Not a Part of Aging: SUI in Older Adults

As women get older, it’s a common misconception that incontinence is inevitable. Experiencing leaks as we age, has become a characterization of aging when, in fact, urinary incontinence, while common, is not a part of the aging process. Specifically, we’re talking about Stress Urinary Incontinence, SUI, or Light Bladder LeaksI in older women. It impacts around 15 million adult women in the U.S. alone. So what is SUI, and how does it impact older women?

About Stress Urinary Incontinence

Stress Urinary Incontinence is the accidental urine leakage that occurs when you put stress on your bladder or urinary tract. This is due to the weakening of the pelvic floor muscles that regulate and control the flow of urine, causing little leaks during activity. Activities that can trigger SUI leaks can range from high-impact like running or jumping to pretty typical day-to-day activities like coughing or bending down. The actual leakage can range from a couple of drops to a stream of urine. There are actually two kinds of SUI -

• Urethral Hypermobility - the urethra shifts due to a change in abdominal pressure
• Intrinsic Sphincteric Deficiency (ISD) - the sphincter muscle doesn’t seal off correctly at the bladder

It is believed that most women that are experiencing leaks with SUI have some degree of ISD. There can be a number of causes when it comes to women developing SUI such as surgery, childbirth, or obesity. Years of high impact activities like jogging or mountain biking may also weaken the pelvic floor.

Aging and Incontinence

While women of all ages can experience stress incontinence, it can impact older women in particular. Age is actually a factor of SUI, but again, while it is a common problem it’s not a normal part of the process. Older women can experience incontinence after pelvic surgeries like a hysterectomy, a process that removes the uterus and ovaries for medical purposes. Women that have had vaginal births are more likely to develop SUI later in life as well. After around age 30, our muscles stop growing and developing and we start losing muscle mass and function with a phenomenon called age-related sarcopenia. This is true for women and their pelvic floor muscles as well, which is another reason that older women may experience SUI more often. Menopausal women, specifically in the perimenopause stage, commonly have SUI develop during this period of life. This is due to the lower levels of estrogen produced thinning the lining of the urethra. These factors that increase the likelihood of developing SUI later in life are pretty normal and healthy for a woman to experience, which is perhaps why it is so common to develop. While it is common, a lot of older women struggle with the embarrassment of having stress incontinence.

Impact on Mental and Physical Health

Older women who have the occasional leak with stress incontinence often feel alone in dealing with it. It’s hard to discuss urinary problems with friends and family members because it is embarrassing to talk about. Some choose to isolate themselves and avoid social interaction to prevent embarrassing moments or a cleanup. But isolating oneself later in life can negatively impact mental and physical health. Studies have shown that social isolation increases the risk of:

• Depression
• Anxiety
• High Blood Pressure
• Heart Disease
• Alzheimer’s Disease
• Obesity
• Weakened Immune System

These are health problems a lot of older Americans cannot afford to have. In addition, depression and anxiety have their own side-effects on both mental and physical health that can impact an older woman's quality of life beyond her SUI. With around 28% of older Americans living alone, another factor to consider is that there is a lack of immediate support at home, both emotionally and physically, to deal with stress incontinence.

Solutions

There are options for older women that are suffering from SUI. One option is using one-time use liners or pads to absorb and cover up leaks. Worn much like a menstrual pad (but still a different product), incontinence pads are available in a variety of sizes, absorbances, and styles for women to try. But there are a few downsides: they just cover up the leaks, so there is a chance of an odor or excess liquid occurring while wearing. These liners and pads are also made up of non-bio-degradable materials that end up in landfills and hurt the environment. Some women like to wear washable incontinence underwear instead, that gets washed in the laundry to avoid the waste. but are at equal risk for odor and accidental leaks. Another option is performing pelvic floor muscle exercises like Kegels to rebuild the weakened or lost muscle mass. This may be difficult for older women to do correctly and safely, especially if they live alone. Pelvic mesh surgery may be an option, but there are risks and financial costs to consider.

Revive™

A solution for women to help reduce their bladder leaks is the over-the-counter product called Revive. Revive is a reusable bladder support device that helps reduce SUI symptoms and helps keep women dry for up to 12 hours per day. In a clinical trial, 71% of women said that they experienced a reduction in symptoms and that they felt dry 75% of the time using it. The one size fits all device can be safely inserted at home without a prescription for leak protection. Designed for all-day comfort, 90% of trial participants felt that Revive was a good fit upon first use. Available at retailers nationwide for a months supply!