Understanding Urinary Incontinence in Women: Stress Incontinence Urge Incontinence

Background
Female urinary incontinence (“incontinence” for the purposes of this article) is an inability to hold your urine until you get to a toilet. Women experience incontinence twice as often as men. Four natural factors account for this difference: (1) pregnancy, (2) childbirth, (3) menopause, and (4) the basic structure of the female urinary tract. Women can also become incontinent from neurologic injury, birth defects, strokes, multiple sclerosis, and physical problems associated with aging.

While older women, more often than younger women, experience incontinence; incontinence is not inevitable with age. Incontinence is treatable and often curable at all ages.

Incontinence: Overcome Embarrassment and Take Control
Most women who experience incontinence might feel embarrassed and don’t realize that loss of bladder control can be treated. A near term goal should be to overcome that embarrassment and see a doctor and learn about the treatments available for this underlying medical condition.

Stress Incontinence and Urge Incontinence
Incontinence in women usually occurs because of problems with muscles that help to hold or release urine. Incontinence will occur if your bladder muscles suddenly contract or muscles surrounding the urethra suddenly relax. Most often women are dealing with either Stress Incontinence or Urge Incontinence.

Stress Incontinence: When coughing, laughing, sneezing (or other movements that put pressure on the bladder) cause urine “leaks,” stress incontinence may be the root cause. Stress Incontinence, the most common form of treatable female incontinence, is often a result from the physical changes brought on by pregnancy, childbirth, or menopause.

Stress incontinence can worsen during the week prior to a woman’s menstrual period when lowered estrogen levels might lead to lower muscular pressure around the urethra, increasing chances of leakage. The incidence of stress incontinence increases following menopause.

Urge Incontinence: This condition is a loss of urine for no apparent reason while suddenly feeling the need or urge to urinate. The most common cause of urge incontinence is inappropriate bladder contractions (often described by medical professionals as an "unstable," "spastic," or "overactive" bladder). It might be diagnosed as "reflex incontinence" if it results from overactive nerves controlling the bladder.

Urge incontinence can mean that your bladder empties during sleep, after drinking a small amount of water, or when you touch water or hear it running (as when washing dishes or hearing someone else taking a shower).

Involuntary actions of bladder muscles can occur because of damage to the nerves of the bladder, to the nervous system (spinal cord and brain), or to the muscles themselves. Multiple sclerosis, Parkinson's disease, Alzheimer's disease, stroke, and injury—including injury that occurs during surgery—all can harm bladder nerves or muscles.