What is incontinence?
By definition, incontinence is the involuntary loss of urine or faeces. It can be anything from a few drops of urine through to the complete loss of bladder and bowel control.
Additionally, some symptoms aren’t technically incontinence but indicate that something is amiss with your bladder function. These include:
- Waking several times in the night to go to the toilet
- Having overwhelming and sudden urges to go and only just making it
- Having to urinate so frequently that it interrupts your daily activities
Incontinence is a symptom
Incontinence isn’t a stand-alone disease, but a symptom caused by some other issue. It should never be ignored or accepted as just part of ‘being a woman’ or ‘getting older’.
Persistent incontinence can have detrimental effects on your self-esteem, daily activities and exercise, as well as your social and sex life.
In many instances, it can be resolved or at least improved when the cause is identified and treated.
What are the causes?
Causes of incontinence can be medical, physical, neurological and even psychological.
- A Urinary Tract Infection (UTI)
If incontinence has a sudden onset, it may be caused by an infection.
- A weak pelvic floor muscle
The pelvic floor is a sling of muscle that is attached to the pubic bone at the front and tailbone at the back. It plays a crucial role in supporting pelvic organs as well as bladder and bowel control. It’s the muscle that allows you to ‘hold on’ when you have the urge to urinate, pass wind or a bowel movement. If it has become weak or damaged, it may not be able to clench firmly enough, especially under the pressure of a sneeze, cough or laugh, resulting in incontinence.
The pelvic floor muscle can be affected by:
- A smoker’s cough
- Pelvic surgery
- Persistent straining from constipation,
- Jarring from high-impact exercise or,
- Lifting heavy weights
The term prolapse refers to any organs that have shifted or dropped out of their correct position. In relation to incontinence, if any of the pelvic organs have moved – bladder, bowel, urethra, vagina, rectum, bladder – it can cause incontinence.
A side effect of some heart, blood pressure, muscle relaxant and sedative medications, among others, is an increase in urine production and a stimulation of the bladder. If the pelvic floor has some weakness, this may be difficult to control.
There are many lifestyle factors that contribute to incontinence, including being overweight or obese, continual constipation, smoking (because of the associated cough) or a lack of exercise, especially of the pelvic floor muscle.
There are also food and drink choices which can stimulate the bladder; alcohol, carbonated drinks, artificial sweeteners, caffeine, spicy food, chilli, chocolate, tomato and citrus.
Dehydration causes urine to become increasingly concentrated, which irritates the bladder and stimulates it to void more frequently.
Habitually going to the toilet ‘just in case’ or anxiety around having incontinence can train the bladder into holding less. Coupled with a weak pelvic floor muscle, if the bladder does become full, it will be challenging to control.
- Ageing and menopause
It used to be accepted that a decline of muscle strength and weight gain was fairly inevitable with the decline of estrogen during and post menopause. Contemporary thinking is that with exercise and attention to diet, both can be avoided.
It is true that organ walls can become thin (urethra, vagina, etc.) and that an overactive bladder will induce Urge Incontinence, but with a strong pelvic floor, these changes shouldn’t necessarily result in incontinence.
- An enlarged prostate or prostate cancer treatment
For men, the enlargement of the prostate gland as they age can put pressure on the bladder or restrict the urethra (the tube that transports urine from the bladder to outside the body and runs through the prostate gland). Further, treatment for prostate cancer, including surgery and radiation therapy, can cause incontinence. You can read more about that here
- Chronic diseases and injury
Neurological diseases and conditions such as Parkinson’s Disease, dementia, stroke and spinal damage can inhibit the brain’s ability to receive and respond to messages from the bladder and bowel.
Disease or injury that has caused nerve damage, such as diabetes can affect the sense of the need to void as well as compromising messages from the bladder and bowel to the brain.
- Physical constraints
Being frail-aged, having arthritis or a physical disability can make it difficult to get to the toilet and remove clothing in time. This is sometimes referred to as functional incontinence.
- Bladder cancer. While relatively uncommon, bladder cancer can be the underlying cause of incontinence.
Who’s at risk?
It’s estimated that more than a third of women who’ve given birth experience incontinence. For men aged between 40 and 80 years old, it’s 10%. Due to the stigma surrounding the issue, many healthcare professionals believe the numbers are underrepresented.
As cited above, menopause and the weakening of muscles over time will reduce the ability to ‘hold on’. For men, an enlarged prostate or prostate cancer increases the probability of being incontinent. With further ageing, the loss of mobility, cognitive function or the onset of chronic disease all increase the likelihood of bowel or bladder leaks.
According to the well-respected Mayo Clinic a family history of incontinence, particularly urge incontinence, will increase the risk of experiencing the condition.
As mentioned above, the following can increase the probability of developing incontinence
- Being overweight or obese
- Leading a sedentary lifestyle
- Having a poor diet
- Drinking insufficient water
- Having persistent constipation
- Regularly lifting heavy weights
Reducing the risk of experiencing incontinence by paying attention to your diet, exercising and monitoring your toilet habits.
- Pelvic floor exercises
Strengthening your pelvic floor is often all it takes to keep incontinence at bay. You can read about the exercises and watch the easy-to-follow instructional videos here
- Lifestyle changes
Give up smoking (see your doctor if you need help), keep your weight within the healthy range, drink plenty of water and eat well to ensure your bowel stays regular.
- Good bladder and bowel habits
Over time, we can get into poor habits, like going to the toilet ‘just in case’, holding on for too long, drinking less water and more caffeinated drinks, which all increase the probability of acquiring incontinence.
When to see a doctor
If you are experiencing any continence issues, you must discuss them with your doctor. While most underlying causes may not pose serious health risks, some, like bladder or prostate cancer do, so it’s vital that the cause is investigated and correctly diagnosed.
It’s also impossible to recommend suitable treatment if the cause is unknown.
Some people feel uncomfortable or embarrassed to discuss their symptoms with their doctor, but as health care professionals, they have seen and heard it all before. If you are feeling anxious, this article, Questions for the Doctor will help you prepare for your appointment.
If you are experience bladder or bowel leaks, you may feel more comfortable with the security of an absorbent, disposable product while having the cause investigated.
The TENA range includes super small TENA Liners, an extensive range of TENA Pads and TENA Pants that looks and feel just like regular underwear. All are designed to handle the thinner, faster flow of a weak bladder to keep you dry and odour-free.
Check out the TENA Product Finder Tool, and Free Samples to find the product that best suits your needs.
Asaleo Care makes no warranties or representations regarding the completeness or accuracy of the information. This information should be used only as a guide and should not be relied upon as a substitute for professional, medical or other health professional advice.