Urinary Incontinence Types, Causes & Treatment

Urinary incontinence occurs when urine is released from the bladder involuntarily. This can range from little leaks to full bladder voids. Urinary incontinence is more common than you think. More than one in three women over the age of 18 are dealing with incontinence of some kind—and there are different types of incontinence you can experience. Here we'll review the main kinds of urinary incontinence in women, their causes, symptoms, treatment options and how to best manage incontinence.

What is Incontinence?

So, let’s start with a definition of terms. What is urinary incontinence exactly?

Put simply, urinary incontinence is the loss of bladder control. This can range from occasional little leaks when you cough, laugh or sneeze to an urge to urinate that comes on so strongly that you don’t make it to the bathroom on time.

So how is incontinence different from “bladder leaks” or a “sensitive bladder?” Short answer is that there isn’t much of a difference.

Lots of terms, same thing. There are lots of ways to describe the same thing and this bladder control condition goes by many names and terms including urinary incontinence, sensitive bladder, overactive bladder, weak bladder and bladder leaks.

For example, the term “sensitive bladder” describes a common condition that can also be described as frequent urination in women. It can mean increased urgency, frequency of urination or both. It can also mean bladder leaks.

Why do we say, "sensitive bladder"? We asked many women what they think is a good way to describe their urinary incontinence issues. “Sensitive bladder” is a term that many women liked and related to.

How Incontinence Goes Beyond Bladder Leaks

Many women with urinary incontinence stop doing certain activities as a result of their bladder leaks. Maybe they are afraid of an embarrassing accident while out with friends, so they opt to stay home. Maybe they stop doing much-enjoyed physical activities like aerobics, tennis, dancing or gardening, due to incontinence. Or perhaps even a short run to the store—away from a bathroom—can become a source of anxiety. This need not be the case. With a little management, you can live a life filled with the activities you love despite experiencing incontinence.

There is a common misconception around incontinence—that it’s an affliction of the elderly. In fact, one in three women ages 35 and older experiences incontinence. So, if you experience little leaks or gushes, you are not alone.

Types of Urinary Incontinence

The symptoms of urinary incontinence in women depends on which kind of incontinence you may have. There are five main types of urinary incontinence: stress, urge, overflow, functional and total.

Stress Incontinence:

Stress urinary incontinence is the result of a weakened pelvic floor—the system of muscles, ligaments and nerves that supports your bladder, uterus and anus. These muscles help control the urinary sphincter, which is responsible for closing off the bladder and regulating urine flow. As a result, urine leaks out when pressure or stress is exerted on the pelvic floor during everyday activities like coughing, sneezing, laughing, exercising or during sex.

Urge Incontinence:

Urge urinary incontinence, also known as an overactive bladder or OAB, is caused by damage to the nerves in and around the bladder. As a result, the bladder no longer effectively communicates to the brain when it needs to be emptied. This leads to sudden, intense urges to urinate that often don’t leave you with enough time to get to the bathroom, resulting in an involuntary loss of urine. The strong urge to urinate may come on more frequently than it would with a healthy bladder, often leading you to wake up more than once in the middle of the night to urinate—this frequent urination at night is called nocturia.

Read more about urge incontinence, its causes and treatment options.

Overflow Incontinence:

Learn more about overflow incontinence causes and treatment options.

Functional Incontinence:

If a physical or cognitive disability prevents you from getting to the bathroom on time, you may have functional incontinence. This type of incontinence is best remedied by wearing incontinence products like Always Discreet underwear. They are ultra-thin and absorb up to a full bladder’s loss of urine, locking it away in an absorbent gel core to keep you dry and comfortable.

Total Incontinence:

Total incontinence causes continuous and uncontrollable bladder leaks, usually as a result of a birth defect or a spinal cord injury. Speak with your doctor if you are facing total incontinence. Wearing Always Discreet underwear will keep you dry and comfortable without the bulk of other incontinence products.

Mixed Incontinence:

A combination of stress, urge or overflow incontinence symptoms. The most common type of mixed incontinence among women is a combination of stress and urge incontinence.

Risk Factors and Causes of Urinary Incontinence

The most common causes of urinary incontinence in women may include:

• Pregnancy and childbirth—The hormonal changes and weight of carrying around a fetus can affect the pelvic floor. Vaginal childbirth may damage the pelvic floor muscles and the surrounding nerves and tissues, leading to chronic stress or urge incontinence.
• Being overweight—Carrying extra pounds puts stress on the pelvic floor, leading to stress incontinence. This usually can be rectified by losing weight. Learn more about obesity and incontinence.
• Age—The hormonal changes associated with menopause can cause the lining of the urethra and bladder to deteriorate, as well as the bladder muscles to weaken. This leads to stress incontinence. Learn more about menopause and urinary incontinence.
• Previous surgery—Having undergone a previous surgery in your lower abdominal cavity, such as a hysterectomy or C-section, may have damaged the nerves leading to the bladder, resulting in urge incontinence.
• Obstruction—Blockages anywhere along the urinary system, such as urinary stones or polyps along the bladder or urethra, can prevent the bladder from fully emptying, leading to overflow incontinence.
• Neurological disorders—Diseases such as multiple sclerosis or Parkinson’s affect the brain’s communication with the nerves in the body, which can lead to urge incontinence.
• Smoking—Chronic smokers’ cough can weaken the pelvic floor by exerting continually repeated pressure on the pelvic floor muscles that may eventually lead to the type of urinary incontinence it causes.
• Urinary tract infection (UTI)—Urinary tract infections irritate and inflame the tissues in the bladder and urinary tract, causing urge incontinence. This kind of incontinence is temporary and will go away when the infection clears up.

Talk to Your Doctor About Urinary Incontinence

Any sign of incontinence is something you should mention to your doctor. Whether you just feel like you need to go more than usual, you’re waking up at night to use the restroom or you feel little bladder leaks in your underwear occasionally.

Why Tell Your Doctor About Urinary Incontinence?

Bladder control problems are generally a side effect of another issue. Some of these issues are just a part of life—pregnancy, aging, weight gain and other situations can naturally lead to urinary incontinence. And that’s OK!

However, some incontinence may be a sign of a bigger problem that needs addressed, especially if you are losing total bladder control or your urination is painful. Your doctor will be able to tell quickly what’s going on. That’s why any amount of urinary leaking or increased bathroom urges are worth mentioning.

What Your Doctor Will Do

First, your doctor will ask you questions, probably do an examination and possibly some tests. Here a few possible tests:

• Urodynamic tests check the function of your urethra and bladder.
• Postvoid residual volume tests measure how much urine is left after you go to the bathroom.
• A stress test checks to see if you have bladder leaks after coughing.
• A cystoscopy is a lighted tube and lens that lets the doctor see into your bladder.
• A dye test is when you drink non-toxic dye and wear a special pad that catches your dyed urine to measure urine loss and leakage.

Remedies and Treatments for Urinary Incontinence

How you treat your incontinence depends largely on what type of incontinence you experience. Treatments can range from lifestyle adjustments—like exercise or managing what you eat and drink—to surgery.

Here are some ways you can better manage incontinence symptoms:

• Lifestyle changes (like weight loss)
• Kegel exercises
• Physical therapy
• Incontinence Devices
• Medications
• Bulking agents
• Surgery

Many times, your doctor will suggest a combination of treatments for the best results. It all depends on your unique body and medical conditions.

• Start Doing Pelvic Floor Exercises (AKA Kegel Exercises). The pelvic floor is a system of muscles, ligaments and nerves that creates a basket of support for your bladder. Fitting these exercises into your routine can be pretty straightforward. As you’re sitting at your desk, flex and release the muscles used to hold in urine. Do this at least three times a day. Here's a great guide that walks you through how to do kegel exercises and other exercises used to strengthen your pelvic floor muscles.

• Avoid Foods That Irritate the Bladder. This might mean limiting alcohol, caffeine, citrus and chocolate, as these foods affect the acidity of urine, ultimately irritating an already-sensitive bladder. Keep a journal for a week in which you document what you eat, when you eat it, and how often you feel the urge to urinate. This may help you identify correlations between the food you eat and the intensity of your incontinence so that corrections can be made to your menu.

• Hydrate! While drinking too much of anything will create an urge to go, a critical tool for dealing with incontinence is to drink plenty of water. Sure, this may sound counterintuitive. After all, if you feel like you have to urinate, it might make sense to limit your fluid intake. However, not drinking enough water results in highly concentrated urine, which will irritate your bladder. If you leak overnight, you may wish to cut back in the evenings to increase your chances of making it through the night without having to get up to go. If this is the case, be sure to frontload your fluids during the day to stay hydrated, drinking more fluids than you do in the evening to stay hydrated.

• Bladder Training. Staying on a bathroom schedule can serve to alleviate some of the urgency associated with having an overactive bladder. Start by visiting the bathroom every hour and increase the time between each visit gradually over time. Bladder training of this nature may be helpful for dealing with incontinence. You may be able to train your bladder to go at specific intervals, bringing a level of predictability to your bathroom needs.

• Get Moving. Weight management can help alleviate the symptoms of adult incontinence as extra pounds put pressure on the bladder’s muscles, which can lead to stress incontinence. Simply going for more walks around the block is an easy, straightforward way to get moving.

• Bladder Leakage Protection. No matter what type of incontinence you have, a universal remedy is the use of bladder leak products, such as incontinence liners, pads or underwear. Which type of protection you choose may depend on the amount of urine loss you experience. Compare incontinence products or take this quiz to find out which protection is best for you.

Urinary Incontinence Products

Are you using menstrual products or incontinence products for protection? Many women are unaware they are using the wrong products to manage the flow of urine. Menstrual pads aren't designed to manage the fluids or odor from bladder leaks—Always Discreet incontinence products are!

Always Discreet is a line of ultra-thin and absorbent liners, pads and underpants that allow you to discreetly go about your day without giving a second thought to your bladder leaks. Always Discreet have an absorbent core that turns liquid into gel—eliminating wetness and neutralizing odors within seconds. This technology also keeps Always Discreet products thin and flexible, making them comfortable to wear. This also means they’re not noticeable under your clothes—a big plus if you don’t feel like announcing to the world that you are wearing an incontinence product. Pick out the right Always Discreet product for you and get back to doing the things you love, worry-free of bladder leaks.