How many Women suffer from Urinary Incontinence?
You probably know that the term ‘Urinary Incontinence’ refers to loss of voluntary bladder control. But do we all know just how common urinary leakage is among women?
One of the most common varieties of incontinence is ‘urinary stress incontinence’ or mild incontinence, which is sometimes called ‘a weak bladder.’
This is where you get slight urine leakage whenever you sneeze, cough, laugh or engage in certain exercises such as running or jumping. It is more a weakness in the muscles that control bladder expression rather than the bladder itself, but it is rather common. Men have it also, but they are not as at risk of incontinence as women.
It can be embarrassing as well as inconvenient, and as many as 20% of women suffer from incontinence.
Urinary leakage can present in many different forms, however. It is often characterized by a dribbling or slightly leakage of urine when you’re not intending to release it. Some women have more severe, chronic incontinence – and other women more sporadic, milder incontinence; but whatever form it takes, it can result in mild discomfort or even significant distress.
Not only can it be socially embarrassing or leave your clothing ‘urine scented,’ it can also lead to recurrent episodes of urinary tract infections.
Most women with urinary incontinence report some impairment of quality of life, and want to do something to remedy the problem.
One option might be MonaLisa Touch vaginal laser treatments, which we describe below.
Females are 2 to 3 Times More Likely to Get Urinary Incontinence than Males
An estimated 2 in 10 Women Experience Urine Leakage (Incontinence)
Based on recent research, it has been observed that women are 2-3 times more likely to develop urinary incontinence than men (1). According to another study, one out of every five women suffers from urinary incontinence at some point of their life.
By age 65, potentially HALF of all women will experience urinary incontinence of some form
There are numerous factors that may play a role in urinary incontinence and the commonality of it in Australia; such as:
- Advancing age: As we age, our chances of developing urinary incontinence increase due to the loss of our muscle tone and overall strength.
- Statistics suggests that as many as 50-84% of women develop urinary incontinence after the age of 65 (1).
- Pregnancy or birth-related complications: Loss of bladder control is a fairly common gynecological complication that affects 33% – 66% women after a complicated childbirth (2).
- Pregnancy induced temporary urinary incontinence usually lasts for about 3-6 months after parturition (or childbirth).
- Often special exercises are prescribed by a Post-Pregnancy Physiotherapy – but sometimes other medical treatments may be required (MonaLisa Touch laser treatment may be very helpful for some women)
- Pelvic organ prolapse: In this condition, pelvic organs like bowel, uterus and bladder essentially – drops into – the vagina after losing pelvic muscular support. This can result at times from tears that occur during the delivery process. Females with pelvic organ prolapse can develop incontinence of feces and urine as well as sexual dysfunction, and this can have serious impacts on a woman’s self esteem or quality of life if not treated.
IN addition to pregnancy and pelvic area traumas, other common causes of significant urinary incontinence in women include:
- existence of pelvic tumors
- muscle weakness or organ atrophy from medications or cancer treatments
- injuries or surgeries that involve the pelvic organs (such as a hysterectomy or removal of the uterus)
- spinal injuries or tumors
- urinary stones
- neurological disorders including MS or MND.
Urinary Incontinence in Women – What should you know about it?
Women are more likely to develop urinary incontinence – especially after a pregnancy
According to a study reported in the British Journal of Obstetrics and Gynecology (3), investigators suggested that the risk of urinary incontinence increases by 67% after one vaginal delivery.
- Many healthcare professionals and women believes that vaginal births, or birthing larger babies, can be a primary cause of urinary incontinence.
- But the truth appears to be that regardless of the mode of delivering a baby, many women becomes vulnerable to developing incontinence due to metabolic and hormonal changes caused by the being pregnant, itself, not just the delivery risks.
How pregnancy and hormones impacts continence or incontinence
- Relaxin is a key hormone of pregnancy that plays a major role in the relaxation of the body’s connective tissues and pelvic joints in order to facilitate a vaginal delivery.
- The serum levels of this hormone tend to increase long before the actual birth (parturition)
- Along with the baby’s weight pushing down on your organs in your abdominal area, these hormone changes can also contribute to urinary incontinence in pregnant women.
- Regardless of the type of delivery and your best exercise efforts, your pelvic joints never quite regain their pre-pregnancy strength after pregnancy and giving birth.
- The structural changes in the joint function aggravates your risks of urinary leakage as well as increasing your risk of urinary or vaginal prolapse.
- As your fetus grows inside your womb, your growing belly stretches your pelvic floor muscles.
These changes in your connective tissues and your muscle functions do not, sadly, return to normal even after childbirth. Weakness of your pelvic floor muscles further aggravates the risk of urinary leakage – as does the risk of torn abdominal muscles (which then make it difficult to properly exercise your abdominal area and pelvic floor muscles, especially if you also have an abdominal hernia after pregnancy).
(You’re probably thinking, ‘why doesn’t anyone tell you this BEFORE you get pregnant?’)
- During birth when the baby is moving towards the vagina, the nerves and muscles that control the bladder functions may undergo excessive stretching or serious injury.
- This vigorous stretching makes the bladder muscles weaker and sometimes unable to fully control the urinary system, leading to leakage or incontinence.
- Use of forceps during labour or excessive pushing for extended periods of time (or giving birth to very large-sized babies, not uncommon in diabetic mothers) can also significantly increase the risk of having post-pregnancy bladder dysfunction.
Incontinence Severity: The severity and intensity of leakage varies significantly.
Some women ONLY experience urine leakage when coughing or sneezing or exercising; but others develop a more permanent or more frequent form of chronic incontinence.
Normal physiology of bladder and pelvic floor muscles: the average storage capacity of an adult bladder ranges from 300 ml to 400 ml.
The bladder is a muscular, hollow organ that stores urine which is produced by the kidneys. The storage capacity of the bladder varies from person to person; depending upon several factors like age, gender, overall physical health, and other factors.
- The pelvic floor muscles surround the bladder outlet area
- When there is an urge to urinate; the pelvic muscles relax to facilitate the micturition reflex and release the urine
It is imperative to mention that there are several functions of pelvic floor muscles; besides bladder control. Other functions include:
- Control of bowel movements
- Support pelvic organs such as uterus, bladder and rectum
In short, weak pelvic floor muscles can aggravate the risks of urinary leakage, which is why so many new mums do pelvic floor exercises and why your Physiotherapist or Exercise Physiologist is so pedantic about how you’re doing your abdominal and pelvic floor exercises.
How to manage urinary incontinence
There are two primary types of treatment modalities to address urinary incontinence in females; surgical and conservative.
The conservative treatment options include exercises BEFORE, DURING and AFTER pregnancy to help retrain the pelvic floor muscles for improving muscle tone and bladder control strength. (6).
Pelvic muscle exercise combined with vaginal cones has been proven to greatly improve the outcome in women living with urinary incontinence.
These can get quite high tech, including using ultrasound during exercises or biofeedback training of the bladder musculature (using electrodes).
For women who are older or not ideal candidates for surgery, doctors might advise placing a devise to support the bladder neck. The surgical treatment option, which is more invasive than exercises alone, involves elevation of bladder neck.
There’s another, newer non-surgical option that is making many headlines: MonaLisa Touch vaginal laser therapy. This is offered in our Clinics and you’ll need approximately 4 treatments for best results, with annual follow-up ‘top up’ treatments; but many patients note that it greatly helps improve vaginal laxity, vaginal atrophy, painful sex and mild urinary incontinence including stress incontinence. It is essentially a painless treatment that helps strengthen and renew the tissues of the vaginal area including potentially helping the pelvic floor muscles. It takes less than 15 minutes per treatment and is performed by a Female GP in our Clinics. Phone a Patient Care Coordinator (03) 8849 1444 for details about Mona Lisa Touch vaginal treatments – or send an enquiry form below.
Preventing Urinary Incontinence: Are there other culprits to urine leakage?
Temporary incontinence is often associated with lifestyle factors and certain dietary habits which may include:
- high intake of some vitamin supplements (such as Vitamin B or C) that stimulate the bladder
- increased intake of alcoholic or caffeinated beverages
- consumption of high fructose corn syrup, artificial sweeteners, spicy or sugary foods consumption of carbonated drinks
- being very overweight or obese
Some lifestyle changes can thereby help in improving the bladder functions; such as:
- Reducing Obesity can help, as obesity is a recognized risk factor for incontinence – healthy weight loss often helps in regaining muscle strength and tone and being well enough to engage in an active lifestyle and fitness programs to strengthen the pelvic floor muscles.
- Quick weight loss might actually weaken the bladder and abdominal muscles, however, so you’ll want a supervised plan if you have a lot of kilos to lose and be sure you’re strengthening your muscles as you’re losing weight (if you lose weight quickly it is often muscle weight as well as body fat, and that can weaken muscles)
- Some Doctors recommend avoiding lifting heavy weights or engaging in vigorous training for at least 3 months after child birth to allow the body to heal properly
- Steer clear of foods that cause constipation
- Limit the consumption of identified bladder irritants
It is highly recommended to see a Specialist or GP at your earliest convenience if you are experiencing urinary incontinence after a recent medical procedure or childbirth.
Urinary incontinence can be a very embarrassing situation and may significantly compromise your physical, sexual and social relationships. But it is very important to realize that there are several potentially effective treatment options that can restore your normal quality of life, including the non-invasive option of the Mona Lisa Touch laser.
- Milsom, I., Coyne, K. S., Nicholson, S., Kvasz, M., Chen, C. I., & Wein, A. J. (2014). Global prevalence and economic burden of urgency urinary incontinence: a systematic review. European urology, 65(1), 79-95.
- Sangsawang, B., & Sangsawang, N. (2013). Stress urinary incontinence in pregnant women: a review of prevalence, pathophysiology, and treatment. International urogynecology journal, 24(6), 901-912.
- Gyhagen, M., Bullarbo, M., Nielsen, T. F., & Milsom, I. (2013). The prevalence of urinary incontinence 20 years after childbirth: a national cohort study in singleton primiparae after vaginal or caesarean delivery. BJOG: An International Journal of Obstetrics & Gynaecology, 120(2), 144-151.
- Nigam, A., Ahmad, A., Gaur, D., Elahi, A. A., & Batra, S. (2016). Prevalence and risk factors for urinary incontinence in pregnant women during late third trimester. Hindu, 95, 23-75.
- Phelan, S., Kanaya, A. M., Ma, Y., Vittinghoff, E., Barrett‐Connor, E., Wing, R., … & Brown, J. S. (2015). Long‐term prevalence and predictors of urinary incontinence among women in the Diabetes Prevention Program Outcomes Study. International Journal of Urology, 22(2), 206-212.
- Mørkved, S., & Bø, K. (2014). Effect of pelvic floor muscle training during pregnancy and after childbirth on prevention and treatment of urinary incontinence: a systematic review. British journal of sports medicine, 48(4), 299-310.
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