For many women, the perception of developing light bladder leaks is simply that they are a tell-tale sign of aging. And they’re partly right - Stress Urinary Incontinence (SUI) develops much more frequently in older women, due to the natural loss of muscle mass and strength as we get older. This is because the muscles that control and regulate how we go to the bathroom, called the pelvic floor muscles, also become weak just like our other muscles, thus leading to light bladder leaks. To be clear, this is not the sudden and desperate need to urinate (that’s called Urge Incontinence), we’re talking about the little dribble or leak that happens when you sneeze, jump, or laugh. Any sort of pressure on the bladder, abdomen, or urinary tract can trigger a leak, and the weakened pelvic floor muscles are unable to effectively stop it. If you’re experiencing these leaks, but aren’t necessarily older, you’re probably wondering “what is going on?”. Unfortunately, as often as it occurs in older women, SUI can also develop in women as young as 18. There could be a number of reasons why a woman may start to leak a little, ranging from serious changes to the body to lifestyle choices.
For some women, the chances of developing SUI before middle age has been determined to be influenced by genetic factors. In a study done in Sweden, identical twins with the same genes were compared with non-identical twins to evaluate urinary incontinence and other urinary tract problems. The conclusion? That at 51%, just over half of the variation, can be explained by genetic factors. This means that about half of people’s risk of developing urinary incontinence is genetic as compared to environmental.
Childbirth and Hormonal Changes
Another common cause of bladder leaks is giving birth. Women’s bodies go through a lot during the pregnancy and delivery of a baby. The pelvic floor is especially susceptible to trauma, muscle and nerve damage, and weakness post-baby depending on the delivery. The impact of giving birth can manifest years, even decades after doing so. In one study done in the UK, around 40% of women reported SUI or other urinary incontinence symptoms 20 years after their first delivery. Conversely, once women are out of their childbearing years the production of the hormone estrogen is slowed. This occurs due to the natural process women go through called menopause. Women going through this hormonal stage, especially women in perimenopause are more likely to experience bladder leaks. Estrogen helps the tissue that lines the urethra to support it, and when hormone production is slowed the support can be weakened, leading to leaks.
High-impact on the Pelvic Floor Muscles
While childbirth or hormonal changes may be able to explain some women’s incontinence cases, young women who have never given birth or have been pregnant have reported light bladder leaks as well. Studies have found that around 25% of young women in high school or collegiate athletic teams were experiencing stress incontinence. The thought is those years of training and performing high-impact activities like running, jumping, and dancing takes a big toll on the pelvic floor. Other factors could be putting stress on the pelvic floor as well. Smokers often have a chronic cough and cough harder compared to nonsmokers. Years of repeated hard coughing impacts the pelvic floor muscles. Women that are overweight or obese are more likely to suffer from stress incontinence symptoms as well, as extra body mass is added stress on the urinary tract and pelvic floor.
Any sort of trauma that the pelvic floor goes through may lead to consequential leaks, including surgery. A common surgery for women to get that could impact pelvic health is a hysterectomy. According to the Office on Women’s Health, a hysterectomy can be described as “surgery to remove a woman's uterus (her womb). The whole uterus is usually removed.” In some cases, the fallopian tubes and ovaries are also removed. Leaks are more likely to occur with a Radical Hysterectomy wherein the entirety of the uterus is removed with the cervix as well as the surrounding tissue, usually in cases where cancerous cells are present. The more extensive the surgery means more potential damage to the pelvic floor muscles, nerves, and tissue.
What Should I Do About My Leaks?
Women have been experiencing stress incontinence for thousands of years, which means that solutions have been changing and improving for generations. We have moved past using half a pomegranate as bladder support as Hippocrates suggested into much safer, more comfortable, and effective methods. Hormonal Treatment - Some doctors may prescribe a hormonal treatment for women in the form of a pill or cream to boost estrogen production and restrengthen urethral tissue. Pads & Other Products - Much like the pads used for menstruation: one-time use, absorbent cotton is placed onto (or completely replaces) underwear. Unlike tampons or pads, incontinence liners are designed to absorb and wick away urine discretely as opposed to absorbing blood, which has a much different consistency. Surgery - Some women have turned to surgical procedures to support the bladder internally and reduce leaks. Unfortunately, the FDA has halted production and distribution of pelvic mesh to be used in this surgery out of concern for public health and safety. Revive™ - Revive is a reusable bladder support device that works from the inside out. The soft, flexible design is uniquely shaped to fit in the woman’s anatomy comfortably for up to 12 hours a day. Once done, the device is easy to retrieve, clean, and store for up to 31 uses. Available at retailers nationwide without a prescription!