The family dinner was going well — until a condition known as femaleincontinence got in the way.
The middle-aged woman has urge incontinence, sometimes called overactivebladder (OAB). As the name suggests, when the urge to go to the bathroom comeson, it often can’t be controlled.
She leaked urine through her clothes and onto her son and daughter-in-law’supholstered dining room chair, an embarrassment that didn’t go unnoticed.
After the cleanup, even with her daughter-in-law and other family membersassuring her that everything was fine, the woman was so humiliated she now hastrouble accepting invitations.
Urinary incontinence is primarily a physical problem, affecting an estimated12 million U.S. adults. But incontinence can also take an emotional toll on aperson.
Emotional Toll of Female Incontinence
“Incontinence is embarrassing,” says Jennifer Anger, MD, MPH, anassistant professor of urology at the University of California Los AngelesDavid Geffen School of Medicine and an attending physician at Santa Monica –UCLA Medical Center in Santa Monica, Calif.
But if you get a medical evaluation when you first notice symptoms of femaleincontinence, your doctor can suggest a host of treatments that will improve oreliminate the condition.
“Older women think it’s a normal part of aging,” Anger says,clarifying that it is not. While the condition does affect older women morethan younger, it doesn’t have to be a side effect of aging.
Female Incontinence and Depression
Depression is more common in women with female incontinence, according toseveral studies. In one study, published in a 2005 issue of Obstetrics& Gynecology, researchers found that nearly three times as many womenwith female incontinence had depression compared to those without thecondition.
They surveyed nearly 6,000 women, ages 30 to 90, with more than 40% of themreporting some degree of female incontinence.
Another study, published in Social Science Medicine in 2005, foundthat urinary incontinence is associated with depression in both women and men.And if a woman is incontinent, her husband is also more likely to be depressed,the researchers found.
Female Incontinence Impact on Quality of Life
Not surprisingly, the more severe the urinary incontinence, the greater theimpact on quality of life, report French researchers who evaluated 556 womenwith female incontinence and compared them to more than 2,000 women without thecondition. These women had lower self-esteem, impaired well-being, and reducedsexuality compared to the women without female incontinence.
Urinary incontinence in severe forms should be considered a disability, theFrench researchers conclude in their report, published in a 2006 issue ofNeurourology and Urodynamics.
Female Urge Incontinence
While all types of female incontinence can cause emotional distress, urgeincontinence is far more distressing, says Halina Zyczynski, MD, associateprofessor of obstetrics and gynecology at the University of Pittsburgh Schoolof Medicine and a specialist in female incontinence at the Magee-WomensHospital.
It’s the unpredictable nature of urge incontinence that makes it sodistressing, she says. Urge incontinence isn’t totally understood, but expertsthink the bladder muscle may give the wrong messages to the brain, with thebladder feeling fuller than it really is. As a result, a person with urgeincontinence feels the urgent need to go to the bathroom, even if they havejust done so.
Stress incontinence, which causes urine to leak when lifting objects,laughing, coughing, or sneezing because of weakened pelvic floor muscles, isless emotionally draining, Zyczynski says. “Women can learn which positionsor situations predispose them to stress incontinence [and avoid them].”
“If you know, for instance, that doing the Stairmaster makes you leak[urine], you can avoid it,” she says. “If you know that sneezing [makesyou leak urine], as your sneeze comes on, you can cross your legs or squeezeyour pelvic floor muscles.”
But, unlike stress incontinence, urge incontinence occurs without warningand is especially upsetting. “Before a woman has a chance to respond tothat urge to go [to the bathroom], urine is already running down her leg,”says Zyczynski.
The sheer volume of leaking urine associate with urge incontinence isanother reason why this condition is so distressing. Women with stressincontinence tend to leak urine in small amounts, perhaps a teaspoon or atablespoon, says Zyczynski. But with urge incontinence, a woman can leak a cupor two of urine, saturating an absorbent pad and soaking through theirclothing.
What Can You Do About Female Incontinence?
Whatever form of female incontinence you have (and some women have both urgeincontinence and stress incontinence – called mixed incontinence), it iscrucial to seek help before the condition leads to social isolation, Zyczynskitells WebMD. Once women stop socializing, she says, it’s easy to see how thewithdrawal can lead to depression.
If you notice symptoms of incontinence, such as leaking urine, tell yourdoctor. He or she may recommend you see a specialist, such as a urogynecologist– an obstetrician-gynecologist who specializes in the treatment of women withpelvic floor problems, which includes female incontinence – or a urologist withexperience treating female incontinence.
Treatment Options for Female Incontinence
Some medications may aggravate female incontinence, such as high bloodpressure drugs and antihistamines. If you have female incontinence and aretaking these medications, your doctor may switch you to a different drug inhopes of alleviating the problem.
Simple remedies, such as the use of protective garments like pads oradult-size protective panties, may lessen the problem, says Zyczynski.Strengthening the muscles that control the bladder by doing Kegel exercises mayalso help, she says.
Biofeedback may also improve female incontinence. In one study of 26 womenwith urge incontinence, presented at the 2006 meeting of the AmericanGeriatrics Society, biofeedback helped the women learn to control their bladdermuscles and reduce the number of overactive bladder episodes.
If urinary incontinence is not helped by these remedies and is significantlyinterfering with your life and activities, your doctor may suggest medicationsor surgery. In one surgical procedure, surgical threads are used to help liftthe bladder up to a normal position. This allows the muscles that help holdurine in to work better.
Another procedure, called a “sling,” uses strips of material, eithernatural or synthetic tissue, to support the bladder neck and prevent urinaryincontinence.