Incontinence in Women: Stress and Other Concerns

 By: Jill Smi
Does coughing, sneezing, or laughing too much cause you to leak urine? You might be experiencing a urinary problem which is the most common form of incontinence in women. Incontinence is defined as an involuntary loss of urine that is enough to cause a social or hygiene concern. Urine is produced by the kidneys and collected in the bladder, which expands like a balloon as the volume increases. When full, the bladder empties itself by releasing the urine via the urethra. Most people need to pass water every three to four hours during the day and up to once or twice in the night. For normal urination, the muscular wall of the bladder has to contract at the same time as a valve mechanism at the outlet of the bladder relaxes.

However, urine tends to leak most when one coughs, during intense laughter, or when doing exercise such as jumping or running. In these kinds of situations, there is a sudden extra pressure within the abdomen and on the bladder. Urine leaks because the pelvic floor muscles and urethra cannot withstand the extra pressure. The incontinence develops because the pelvic floor muscles are weakened, reducing the person's ability to hold the urine and prevent the leak. Stress incontinence is when urine leaks when there is a sudden extra pressure or "stress" on the bladder.

Stress incontinence is common in women who have had children and those who are overweight and obese. It is also more common with increasing age as the muscles become weaker, particularly after the menopause. Women experience incontinence two times more often than men. Pregnancy and childbirth, menopause, and the structure of the female urinary tract account for this difference. Stress incontinence can worsen during the week before a woman's menstrual period. During that time, low estrogen levels might lead to lower muscular pressure around the urethra, increasing chances of leakage. The incidence of stress incontinence increases following menopause. By the age of 75, at least 16% of women experience some incontinence, but younger women can also be affected.

If a woman experiences stress incontinence, she may feel embarrassed and distressed by the condition. It often disrupts work, social activities, interpersonal relationships, and even sexual relations. But stress incontinence is a preventable disorder. Healthy lifestyle choices that may reduce the risk or lessen complications of the disorder include a regular exercise routine, weight management, and limited consumption of caffeine and alcohol.

The main treatment which often works well is to do exercises to strengthen the pelvic floor muscles. Pelvic floor exercises may include the use of incontinence-control devices as directed by a physician. In some cases medication may help in addition to exercises if exercises alone do not work. Surgery may also be recommended in order to tighten or support the bladder outlet. Following a doctor's advice is important for managing overactive bladder. Talk to a doctor if the symptoms of stress incontinence interfere with the activities of daily living, such as work, interpersonal relationships, social life and general well-being.
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