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Stress Incontinence Causes, Symptoms and Treatment

Woman getting stretched at therapy session

If you dread laughing, coughing, sneezing or lifting heavy objects because of accidental urine leaks, you may have stress incontinence. Stress incontinence is the most common type of adult urinary incontinence in women.

More than 1 in 3 women suffer from incontinence, and many women are younger than you may think. Contrary to popular belief, urinary incontinence doesn't just impact older adults. The changes that a woman’s body goes through is a natural part of life and those changes can result in stress incontinence.

What is Stress Incontinence?

There are two other types of urinary incontinence, urge incontinence and overflow incontinence.

If you have sudden urges to pee that sometimes lead to bladder leaks, you may have urge incontinence.

If you feel like you’re not able to empty your bladder completely or often have bladder leaks without feeling the urge to urinate, you may have overflow incontinence.

If you experience a combination of symptoms from stress incontinence and urinary incontinence, this is called mixed incontinence. Learn more about mixed incontinence and how to treat it.

Stress Incontinence Symptoms

If you experience bladder leaks as a result of the following pressure-applying activities, you likely have stress incontinence:

  • Coughing
  • Sneezing
  • Laughing
  • Standing up
  • Lifting something heavy
  • Running
  • Having sex

Stress Incontinence Causes and Risk Factors

Sneezing, coughing, laughing, lifting heavy objects and exercise are the most likely activities to cause stress incontinence and urine leakage. Though, there are other causes and risk factors associated with stress incontinence, which include:

Pregnancy & Childbirth Delivery
Experiencing urinary incontinence during or after childbirth is perfectly normal, and many women go through it. During the nine months of pregnancy and especially during the birth process itself, your pelvic floor muscles—the system of muscles, nerves and tissues that support your bladder and urethra—are stretched and strained. Vaginal delivery births are more likely to result in stress incontinence.

Excess Weight
Carrying a few extra pounds can put a strain on your bladder and your pelvic floor muscles, which act like a hammock to support your bladder. As a result, these muscles can become stretched and fatigued, which can lead to stress incontinence. Learn more about how being overweight can cause urinary incontinence and how to treat the symptoms.

Hormone Imbalance
The hormones in your body can also weaken the pelvic floor muscles. Hormonal changes experienced during menopause can result in new or worsening stress incontinence. Learn more about the connection between menopause and urinary incontinence.

Chronic Coughing
Any illness or condition that results in chronic coughing can weaken the pelvic floor muscles. Smokers are susceptible to stress incontinence since smokers’ cough can be persistent and prolonged over many years.

Stress Incontinence Diagnosis

You should talk to your doctor if you suspect that you have stress incontinence, or if the symptoms are impacting your daily activities or social life.
Be sure to keep a journal or diary of your urination schedule and include details on when you experience bladder leaks. Your doctor will likely ask questions like:

How often do you urinate?
Do you pee when you laugh, cough or sneeze?
Do you pee when you go running or during exercises?
Do you leak urine randomly or is it prompted by an activity?

The more information you can provide to your doctor about your experience with stress incontinence or bladder leaks, the better treatment options he or she can provide—so don't be shy with what you write down. Be prepared to discuss details like your medical history, previous surgeries or pregnancies, underlying medical conditions or medications you are taking. Your doctor may also conduct a physical exam or a stress test to assess the cause of your bladder issues.

Your doctor may find that your bladder problems are caused by something else, like a bladder prolapse, an overactive bladder or a previous pelvic surgery.

Stress Incontinence Treatments & Remedies

Luckily, there are a lot of things you can do to treat stress incontinence. Most of them involve minor tweaks to your daily routine, making them quite doable. Here’s a list of some stress incontinence remedies and treatments:

Stay Hydrated on a Schedule
Though it may be tempting to drastically limit fluid intake for fear of leaking urine, this is not advised. Don’t limit fluids to the point of dehydration. Instead, drink prescribed amounts throughout the day in order to avoid overstressing your bladder with a large amount of fluid all at once.

Get Moving
Shedding some extra weight can help alleviate the symptoms of stress incontinence by removing one of its root causes—being overweight. Even a daily walk around the block to get moving can go a long way in chipping away at the pounds.

Pelvic Floor Exercises
Stress urinary incontinence is a result of a weakened pelvic floor. Your pelvic floor is a system of muscles, nerves and ligaments that acts like a supportive basket for your bladder, uterus and anus. Kegel exercises are commonly used to strengthen the pelvic floor muscles. Kegels involve flexing and releasing the muscles used to hold in urine so they get stronger.

Doing pelvic floor muscle training three times a day can help alleviate stress urinary incontinence over time. Here is a sample routine for kegel exercises:

  • LONG SQUEEZES: Tighten your pelvic floor muscles and hold for several seconds and then relax for the same length of time. Start with 5 seconds and work your way up to 10 seconds as you get practice.
  • SHORT SQUEEZES: Tighten your pelvic floor muscles for one second, then relax.

Exercises such as squats, bridges and certain yoga poses involve tightening your pelvic floor and will go a long way in strengthening your pelvic floor muscles.

Not sure how to do the exercises or if you're doing them right? Check out this helpful guide on "How to Do Kegel Exercises" and get other exercises to strengthen your pelvic floor muscles to treat stress incontinence.

Bladder Training
Bladder training can both lengthen the amount of time between your bathroom trips and increase the amount of urine your bladder can hold, giving you more bladder control. Start by holding your urine for five minutes every time you feel the urge to go. When that starts to feel easy, try holding it for ten minutes, and gradually work your way up, strengthening your bladder muscles over time.

Another way to train your bladder is to make a ‘go schedule’ in which you use the bathroom on a fixed schedule—say, every hour at first – whether or not you feel the urge to urinate. Once you feel comfortable with your schedule, try increasing the amount of time between each scheduled bathroom visit.

Wear Incontinence Liners or Pads to Manage and Prevent Leaks
Many women turn to period liners or pads because they are familiar and may still be kept around the house. However, urine leakage is different than periods, and period liners may not be enough to help manage leaks from stress incontinence. Always Discreet Liners and Pads are made just for bladder leaks—they keep you dry and fresh all day, while staying thin and comfortable, so no one will know. They are also wrapped in feminine wrappers so you can stash them discreetly in your purse and easily dispose of them.