small balloon inflates to stop leaks in their tracks. Currently, urethral inserts aren’t that popular and are a little challenging to find, but they definitely an option for stress incontinence.

Surgery Can Be A Solution

In most cases, surgery is not medically necessary for stress incontinence, but your doctor may recommend it as a last resort. One option is the sling procedure and it’s the most common surgery for ladies with stress incontinence. For the mid-urethral sling procedure, a surgeon uses a thin strip of mesh and places it under the urethra in one of three ways:

  • Retropubic method: Your surgeon makes two small incisions above the pubic bone and uses a needle to place the sling under the urethra and behind the pubic bone.
  • Single-incision mini method: Your surgeon makes one small cut in the vagina and pulls the sling through.
  • Transobturator method: Similar to the retropubic method, except instead of cutting above the pubic bone, the surgeon cuts each side of the labia. (Yikes!) After that, they put the sling under the urethra.

The traditional sling procedure is a little more complicated. With this procedure, your surgeon will take a strip of tissue from your stomach or thigh (or a donor’s) to create the sling. They then make one cut in the vagina and one cut in the belly. The sling will then be stitched to the inside of the stomach wall. Essentially, all slings methods have the goal of keeping the urethra closed until it’s actually time to pee.

Don’t Stress About Incontinence

While it’s hard not to be a little anxious about your next sneeze causing an unexpected leak, you’ve got options. We hope one of the options above will help you manage and prevent future spritz and sprinkles.

If you’re looking to stress less about drips and dribbles, Lily Bird has you covered with pads and underwear for leaky laughs and dribble dilemmas delivered right to your door. Start your trial today.

By Jessica Thomas, MPH