Understanding and Managing Stress Incontinence in Women

Do you cut your laugh short because of an unexpected leak? Do you experience urine leaks when coughing, sneezing, jumping or heavy lifting? You may be experiencing stress incontinence, the most common type of incontinence among women.  

“Sometimes it just takes a big sneeze” jokes Deborah, one of the participants in our Age of Confidence campaign, which investigated how British women feel about their body image and how incontinence affects this, and their wellbeing. 

At TENA, we recognize that this is more than just a physical challenge—it's about maintaining your confidence and comfort while living life to the fullest.  

In this article, we'll explore the causes of stress incontinence in women, helpful strategies for managing stress incontinence, and treatment for stress incontinence in females to help you live life on your terms. 

Stress incontinence in women is characterized by unintentional urine leakage during certain activities. These activities can include: 

• Sneezing 

• Coughing 

• Exercising 

• Lifting heavy objects/weight 

• Jumping 

Stress incontinence in females happens when the pelvic floor muscles that support the bladder weaken and are unable to provide enough support to prevent urine leakage when under strain. Various types of strain on the body can increase pressure on the bladder, and if the pelvic floor muscles are too weak this can cause urine leaks. Usually these leaks are small, but this can vary. 

Female stress incontinence occurs when the muscles that support the bladder and regulate the release of urine become weakened or damaged. This can happen for several reasons: 

• Pelvic Floor Muscle Weakness: The pelvic floor muscles provide crucial support for the bladder and urethra. When these muscles are weakened, they can't effectively maintain control, leading to leakage during activities that increase abdominal pressure. These muscles can weaken for various reasons, a common cause being urinating too often. Thankfully, you can strengthen your pelvic floor muscles using Kegel exercises. 

• Stress Incontinence After Childbirth: One of the most common causes of stress incontinence is pregnancy. Childbirth can stretch and weaken the pelvic floor muscles and nerves, especially after vaginal delivery. The more children a woman has, the higher the risk of developing stress incontinence. 

• Hormonal Changes: Declining oestrogen levels, particularly during menopause, can lead to a weakening of the urethra and surrounding tissues, making stress incontinence more likely. 

• Aging: As part of the natural aging process, muscles and tissues may lose some of their strength and elasticity, including those that support the bladder. Again, you can reduce this significantly by using Kegel exercises and strengthening your pelvic floor. 

• Obesity: Excess weight increases abdominal pressure, which can place additional strain on the bladder and pelvic floor muscles, leading to stress incontinence in women. 

• Previous Pelvic Surgery: Surgeries involving the pelvic region, such as a hysterectomy, can alter the support structures of the bladder and contribute to incontinence. 

Awareness of the contributing factors can help you to make appropriate lifestyle changes where possible and seek medical advice to reduce the impact of stress incontinence on your life. 

Making targeted lifestyle changes can significantly help manage stress incontinence and reduce the frequency of leaks: 

• Weight Management: Achieving and maintaining a healthy weight can reduce abdominal pressure on the bladder, alleviating stress on the pelvic floor muscles and potentially improving symptoms. 

• Dietary Adjustments: Certain foods and drinks, like caffeine, alcohol, and carbonated beverages, can irritate the bladder. Reducing or eliminating these from your diet might decrease episodes of incontinence. 

• Fluid Intake: While it's important to stay hydrated, moderating fluid intake and spreading it evenly throughout the day can help avoid overwhelming the bladder. Avoid excessive drinking right before bedtime to prevent nighttime leaks. 

• Regular Exercise: Incorporate pelvic floor-safe exercises, such as walking or swimming, to enhance overall muscle tone without putting excessive strain on the pelvic region. 

• Avoid Heavy Lifting: Practice safe lifting techniques and avoid lifting heavy objects whenever possible to reduce pressure on the pelvic floor. 

For those who need additional support beyond lifestyle changes and Kegel exercises, several medical treatments can help you manage stress incontinence: 

• Medications: Although no medications are approved specifically for stress incontinence, drugs like topical oestrogen creams can help strengthen pelvic tissues in post-menopausal women. 

• Physical Therapy: Specialized physical therapy can focus on strengthening pelvic floor muscles. A physiotherapist may guide you through exercises tailored to your needs. 

• Pessary: A vaginal pessary is a device inserted into the vagina to support the bladder and reduce pressure, which can help lessen leakage during physical activities. 

• Surgical Options: In more severe cases, surgical interventions such as sling procedures or bladder neck suspension can provide added support to the urethra and bladder neck, potentially reducing incontinence. 

If you are experiencing stress incontinence its best to consult with your doctor for help determining the most suitable treatment approach. 

Living with stress incontinence doesn't mean you have to miss out on enjoying life. Adopting effective management strategies can help you regain confidence and minimise its impact on your daily routine.  

Embrace a proactive mindset; incorporate pelvic floor exercises and adjust lifestyle habits to see gradual improvements. Make use of quality incontinence products designed to provide discreet protection from leaks, ensuring you remain comfortable and confident during all activities.  

Remember, you're not alone—many women share similar experiences, but with the right steps and incontinence protection supporting you, you can live on your terms in confidence and comfort.