A Forum For Women's Health







Incontinence and Overactive Bladder
What is it?
Incontinence is the involuntary loss of urine, and is fairly common in women. 50% of women who have never had children and who are between the ages of 18 and 25 find that they experience incontinence with some type of activity. 16% of these women experience incontinence on a daily basis. Incontinence can be caused by weakness in the pelvic muscles, a strong urge to urinate that causes the person to "let go" suddenly, or an overfull bladder.

Another condition that can be related to incontinence is overactive bladder. Overactive bladder means that the bladder contracts spastically. This tends to change a woman's pattern of urination in several ways. Some women find themselves needing to urinate more often, sometimes as much as eight or more times a day. Others will experience the aforementioned strong urge to urinate. This will sometimes lead to the involuntary loss of urine.

Very small things can trigger symptoms of an overactive bladder. For example, drinking a small amount of fluid, or hearing or seeing running water, has been known to induce symptoms.

Day-to-day Impact
Overactive bladder and incontinence can be very disruptive to a woman's daily life. The frequent and/or urgent need to use the bathroom causes women to always be planning around bathroom availability. Some women, due to their fear of losing urine, will restrict their activities or stop going out altogether. Women may avoid sex or wear pads. Many adopt unhealthy fluid restrictions in an attempt to curtail involuntary urine loss. The disruption of sleep caused by frequent nighttime trips to the bathroom can disrupt daily functioning. Depression is a common result of these difficulties.

Incontinence and overactive bladder are more common in women than in men. Women often allow it to go untreated for many reasons. They are often embarrassed, they assume it is part of the natural aging process, or they assume that if they have not actually lost urine (as is sometimes the case with overactive bladder), it is not something that needs to be discussed with their doctor.

There are several treatments for incontinence and overactive bladder. However, first a doctor must evaluate the symptoms including examining issues such as frequency, urgency, and urge incontinence. Treatments include estrogen replacement therapy, surgery, medication, dietary changes, and pelvic muscle exercises (Kegel exercises). The treatment recommended by the physician will depend upon the specific circumstances under which incontinence occurs. Treatment usually includes estrogen replacement therapy or Kegel exercises. Sometimes combinations of different approaches are used. Surgery is not a common solution for incontinence.

Estrogen replacement therapy can either take the form of oral medication or a vaginal estrogen replacement in the form of a cream that is applied directly to the vaginal and urethral area. Estrogen replacement therapy is usually used together with other forms of treatment, especially pelvic muscle exercises.

Pelvic muscle exercises are designed to strengthen the muscles that control the expulsion of urine from the bladder. These exercises teach the patient to voluntarily contract the muscles used to hold urine in the bladder. This skill can then be applied during stressful activities or episodes of urgency. A strong, voluntary contraction of the muscles of the pelvic floor can give the person enough time to make it to the bathroom without worrying about leakage or about losing control.

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