As we get older, our bodies change. And one of the biggest, and potentially most embarrassing changes women experience is urinary incontinence.
There's no need to be ashamed of the changes our bodies go through, but it's important to understand them. Here's a no-nonsense guide to urinary incontinence in older women: what it is, how and when it happens, and how to deal with it.
It Starts as a Trickle...
Urinary incontinence is the accidental leaking of urine. As with so many things, size doesn't matter: it can be a little trickle or squirt, or it can be a fountain.
There are four main types of urinary incontinence:
Urge incontinence. In cases of urge incontinence, the bladder says we have to go NOW. Like a little kid, it won't take "no" or "wait" for an answer. Urge incontinence is caused by an overactive bladder, which is a chronic medical condition -- not a one-off instance where you've chugged a soft drink and can't find a restroom.
Functional incontinence. Functional incontinence is what happens when we know we have to go, but for whatever reason we just can't make it to the bathroom in time on a regular basis. Someone may have a serious physical problem, such as eyesight or mobility issues which makes it difficult to get to the bathroom in time. Alternately, they may be experiencing dementia or other memory loss which makes it difficult to remember the way there. If a person resolves these problems, they can make it to the bathroom in time and are no longer functionally incontinent.
Stress incontinence. Stress incontinence has nothing to do with emotional stress! Instead, it's when the bladder and its surrounding muscles don't have the strength to hold the bladder closed. Physical changes due to childbirth, along with lowered estrogen levels during menopause, can increase a woman's likelihood of stress incontinence.
Overflow incontinence. Overflow incontinence is just what it sounds like -- the bladder becomes overly full, and spills out its contents. This often has a biological cause -- for instance, someone's bladder outlet is blocked, or they're otherwise having trouble urinating when they'd rather. Overflow incontinence is more common in men than women, and when women have it, it's usually due to medications, or a cyst or tumor that's blocking the exit, so to speak.
Is It Really a Problem?
Many women think urinary incontinence is normal. While it's definitely common -- 30-40 percent of adults over 65 experience at least some urinary incontinence, and it's twice as common in women compared with men -- it's not a normal part of getting older.
Doctors say no amount of incontinence should be considered normal for adults. No, not even if someone coughs or sneezes. Not even if someone's laughing, or having an orgasm or asleep. Not even if a woman's getting older. If we're peeing when we don't want to be peeing, there's a problem.
As the list above shows, many cases of urinary incontinence are linked with underlying medical problems that are probably negatively affecting a woman's quality of life in other ways. By getting those conditions resolved, our health will improve overall.
Left alone, most problems with urinary incontinence will only get worse -- more common, with more flow. We should all save ourselves the soggy panties, funny smells, and embarrassment, and start seriously looking for options when we're noticing incontinence.
Give It a Squeeze
As we saw above, one of the most common causes of urinary incontinence in older women is stress incontinence. One of the best ways to prevent stress incontinence is by toning the Kegel muscles. The Kegel muscles are part of a complex system of muscles called the pelvic floor.
Cosmo and other magazines rave about how toning the Kegel muscles will improve a woman's sex life. That's true, but they'll also improve urinary and fecal incontinence too. Not as sexy, but far more practical.
If someone's never done Kegels before, it's best to start on the pot. Start a flow of urine, and then stop it. Those muscles that clench are the Kegel muscles. (Try isolating the muscles, so the muscles of the anus aren't clenching. It may take some practice.)
Once we've discovered our Kegel muscles, it's time for Kegel fun. Squeeze them for 30-60 seconds at a time, any time you please. Alternately, try clench-release cycles for what the athletes among us might call high-intensity interval training.
If Kegels aren't cutting it, here are some more common ways to stop a woman's body from going with the flow:
Change medications. Some medications can cause various forms of incontinence. Sit down with your doctor to discuss current medications and any potential side-effects. The doctor may swap these medications out for other ones, or may prescribe an additional medication to reduce incontinence.
Limit caffeine and alcohol. If we have overactive bladders, diuretics like caffeine and alcohol make it worse. It's best to skip these.
Catheters or surgery. If a woman's experiencing overflow incontinence, she may need help getting it out. A catheter may cause short-term relief. For serious obstructions, surgery may be necessary.
Urinary incontinence in older women is common, but not normal. By educating ourselves, strengthening our pelvic floor muscles, and talking to our health care providers, we can take steps to improve our health and make sure we go where we want to, when we want to.
Written by: Jackie S.