In the United Kingdom, 9.6 million women are affected by bladder problems. Despite the physical and psychological impact, incontinence in women is arguably one of the most poorly understood health conditions.
Dr. Elaine Waetjen, a gynaecologist with the UC Davis Medical Center, has been studying urinary incontinence for more than 16 years and considers it an “important but under-acknowledged issue in women’s health”. Urge incontinence, the second most common form of incontinence in women, is often overlooked due to the high prevalence of stress incontinence. Although the prevalence of this condition is lower than others, the symptoms and impact of urge incontinence should not be dismissed. Various research shows that individuals with urge incontinence are actually more likely to require treatment. Urge incontinence can be completely unpredictable and can make individuals avoid many everyday situations. In addition to this, urge incontinence tends to be considerably more bothersome than similar degrees of stress incontinence. It is therefore important to be aware of the main symptoms and treatment for the condition, as it can be the cause of social and hygienic problems for both patients and carers.
59 year old Mary remembers how living with urge incontinence led her to “carry around changes of underwear, wipes, sanitary towels, air freshener.” She explains how the fear of a situation causing a leak meant that she always wore dark, baggy clothes, which resulted in her feeling like she was “going on a camping trip”. Mary is just one of the many females who are affected by urge incontinence as a result of the menopause. 10% of women between the ages of 40 and 44 suffer from urge incontinence, while 31% of women over the age of 70 suffer from the condition.
What is Female Urge Incontinence?
Urge incontinence is characterised by loss of urine that is associated with a sudden, strong desire to urinate that cannot be postponed. Women with urge incontinence often find they have to go to the toilet more often than those who don’t. This results in the bladder contracting too early, giving you the feeling that you have to pass urine urgently. If you are suffering from urge incontinence, the communication between your brain and your bladder does not function correctly. You may feel the need to empty your bladder straight away although your bladder may not be particularly full. This leaves you with little or no time to get the bathroom, and you are often at risk of leaking urine at inappropriate times. You may leak urine when you are in public or sleeping for example. Interestingly, certain situations can cause leakages in urge incontinence. Common triggers are unlocking the door when returning home, going out in the cold, washing your hands or even seeing running water. In some women, changing position may trigger bladder contractions and lead to urine loss. In a recent study, many women described this sensation as a “mounting pressure” or “sudden loss of urine in a rush to reach the toilet”. Urge incontinence symptoms often include a need to urinate frequently during the night and waking often during the night to empty your bladder.
What Causes Urge Incontinence in Women?
Urge incontinence in women is most commonly caused by abnormal bladder contractions. Additionally, women with diseases that affect the nerves linked to the bladder such as Multiple Sclerosis and Parkinson’s can be prone to urge incontinence. It is also common for women who have suffered a stroke to develop urge incontinence, and people with a urinary tract infection are at particular risk of urge incontinence. Alcohol consumption and diuretic medicine may underlie urge incontinence. Infections or inflammation that either irritated the bladder or damage its nerve may trigger symptoms.
Who is at a higher risk of developing Urge Incontinence?
Prevalence of urge incontinence in women has been shown to peak around menopause, with a steady rise there-after into later life. Women who have had a C-Section or other pelvic surgery are at a particular risk of developing urge incontinence. A study in 2009 revealed that risk factors for urge incontinence include prior hysterectomy and a urinary tract infection. The study also showed that urge incontinence is highly prevalent in individuals who are obese and have type 2 diabetes.
Read our blog on maintaining a healthy weight to reduce symptoms of incontinence for advice on staying healthy.
Treatment for Urge Incontinence
The impact and degree of bother of your incontinence is very important in determining which kind of treatment you should look into. If your urge incontinence is related to thinning of the lining of the vagina after the menopause, it is likely you will benefit from oestrogen cream applied directly inside the vagina.
There are a number of treatment methods you can practice at home. These include practising Pelvic Floor Muscle Exercises, which work to strengthen the pelvic floor muscles. You can find out how to do pelvic floor muscle exercises on our blog. Another key lifestyle change is to practice some relaxation techniques such as meditation to reduce anxiety symptoms. You should also ensure the route to the toilet in your home is as easily accessible as possible to avoid having unwanted leaks when you have the urge to urinate. In addition to this change, a switch to a diet that eliminates caffeine can be incredibly useful. Incontinence experts recommend that you find alternatives to drinking caffeinated drinks such as tea, coffee and cola, which increase the amount of urine your body produces.
Your GP may recommend having pelvic floor therapy, which involves restoring function, improving muscular support around the pelvis and improving behavioural/dietary habits. The treatment also involves re-training body movements to allow for optimal organ and structural function.
Urge incontinence may be a sign of something more serious, which can be detected depending on how your body reacts. If you have blood during urination, experience recurrent urinary tract infections, or an inability to fully empty your bladder, you should see your Doctor right away.
In being proactive by ensuring you have the correct products and have spoken to professionals, you are already on the road to reducing urge incontinence.