Women and Incontinence

Stress Incontinence in Women

Stress incontinence from weakness of the pelvic floor is one of the most common types of incontinence in women. Loss of urine may occur with activities such as a cough, laugh, sneeze, or with physical exertion (lifting or running). Multiple pregnancies, childbirth, and abdominal surgeries can cause your pelvic floor muscles to become weak. The pelvic floor muscles support the bladder, uterus and rectum. If the pelvic floor is weak, the bladder can drop down toward the vagina and leak urine. This is known as prolapse, and incontinence can get very severe. Regaining the strength of your pelvic floor will properly support the bladder and stop urine from leaking. Early treatment of stress incontinence after pregnancy, childbirth, or surgery is important to prevent prolapse. Kegel exercises are easy to perform and can be done at home to cure this type of incontinence.

Obesity and Diabetes in Women

Women who are over weight or have diabetes, have a higher incidence of urinary incontinence than those without these conditions. Keeping your blood sugar under control and reducing your body weight are important aspects of your treatment plan to help eliminate your incontinence.

Menopause and Incontinence

There has been evidence linking low estrogen levels in women to urinary incontinence. As a woman ages, her estrogen levels decrease. Lower estrogen levels can lead to loss of muscle strength surrounding the bladder. If the weakness is not treated, it can trigger pelvic organ prolapse. Prolapse is when the bladder, uterus or rectum drop down out of position in the body. Estrogen deficiency can also cause the urethra to become thinner, and it may not be able to close properly. Without full closure of the urethra, incontinence can occur.

Research has shown that women who have had a hysterectomy, have less incidence of incontinence. A hysterectomy should not be performed to cure incontinence. A hysterectomy is only performed for other medical conditions. If a women requires a hysterectomy for a medical reason, it may decrease her symptoms of incontinence.

Hormone Fluctuations and Incontinence

Urinary incontinence can be more pronounced the week before a woman's menstrual period.

Female Athletes and Incontinence

Female athletes can also experience symptoms of urinary incontinence. This is usually due to an imbalance of muscles in the female athlete. Many times female athletes have a very strong core and abdominal muscles, but weaker pelvic floor muscles. During physical exertion, the pressure of the core muscles overpowers the pelvic floor muscles. Strengthening the pelvic floor muscles is imperative with the female athlete to help stop bouts of incontinence. Wearing a tampon while running or doing strenuous exercises can help provide resistance to the urethra to slow down urine leakage associated with stress incontinence. This should not be done on a daily basis or all day long. This is only helpful when performing strenuous activities for a short duration of time.

Urge Incontinence in Women

Urge incontinence, or over active bladder syndrome (OAB), can affect women of all ages. The bladder muscles activate too often, or very suddenly, when you do not want them to act. Symptoms of urge incontinence include frequent urination, very little urine output, or urgent feelings of needing to void. This can be caused by chronic stress incontinence that is not treated, neurological diseases such as multiple sclerosis, surgery or other trauma to the pelvic floor muscles. It may also occur as a side effect from a medication that you are taking.

Voiding Diaries are very helpful to treat urge incontinence. Recording what you eat, drink, and how often you urinate, can help determine the best treatment for your incontinence. It is important to limit your bathroom trips to every 3-4 hours. If you go more frequently, then your bladder is not completely filling up. Using the bathroom at frequent intervals, sends a mixed signal to your brain. It reinforces that your bladder has to empty, even when it is not full. Sitting down, crossing your legs and tightening your pelvic floor, are all ways to reduce your feelings of urgency to void. If you can maintain a schedule of 3-4 hour intervals between bathroom trips, your brain is receiving the right message. For more on voiding diaries, see our Treatment Page.

Kegel Exercises

Kegel exercises are the most commonly prescribed treatment for urinary incontinence. Kegel exercises are designed to strengthen the pelvic floor muscles, which can help resolve stress incontinence. The pelvic floor is a group of muscles that support the bladder and pelvic organs of the body. Kegel exercises need to be performed every day for a minimum of 6-12 weeks to see effectiveness. See our treatment page for a detailed description of how to properly perform Kegel exercises.

Vaginal Cones

Vaginal cones are medical weights that can be inserted into the vagina to strengthen the pelvic floor muscles. Insertion of a vaginal cone triggers the contraction of the pelvic floor muscles. This is performed twice a day for 15-20 minutes each day. Daily activities are not interrupted with the use of vaginal cones. As the pelvic floor gets stronger, a heavier vaginal cone can be used to continue to challenge and strengthen the muscles.

Vaginal cones are an effective treatment for stress incontinence in women. Strengthening of the pelvic floor muscles can be seen in 2-3 weeks, with resolution of incontinence symptoms in 6-12 weeks of daily therapy.

Pessaries for Women with Urinary Incontinence

A pessary is a medical device that is inserted into the vagina to treat urinary incontinence. It is ring shaped, and helps support the vagina and female reproductive system from prolapse (or dropping). The pessary puts pressure upwards on the urethra and bladder. This can help some women with stress leakage, but can cause urinary tract infections. Your doctor needs to monitor the pessary to ensure proper position and function of the device.

Biofeedback Treatment

Biofeedback can be a very useful treatment for both stress and urge incontinence in men and women. Electrodes can be placed inside the vagina or rectum. The electrodes sense whether a muscle is activated and working properly. Sometimes it is difficult to contract your pelvic floor muscles. Electrodes provide feedback if you correctly activate a muscle. You can then get a better understanding of when your pelvic floor muscles are working correctly by using visual, auditory and tactile responses from the biofeedback unit.

Electrical Stimulation Treatment

Electrodes are placed inside the vagina or rectum to activate the pelvic floor muscles. It can help stimulate or strengthen muscles, or it can be used to calm down overactive muscles. Therefore, this treatment is helpful with both stress and urge incontinence. It is performed by a doctor or physical therapist trained in this type of medical procedure.