The medical term for losing bladder control is urinary incontinence. There are 5 types of urinary incontinence that can affect otherwise healthy women over 50: stress, urge, overflow, mixed, and gross total. The types range from an occasional leaking bladder (the “I pee when I laugh syndrome”) and the urgency that you have to urinate all the time to not being able to make it to the bathroom in time.
Stress Incontinence: Light Bladder Leakage
The most common type of incontinence is stress incontinence. Stress urinary incontinence (also known as SUI) is involuntary, light leaking bladder resulting from abdominal pressure (or stress) on the bladder. The cause of this stress? Harmless (and not stressful) activities like laughing, coughing, exercising, sneezing, or lifting. A leaking bladder can be embarrassing, but if you have experienced stress incontinence as you age, you are not alone. While bladder weakness is not normal, stress incontinence is very common in menopausal and post-menopausal women.
Physical changes associated with childbirth and menopause can cause stress incontinence. According to VibrantNation.com blog circle member AgingButDangerous, “In the U.S., 13 million adults suffer from urinary incontinence (UI). According to ‘What Your Female Patients Want To Know About Bladder Control,’ 1 in 4 women ages 30 to 59 deal with UI. According to Agency for Health Care Policy and Research (AHCPR), $11.2 billion is spent yearly on pads and adult diapers to manage UI.”
The primary causes for stress incontinence in women over 50 are childbirth and the loss of estrogen in menopause. Pregnancy and childbirth can stretch and weaken the pelvic floor muscles that support the urethra and bladder; bladder weakness and a leaking bladder related to childbirth can arise years after you actually give birth. Estrogen keeps the tissues that surround the bladder and urethra plump and healthy. With the loss of estrogen after menopause, those tissues weaken and it becomes more difficult for the urethral sphincter to control your flow of urine. Weak pelvic floor muscles and a weakened urethra can cause occasional bladder weakness and a leaking bladder.
Unlike other symptoms of menopause caused by the loss of estrogen (like hot flashes and painful sex), hormone replacement therapy (HRT) is not recommended as a way to reduce the risks of stress incontinence (some studies have shown that the use of topical estrogen therapy may help reduce stress incontinence – something you may want to ask your doctor about.)
Other factors that can contribute to a woman’s bladder weakness and a leaking bladder are hysterectomy and other changes from aging. The uterus and bladder are located very close to one another; when the uterus is removed, you run the risk of damaging and weakening the muscles around the bladder. And as the bladder ages, its storing capacity decreases, which can also result in an overactive bladder.
Urge Incontinence: The Overactive Bladder
Urge incontinence (also called an overactive bladder) is a sudden, urgent feeling that you need to urinate. Generally this is followed by an uncontrolled loss of urine. One common cause of urge incontinence is a urinary tract infection or bladder infection. Overactive bladders that continue into nighttime can cause disruptions in sleep (as well as wet beds). Women with Parkinson’s, Alzheimer’s, MS, or who have had a stroke are prone to developing urge incontinence.
Overflow incontinence is when you constantly dribble urine because you are unable to completely empty your bladder. The causes of overflow incontinence are damaged bladder or a blocked urethra.
Mixed incontinence is the combination of different types of urinary incontinence. You can, unfortunately, have both light bladder leakage (stress incontinence) and an overactive bladder (urge incontinence).
Gross Total Incontinence
Gross total incontinence is the continuous leaking of urine and is uncontrollable. This is the most severe case of incontinence. Those with gross total incontinence have usually had an injury to the spinal cord or were born with a birth defect that hinders their ability to control their bladder.
Note: If bladder weakness and a leaking bladder are affecting your daily activities (or those of your husband – prostate and other problems associated with aging create similar problems for men), make an appointment to see your gynecologist or a urogynecologist or urologist today!
Your doctor can explain prescription and surgical approaches to tackling your leaking bladder, but should also explain ways that you can manage bladder weakness and a leaking bladder without external or risky solutions.