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Medically Reviewed by Brittany Stopa, MPH

Written By By Heather Cooper, RPh August 13, 2022

Urinary Incontinence: Causes, Risk Factors, Symptoms, and Treatments

Photo Courtesy: Ivan-balvan/iStock

Do you have trouble with bladder control? Maybe you occasionally leak urine when you cough or sneeze. Or maybe, you have sudden urges to urinate that are so sudden and strong you don’t get to a toilet in time. If so, you are not alone, and you may have urinary incontinence. Urinary incontinence is a common problem for both males and females. About 4 in every 10 adults struggle with urinary incontinence, and the likelihood of it increases with age. Urinary incontinence is a symptom that can be caused by different health conditions. Urinary incontinence can interfere with everyday activities and cause embarrassment, but it can be managed. Read on to learn more about this condition.  

What Is Urinary Incontinence?

Urinary incontinence means that you have a difficult time controlling your bladder. As a result, you cannot hold urine (pee) until you make it to the bathroom. Depending on the cause of your urinary incontinence, this could come with a sudden urge, or it could just leak without you realizing you need to pee.

The kidneys filter waste products in your body, creating urine to be collected and stored inside the bladder. When the bladder is full, it signals the brain to empty the urine through tubes connected to the bladder. There are muscles that control the opening and closing of the bladder and the tubes that carry the urine away from the bladder into the urethra. The last step is emptying the urine by peeing. People with urinary incontinence have a problem with one of the steps in the normal process of urinating.

Everyone can experience urinary incontinence, but it’s more common in females and older adults over 60. It’s important to know that urinary incontinence is not a normal part of growing older – it is a sign of a problem, usually related to another medical condition.

Types & Causes of Incontinence

There are a few different types of urinary incontinence, such as:

Stress Incontinence 

Females commonly experience stress incontinence because of weaker muscles near the bladder after childbirth and menopause. This causes incontinence with coughing, laughing, sneezing, and exercising.

Urge Incontinence

Urge incontinence is when you have the sudden feeling, or urge, to urinate and can’t make it to the toilet fast enough. It is also called “overactive bladder” because the muscle in the bladder wall activates when it’s not supposed to. 

Overflow Incontinence

Overflow incontinence involves leaking urine after peeing and between trips to the bathroom because your bladder isn’t completely empty. This can happen when the muscle in the bladder wall is underactive, so it doesn’t activate to squeeze out all the urine. It can also happen when there is a blockage between the bladder and the urethra, such as an enlarged prostate. 

Mixed Incontinence

Sometimes, people experience mixed incontinence with more than one type. Mixed incontinence usually involves stress and urge incontinence.

Functional Incontinence

This type of incontinence happens when someone has a barrier to peeing that is not related to their urinary system. People with a disability such as difficulty walking may not be able to reach the toilet when they need to pee.

Signs and Symptoms of Urinary Incontinence

So, how do you know if you have urinary incontinence? If you plan your activities to make sure that you will be near a bathroom because you’re afraid you won’t be able to make it in time, then you probably have urinary incontinence.

The symptoms of urinary incontinence may include:

  • Suddenly feeling like your bladder is full and you need to pee
  • Leaking urine when you laugh, cough, exercise, or have sex
  • Wetting bed sheets or blankets while you’re asleep
  • Feeling like you didn’t empty your bladder after peeing
  • Dripping or leaking between trips to the toilet

Diagnosing Urinary Incontinence

Your doctor will ask you to describe the symptoms that you have experienced to decide which tests you need to help diagnose urinary incontinence. 

It’s helpful to keep a journal with notes about these questions, sometimes called a “voiding diary.” This is helpful when you talk to your doctor. It would help if you made note of the following information about your symptoms:

  • How many times do you urinate each day?
  • How much urine are you leaking? Is it enough to require the use of a pad or diaper?
  • What times of day do you notice the urine leaking?
  • How much water, alcohol, and caffeine are you consuming?
  • Which medications are you taking?
  • Do you feel a sudden urge to urinate before you have a leak?
  • Do you notice wet bed sheets caused by leaking overnight?
  • Does it feel like you didn’t empty your bladder after you pee?
  • Do you leak urine when you sneeze, cough, bend over, exercise, or during sex?
  • Do you leak between trips to the toilet?

Your doctor will use the answers to the questions listed above and check your body during a physical exam to see if something is causing urinary incontinence, like enlarged prostate in males or pelvic floor muscles in females.

  • Other tests used to diagnose urinary incontinence include:
  • Stress test with coughing to see if you have leakage
  • Urine sample to look for signs of infection
  • Ultrasound to get an image of your bladder and pelvis

Treatments for Urinary Incontinence

Treatment for urinary incontinence depends on the type you have, and your doctor will work with you to come up with a treatment plan that works best for you. For example, incontinence may be treated with limiting fluid intake, weight loss, medications, pessary devices, pelvic floor therapy, bladder training, and sometimes surgery.

There are medications to help cut down the number of trips to the bathroom in people with urge incontinence. You can talk to your doctor to decide if medication would be useful, depending on your job or lifestyle. Medication isn’t necessary to treat the condition, but it is an option for some people.

Over-the-Counter Incontinence Products

There are products that you can find in most drugstores to help you manage your urinary leaks, such as:

  • Disposable pads lined with waterproof material protect your clothes and skin.
  • Adult diapers are helpful for large leaks and can be thrown away after each use or washed and reused. 
  • Protective underwear is available in disposable and reusable styles, and you don’t need to wear a pad with these.
  • Waterproof pads under your bed sheets or furniture can make it easier to keep moisture away from your body.

Preventing Urinary Incontinence

It’s difficult to prevent many conditions that cause urinary incontinence. However, there are things you can do to manage the symptoms:

  • Limit drinks that can make symptoms worse, like coffee, tea, alcohol, and soda
  • Control blood sugar if you have diabetes with your medications, eat healthily, and keep scheduled appointments with your doctor
  • Don’t drink liquids too close to bedtime
  • Take medications that make you use the bathroom frequently, like diuretics (water pills), earlier in the day or plan for when you are sure to be near a bathroom
  • Try pelvic floor exercises to make the muscles that control urine flow stronger
  • Stop smoking to prevent other health conditions that can lead to urinary incontinence
  • Stay active with regular physical activity, and make healthy food choices to maintain your weight, prevent constipation and improve your overall health

Next Steps

You should speak to your doctor if you notice any of the following symptoms:

  • Leaking urine
  • Increased urge to pee
  • Peeing more often than you used to
  • Feeling like your bladder didn’t empty after using the toilet
  • Wet spots in your underwear, pants, or on your bed sheets
  • Pain during urination
  • Blood in urine

Urinary incontinence can be successfully treated and managed – so don’t wait if you are experiencing these signs. 

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