Real talk: Call it what you will—incontinence, light bladder leakage, involuntary peeing—but it affects most women at some point in their lives.
We don’t really have an accurate number because so many people are afraid to talk about it. We hope that’s changing: After all, as a society, we’ve made great strides in talking about periods and poop, so what’s one more bodily function to add to the mix? The National Association for Continence estimates that one in four women experience some sort of involuntary bladder leak, and of the 25 million adults who experience incontinence, about 80 percent of them are women. And often, that means young women.
Incontinence has the stigma of being associated with the elderly and the sick (and to date, the products to treat it tend to be in that dreaded diaper aisle), but the numbers show that’s simply not true. According to the National Institutes of Health, about a quarter of American women are affected by pelvic floor disorders, which can lead to incontinence manifested by involuntary peeing when you laugh, sneeze, or exercise. More than a quarter of female high school and college athletes experienced some incontinence too, but a whopping 90 percent of those girls were too embarrassed to seek help. And incontinence particularly affects women after they give birth. One study found that half of mothers experienced urinary incontinence in the first year after giving birth. As if new moms aren’t already dealing with enough.
So all that is to say: If you’re experiencing bladder leaks, welcome to a pretty non-exclusive club! We know it can suck. But it’s important to know that incontinence is caused by a number of different factors that can be effectively treated and managed. But the truth is that many people who experience incontinence are too embarrassed or even ashamed to seek help. I mean, nobody wants to admit that they’re peeing their pants, right?
Odds are, though, that if you’re in a group of women, someone else is doing just that. And talking about it might mean that you can really help someone who’s struggling with incontinence, too. So let’s talk.
What is incontinence anyway?
The most common kind of incontinence is urinary incontinence, which is simply the loss of bladder control. It means that you pee—a little or perhaps a lot—when you don’t mean to. (The other type of incontinence is fecal incontinence, but this is less common, especially in younger people.) Under normal circumstances, the pelvic and bladder muscles keep the urethra closed until it receives a message from the brain that you’re ready to urinate. Then the muscles contract, the urethra opens, and pee is released. However, weakened muscles—which can occur for a lot of reasons not necessarily in your control—or crossed brain-bladder signals are often to blame for incontinence.
There are four types of urinary incontinence. Stress urinary incontinence (SUI) is the most common, especially in women. It occurs when pelvic muscles—which form a “sling” that holds the bladder, uterus, bowel, and rectum in place—have been stretched and weakened. Stress on the bladder then causes it to leak, and those weakened muscles can’t do much to stop it. In this case, “stress” doesn’t refer to anxiety, being overworked, or worries about personal problems, but rather to pressures exerted by exercise, lifting heavy things, sneezing, coughing, or laughing. Pelvic muscles can weaken for a variety of reasons, but childbirth is a major one, which is why so many women experience postpartum SUI. In addition to all the other challenges that come with having a baby and suddenly taking care of a new human, lifting the baby or trying to get back into a workout routine can often come with the gift of unexpected spurts of pee. But luckily, SUI can be managed by anything from Kegel exercises to surgery, if necessary.
The second type of urinary incontinence is overactive bladder (OAB), which occurs when the brain tells the bladder to empty too often, and often before it’s full. According to the American Urological Association, 40 percent of women experience OAB, often after menopause.
The other types of urinary incontinence are mixed incontinence, which combines aspects of SUI and OAB, and overflow incontinence, a rare type in which the bladder makes more urine than it can hold.
What can be done about incontinence?
As weird as it is to say, there is good news about incontinence: Treatments for it work really well! Depending on your situation—the type of incontinence, its cause, its severity, your lifestyle—a doctor might prescribe drugs, surgery to restore or replace the pelvic muscles, physical therapy or exercises such as Kegels to strengthen the pelvic floor, or neuromuscular electrostimulation.
The key thing is that incontinence doesn’t need to be some shameful secret. I mean, the secret is already out: One in four women deal with it, so it’s really no secret at all! Whether you talk about it with your doctor or with your friends, the key is to talk about it, normalize it, and find a way to make it easier for you. And as if leakage itself weren’t bad enough, incontinence is also associated with a slew of other problems. For instance, one study found that women who experience incontinence after getting birth are nearly twice as likely to develop postpartum depression. Another study reports that 25 percent of women experience incontinence so severe that it noticeably impacts their quality of life. It can also lead to mental repercussions such as deep-seated feelings of shame and lower self-esteem and to some sexual dysfunctions and disorders.
So the bottom line here is that incontinence is a real issue that can lead to significant (preventable and fixable!) problems. The good news—there’s good news!—is that you’re definitely not alone, and incontinence affects way, way more people than you realize. Talking about it can really make a difference, and that’s what Motherfigure is for.