There are so many different ways of talking about urination. We’ll say things like “my bladder is full,” “I have to relieve myself,” or even “I need to pee!” Everyone needs to empty their bladders – it’s a normal part of life. But when you find you’re having urine leaks, you may well not want to talk about it.
Ladies who leak are often very embarrassed by it. But you’re not alone! Incontinence is very common. 45% of women ages 40-60 — and 1 in 3 women overall — experience bladder leaks. So, millions of women are in your same situation.
How your bladder works
To understand which of the many types of incontinence you have, it’s helpful to understand how the urinary system works. So let’s go back to science class. The bladder is a balloon-like organ that stores your urine. Urine is made up of water and waste that has been removed from your kidneys. The urethra is attached to the bladder, and it’s through this ‘pipe’ that urine leaves the body. Your bladder and urethra are controlled by muscles and nerves that either hold or release the urine.
When you urinate, two things happen at the same time – the muscles in the wall of the bladder contract, forcing urine out of the bladder into the urethra. At the same time, the pelvic floor muscles around the urethra relax, letting the urine pass through. Pretty tricky coordination, huh? Incontinence occurs when these muscles and nerves no longer work optimally.
Types of incontinence
Not all bladder leaks are created equal. Keep reading to find out which one of these types of incontinence you might have.
Do you ever pee a little when you sneeze, laugh, or cough? You might have stress incontinence. Stress incontinence occurs when small amounts of urine leak out when you do certain physical things, like exercising or lifting something heavy.
In this type of incontinence, ‘stress’ is placed on your bladder, and you won’t be able to keep it closed. This usually happens because the pelvic floor muscles have weakened or the urethral sphincter isn’t strong enough to remain closed. These small leaks will occur when you don’t feel the urge to urinate, and your bladder probably won’t be full.
A number of things can weaken your pelvic floor and cause stress incontinence. Pregnancy and childbirth stretch the pelvic floor muscles, which puts women at risk for stress incontinence, for example. This is particularly true if you’ve given birth to a large baby, multiple babies, or have had a long labor. But, it’s a myth that only women who have kids get bladder leaks. Age also plays a role too, as the muscles of both the urethra and the pelvic floor weaken as you grow older. During menopause, hormone changes also increase the likelihood of leaks.
Do you often feel a strong urge to urinate even when you know your bladder isn’t full? If so, you probably have an overactive bladder. This can be annoying, but it doesn’t necessarily result in leaks. However, if you have to keep running to the bathroom but often don’t get there in time, you might have urge incontinence.
Women typically urinate up to 7 times a day. That’s a lot. But with urge incontinence, you may need the bathroom even more than this, and you feel like you have to get there in a hurry. The reason for this is that your nerves are sending messages to your bladder to contract, even though your bladder isn’t full. And voila, that gives you the “gotta go NOW” urge. This urge can happen during the day, at night, or both.
Urge incontinence is more common in older women – particularly those who are post-menopausal. This is because age changes the bladder lining and the muscles that control urination. Certain medications and even your diet can make this condition worse.
Got urge incontinence? Check out these bladder control techniques for when you have to go NOW.
Post void dribbling
The telltale sign of ‘post void dribbling’ is when your leaks happen right after you’ve just gone to the bathroom. How frustrating! What’s happening here is that you think you’ve finished urinating but a few drops will remain behind in your urethra. These drops then leak out as you’re leaving the bathroom or soon after. One way to help with this type of incontinence is to “double void” which essentially means that you go to the bathroom twice. To try it, first go to the bathroom normally. Then, stand up, count to 10, and sit down again to make sure that every last drop is gone.
Nocturia and nocturnal enuresis
Nocturia is the term for when you need to urinate excessively at night. Most people produce less urine during sleep so that they don’t need to keep waking up but that’s not true for people with nocturia. Nocturia doesn’t cause bladder leaks in and of itself but it is sometimes accompanied by nocturnal enuresis. Nocturnal enuresis is a fancy word for bed-wetting. We usually think of bed-wetting as something that happens in kids but it can happen in adults too.
Are you thinking that several of these types of incontinence sound familiar? Well, that’s could be exactly what’s happening. Mixed incontinence occurs when your bladder leaks have multiple causes and it’s very common. The combination of stress incontinence and urge incontinence especially is something a lot of women experience. This can be very challenging! You’ll need to be aware of your symptoms to identify that you have both types of incontinence, as treating one won’t necessarily help the other.
With overflow incontinence you may not be aware that your bladder is full, but your kidneys keep sending urine. Picture a dam that is constantly building up, until it eventually overflows. That’s what’s happening with overflow incontinence.
This happens when your nerves aren’t sending you signals that your bladder needs to be emptied. As a result, your bladder will become full and distended. Eventually, it will literally pull the urethra open and urine will leak out.
Cardiovascular problems, diabetes, and nerve damage from childbirth, surgeries, or illness can all cause overflow incontinence. Once again, age can play a role, as a general decline in muscular strength can prevent the bladder muscles from contracting normally.
Functional incontinence is a bit different from the other types of incontinence. That’s because the urinary tract functions properly in this case. People with functional incontinence usually have an illness or a disability that prevents them from urinating in the bathroom. It could be a mental illness, such as dementia, that makes them either unaware or unconcerned about the need to find a toilet. This means that ‘accidents’ happen frequently. Sometimes the problem is that a person has limited mobility or is simply too far away from a bathroom.
Putting It All Together
Women are more prone to bladder leaks than men because they have a short urethra and experience reproductive events like childbirth and menopause. Incontinence can be a real nuisance, but there are ways to minimize its impact on your normal routine. Acknowledging your situation is an important first step. After that, it’s important to understand which of these types of incontinence you have so that you can take action to minimize the impact of bladder leaks on your lifestyle.
What kind of leaks do you have? Tell us about your experience in the comments!
By Julia Anne George