Dealing with bladder control issues can be frustrating and embarrassing. Whether it’s just a few drops or a complete loss of bladder control, urinary incontinence is a common problem, especially for women. In fact, women are twice as likely to experience it compared to men. If you’ve reached the point of seeking answers, you’re likely tired of managing this condition and ready for solutions.
Urinary incontinence can range from a minor annoyance to a significant disruption in your life. It can lead to embarrassment, frustration, and even financial burden due to the cost of managing it. The good news is you don’t have to accept this as your new normal. Effective treatments are available, and seeking help is the first step towards regaining control.
When to Seek Professional Help for Urinary Incontinence
It’s important to recognize when urinary leakage is more than just a minor inconvenience. You shouldn’t feel the need to rely on pads daily to manage urine leakage. Ask yourself these crucial questions to assess the impact of incontinence on your life:
- Does the constant urge to urinate or urine leakage disrupt your work or daily tasks, requiring frequent bathroom breaks or causing accidents?
- Do you find yourself constantly planning your outings around bathroom locations, a common strategy for those worried about access?
- Is urinary incontinence negatively affecting your intimate relationships or sexual activity, causing discomfort or anxiety?
If you answered yes to any of these questions, it’s a clear indication that you’re dealing with a significant issue. It’s time to consult with a healthcare professional, such as a gynecologist or urogynecologist, to discuss your symptoms and explore treatment options.
Identifying the Type of Urinary Incontinence
The first step in addressing urinary incontinence is to determine the specific type you are experiencing. The two most prevalent types are stress incontinence and urgency incontinence. Many women may experience a combination of both.
Stress Incontinence: This type of leakage occurs when pressure is exerted on your bladder, such as during coughing, sneezing, laughing, or physical exercise. The physical stress on the bladder overwhelms the weakened support of the pelvic floor muscles, leading to involuntary urine loss.
Urgency Incontinence: Also known as overactive bladder, urgency incontinence is characterized by a sudden, intense urge to urinate that is difficult to control, often resulting in leakage before you can reach a bathroom. This strong urge can be triggered by various factors and can feel very disruptive.
If you experience symptoms of both stress and urgency incontinence, your healthcare provider will work with you to determine which type is most bothersome and tailor your treatment plan accordingly.
Effective Treatments for Stress Incontinence
Stress incontinence often stems from weakened pelvic floor muscles. These muscles play a crucial role in supporting the bladder and urethra. Weakening can occur due to factors like aging, childbirth (especially vaginal delivery), obesity, and certain medical conditions.
Lifestyle Modifications: If weight is a contributing factor, weight loss can significantly improve stress incontinence. Even a modest weight reduction of around 8% has been shown to reduce incontinence episodes by as much as half.
Pelvic Floor Physical Therapy: A cornerstone treatment is pelvic floor muscle exercises, often guided by a specialized physical therapist. These exercises, commonly known as Kegel exercises, strengthen the muscles that control urination, providing better support for the bladder and urethra.
Pessary: For some women, a pessary can be a helpful non-surgical option. This device is inserted into the vagina to support the vaginal walls and lift the bladder and urethra, providing mechanical support to reduce leakage.
Urethral Sling Surgery: If conservative treatments are not sufficient, a surgical procedure called a urethral sling may be considered. This involves placing a mesh sling under the urethra to provide extra support, especially during activities that increase abdominal pressure, like coughing or sneezing. The sling acts as a hammock, supporting the urethra and preventing leakage.
Managing Urgency Incontinence and Overactive Bladder
Urgency incontinence, or overactive bladder, is marked by the sudden, uncontrollable urge to urinate, often leading to leakage. The exact causes of urgency incontinence are not fully understood, but various approaches can help manage and alleviate symptoms.
Behavioral Therapies: Behavioral modifications are typically the first line of treatment for urgency incontinence. These strategies are tailored to individual needs and may include:
- Weight Management: Similar to stress incontinence, weight loss can also benefit urgency incontinence by reducing pressure on the bladder.
- Fluid Management: Adjusting fluid intake, particularly limiting fluids before bedtime, can reduce nighttime bathroom trips and leakage. However, it’s important to maintain adequate hydration throughout the day.
- Bladder Training (Timed Voiding): This technique involves gradually increasing the intervals between bathroom visits to retrain the bladder. For example, if you urinate every hour, you would gradually extend that time by 15-30 minutes until you can comfortably wait longer between voids.
- Pelvic Floor Exercises: Strengthening pelvic floor muscles is beneficial for both stress and urgency incontinence, helping to improve bladder control and reduce urgency.
- Dietary Modifications: Certain foods and drinks can irritate the bladder and worsen urgency symptoms. Common bladder irritants include caffeine (coffee, tea, soda), chocolate, alcohol, spicy foods, and acidic foods like citrus fruits and tomatoes. Eliminating or reducing these from your diet for a week or two can help assess their impact on your symptoms.
Medications: If behavioral changes are not enough, medications can be prescribed to relax the bladder muscles and reduce urgency and frequency. Anticholinergics are a class of medications that block nerve signals to the bladder, helping to reduce the urge to urinate and improve bladder control, particularly at night. Botox injections into the bladder muscle can also be used in some cases to temporarily relax the bladder and reduce urgency.
Nerve Stimulation Therapies: For more persistent urgency incontinence, nerve stimulation techniques may be considered. Percutaneous tibial nerve stimulation (PTNS) involves placing a small needle near a nerve in the ankle and delivering mild electrical pulses to modulate bladder activity. Sacral neuromodulation (SNM) is another option that involves implanting a small device to deliver electrical stimulation to the sacral nerves in the lower back, which control bladder function. These therapies aim to normalize bladder signals and improve bladder control.
You’re Not Alone
Dealing with urinary incontinence can feel isolating, but it’s important to remember that you are not alone. Many women experience these issues, and effective help is available. Open communication with your healthcare provider is key to finding the right solutions for you.
Gynecologists and urogynecologists are experienced in diagnosing and treating all types of urinary incontinence. By working together, you can explore the various treatment options and develop a personalized plan to regain bladder control and improve your quality of life. Don’t hesitate to seek help – taking that first step can significantly improve your well-being and confidence. For further reading, explore resources on Urinary Incontinence to expand your knowledge and understanding.
Last updated: November 2022
Last reviewed: February 2024
Topics Healthy Aging Pelvic Floor Disorders Diseases and Conditions
Copyright 2025 by the American College of Obstetricians and Gynecologists. All rights reserved. Read copyright and permissions information.
This information is designed as an educational aid for the public. It offers current information and opinions related to women’s health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Read ACOG’s complete disclaimer.
About the Author
Dr. Charlie Kilpatrick
Dr. Kilpatrick is an obstetrician–gynecologist who specializes in urogynecology, also known as female pelvic medicine and reconstructive surgery. He serves as vice chair of Education, Residency Program Director, and associate professor at Baylor College of Medicine in Houston, Texas. He is a fellow of the American College of Obstetricians and Gynecologists and the American Urogynecologic Society.
