Bladder control concerns: What you need to know

Peeing a little when you sneeze is more common than you think. It’s a symptom of urinary incontinence and happens when pelvic floor muscles, which normally tighten to prevent urine from leaking, become weak.

“About one-third of women experience some type of urinary incontinence, but there are many options for treatment that can help,” says Dr. Kimia Menhaji, a board-certified OBGYN and urogynecologist affiliated with Sharp HealthCare.

According to Dr. Menhaji, the first thing you want to do is talk with your doctor when you begin experiencing symptoms. If nothing is done about it, she advises, it could get worse over time.

While urinary incontinence may be relatively common, it can also be embarrassing to talk about, and many women silently suffer with symptoms. Besides physical symptoms, there’s an emotional toll that could lead to avoiding social situations, and even sexual intimacy, resulting in withdrawal and depression.

Causes of urinary incontinence
According to Dr. Menhaji, urinary incontinence can be caused by multiple factors, such as childbirth, heavy lifting or chronic cough. Health issues, such as diabetes, obesity and stroke can also play a role. While aging may be a factor, urinary incontinence is not an inevitable part of aging.

Types of urinary incontinence
There are three main types of urinary incontinence:

• Stress urinary incontinence. This is the most common type, and leakage can occur with sneezing, coughing, laughing or exercising.

• Urgency urinary incontinence. About 18% of women can be affected by symptoms that include a sudden sensation or urge to urinate followed by urinary leakage. It may also be accompanied by nighttime urination.

• Mixed urinary incontinence. Approximately 8% of women experience both stress urinary incontinence and urgency incontinence symptoms.

Treatments for urinary incontinence
The good news is that urinary incontinence is treatable, and depending on the type, may even be reversible. “There are many treatment options, both nonsurgical and surgical, to significantly improve — and in some instances eliminate — urinary incontinence,” says Dr. Menhaji.

The most common nonsurgical option is regularly performing Kegel exercises. These repetitive contractions strengthen the pelvic floor muscles to support the uterus, bladder, small intestine and rectum. Periurethral bulking, a procedure that involves injecting a bulking agent around the walls of the urethra to narrow its width, is another nonsurgical option. For urgency incontinence, bladder training and oral medications are most often used.

The most common surgical option to treat urinary incontinence is the use of slings. These are surgically placed under the urethra and support the pelvic floor.

Important takeaways about urinary incontinence
Whether your urinary incontinence happens as part of aging or having children, it's not something you have to accept as a new normal, Dr. Menhaji reports. “You’re not alone and there are many options,” she says.

She offers the following tips:

• Kegel exercises may be beneficial, and you can do them on your own.

• A healthy lifestyle is important— do not smoke and try to maintain a healthy weight.

• If you're perimenopausal, postmenopausal or even postpartum, ask your doctor if low-dose vaginal estrogen may be right for you.

• If you just delivered a baby and are experiencing urinary incontinence, remember it took nine months to have your baby. The body takes about one year to recover, or slightly longer. You don't have to live with incontinence after having a baby.

Most importantly, Dr. Menhaji says to talk with your doctor to find what works for you. There's an entire subspecialty of care dedicated to helping women with urinary incontinence, as well as many treatment options.

For the news media: To talk with Dr. Kimia Menhaji about women’s pelvic health, contact Erica Carlson, senior public relations specialist, at erica.carlson@sharp.com.