Women's Incontinence Guide
Nearly four million American women are affected by urinary incontinence. The good news is that with the following information you’ll have the know-how to easily manage the condition and the confidence to feel like yourself again.
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The Bladder Leakage Basics
Urinary Incontinence 101
Urinary incontinence, or bladder leakage, is defined as any involuntary leakage of urine. It is a symptom or combination of symptoms related to the two functions of the lower urinary tract system: urine storage and bladder emptying. Symptoms are sometimes related to temporary or reversible conditions. Although it can be related to aging changes in our bodies, it is not the inevitable outcome of aging since many of the risk factors can be controlled with lifestyle changes.
We created this guide to help you better understand bladder leakage, and hopefully make leaks easier to manage – or even stop – everyday.
A very common condition
Bladder leakage is pretty common. In fact, over 65 million Americans experience bladder leakage in one form or another. That’s about 1 in 4 adults, so you’re definitely not alone. Yet, women are 3x more likely to experience urine leakage symptoms than men.*
Something else you may not know: almost half of the adults experiencing bladder leakage are under the age of 50. There is no need to feel embarrassed or ashamed when educating yourself about these symptoms since there are many resources and ways to help you achieve your desired quality of life.
* Kimberly Clark internal research
Causes of Bladder Leakage
Some causes include weak bladder muscles, complications after childbirth and surgery. But as we mentioned before, bladder leakage isn’t a disease. Often times, modifying everyday habits and lifestyle changes can help reduce or eliminate the symptoms. If the symptoms persist and become very bothersome, please do not hesitate to consult with your primary physician or ob-gyn doctor.
Risk Factors for Bladder Leakage
In order to store urine and empty the bladder normally, your pelvic floor muscles and the nerve systems that control bladder function must work together to hold urine and release it under your brain control. This complex orchestration of organs, muscles and nerve systems can be susceptible to getting timing and/or signals scrambled. The following are the risk factors for women in rank order:
- 1) Obesity (BMI>30)
- 2) Major Depression
- 3) Hysterectomies
- 4) Diabetes
- 5) Multiple medications for multiple conditions
- 6) Number of Vaginal Deliveries
- 7) Increasing age/Decade of Life
Types of Bladder Leakage
Lower urinary tract symptoms consist of three groups of symptoms: urine storage, bladder emptying (while urinating), and post-bladder emptying (immediately after urinating). While there are several kinds of bladder leakage, the most common relate to storage symptoms. Specifically, these are:
Stress Urinary Incontinence (SUI): Involuntary leakage that occurs when pressure (due to effort or exertion) is suddenly placed on your bladder. This could happen when you cough, laugh, sneeze, exercise or lift a heavy item.
Urge Urinary Incontinence (UUI): A sudden, intense urge to urinate with, or followed by, urine leakage.
Mixed Urinary Incontinence (MUI): When you experience both Stress and Urge Urinary Incontinence.
Overactive Bladder (OAB): A chronic condition of the bladder that causes sudden urges to urinate due to bladder muscle contractions.
Nocturia: A condition in which you wake up during the night because you have to urinate.Read More About this Topic
Managing Women's Incontinence
How to promote bladder and urinary health
Keep an eye on your diet
Since obesity is a high risk factor for women developing bladder leakage, losing weight can prevent the onset or help relieve symptoms of stress and mixed incontinence. The reduction of body weight will reduce added pressure put on your bladder and the pelvic floor, therefore reducing leaks when laughing, coughing, sneezing and other physical activities.
It is also important to avoid or minimize foods and drinks that can irritate the bladder. These include spicy and acidic foods (like tomatoes and citrus), dairy, alcohol, caffeine, carbonated drinks, fruit juice, and coffee (including decaf). These things are likely to trigger frequency and urgency to go to the bathroom, and may sometimes cause bladder leakage.
Monitor what you drink
When you have bladder leakage you may be inclined to decrease your fluid intake. But actually, to keep your bladder healthy, you should stay hydrated by drinking approximately six to seven 8-oz glasses of water a day. This could vary slightly depending on your size and physical activity level, so listen to your body signals on how much to drink to stay hydrated. When you drink less water, your urine becomes more concentrated and may irritate the lining of the urethra and bladder – which can trigger bladder spasms, frequency to urinate and unexpected leaks.
Exercising is important in many ways including to strengthen internal abdominal and pelvic floor muscles. Pelvic floor health is essential to prevent and reduce both urine and bowel leakage. You can do this with Kegels, Zumba, yoga, Pilates, Tai Chi. There are helpful YouTube videos to help learn how to correctly identify if you are contracting the pelvic floor muscles.
Exercising and walking combined with a healthy diet will help reduce weight and other urine leakage risk factors like diabetes.
Bladder exercises for women
Retrain your bladder to hold more urine, for longer. This works best for people who have urge or mixed incontinence. While awake, empty your bladder at regular intervals (such as twenty to thirty minutes or as long as you can manage). Each week, gradually increase the time between using the bathroom. Continue this exercise until you reach an interval of time that works for you.
You can also practice pelvic floor muscle exercises, known as Kegels, to strengthen the muscles that help control urination. By strengthening pelvic floor muscles through Kegels, you may reduce or eliminate bladder leakage and the urge to go.
Good question. First, locate your pelvic floor muscles by trying to stop your urine flow. This action is known as a pelvic floor muscle exercise (a.k.a. a Kegel). Now squeeze and hold those muscles for three seconds, relax for another three seconds and repeat 10 times. Do 3-4 sets of 10 squeezes per day, and you may begin to feel significant improvement controlling your bladder in just a few weeks.
Getting a good night’s sleep
Follow these simple steps to prevent nighttime accidents:
- Limit your fluids before bedtime
- Avoid bladder irritating foods like caffeine, alcohol, acidic foods, chocolate, hot spices, soda
- Try and urinate 2x before bed
- Keep the path to the bathroom clear and well lit
- Do some Kegel exercises
- Use a product specially designed to your protection need
How to control odor from bladder leakage products
The best way to control odors is a 1-2-3 punch of good hygiene, staying hydrated and using clean undergarments. Make sure to dispose of undergarment products in an airtight container, or, when traveling, in a plastic, zip-style bag. Consider taking urine-deodorizing tablets like vitamin C or supplements made for this purpose. Apple, pear, cherry or other non-citrus juices also help. Finally, find someone you trust to tell you honestly if an odor is present.
Staying in control
Here are some simple things you can do to make sure you’re always prepared when you’re out and about:
- Carry a spare Depend® product in your handbag or purse
- Keep plastic bags on hand for easy disposal
- Have a couple “emergency” changes in your car
- Set a schedule for regular changes
- Locate restrooms ahead of time
- Avoid caffeine or too much water
- Practice those Kegels
- Find the right Depend® product
Bladder friendly foods
Be sure to check out some tips, tricks and tasty recipes for keeping your bladder happy and healthy with the right foods on the Depend® YouTube Channel.Read More About this Topic
Bladder Leakage Products for Women
The right product
We offer a number of Depend® products designed for you. They come in either Depend® FIT-FLEX® Underwear Moderate, Maximum and Night Defense for Women, Depend® Silhouette®, or Depend® Silhouette® Active Fit® Briefs for Women.
Each product features a thin, absorbent pad made of super absorbent polymers that draws wetness in and away from the skin. All products are latex-free and contain no lotion or fragrances.
To help you find the perfect product for you and your needs use our product finder.
Disposing the product
Depend® products are absorbent enough to withstand multiple wettings of varying amounts which means you don’t have to change them as often as other non-premium brands. It is recommend that you wear them once and toss them in a trash bag or other waste containers. You should never flush them because of their super-absorbent material.
Depend® products are not made for washing, just wearing. We unfortunately do not have products designed for swimming either. However, you can purchase an effective adult swim brief that goes under a regular swimsuit from SOsecureproducts.com.
Free samples and more info
You can also order free samples of Depend® products here. Or call 1-877-413-3736 to speak to a helpful representative about our free sample pack.
When purchasing Depend®, consider leveraging your FSA account provided to you by your employer’s healthcare plan. The pre-tax funds in an FSA account allow you to pay for qualifying healthcare expenses that aren’t typically covered by your plan.
A worthy alternative
Do you experience light bladder leaks only when you sneeze, laugh or cough? Poise® offers a range of liners and pads with different levels of absorbency to give women worry-free bladder leakage protection. Find your perfect Poise® product here.Read More About this Topic
Menopause & Incontinence
During and after menopause, estrogen levels naturally decline. Vaginal tissue, including that of the bladder and urethra (the tube from which urine leaves the body) require estrogen to stay strong and elastic. As estrogen levels drop during menopause, these tissues thin and weaken, giving you less control.
Problems that may develop because of changes due to menopause:
Stress incontinence. As estrogen levels naturally decline during menopause, sphincter, urethra and pelvic tissues weaken. This change can make it more difficult to hold urine, resulting in leakage when pressure is exerted on the bladder (such as pressure caused by coughing, sneezing or lifting). It’s one of the most common kinds of bladder leakage in women.
Urge incontinence. As estrogen levels naturally decline during menopause, sphincter, urethra and pelvic tissues weaken. The bladder has a more difficult time stretching to accommodate filling. As the bladder fills, loss of stretch causes irritation, resulting in more frequent urges to go.
Nocturia. A need to wake several times at night to urinate.
Bowel incontinence 101
Bowel incontinence, also referred to as Fecal incontinence or Accidental bowel leakage, is the inability to control bowel movements resulting in an unexpected leakage of stool. Leakage may occur in small amounts consisting of mucus and liquid stool, or more frequently consisting of solid stool. It may be experienced with symptoms such as an urgent need to have a bowel movement, spotting of stool, diarrhea, or constipation. There are two common types of bowel leakage:
- Urge Bowel Incontinence – you experience a sudden urge to have a bowel movement, but cannot make it to the bathroom in time
- Passive Bowel Incontinence – nothing is felt to indicate that a bowel movement is going to occur.
Though it can be embarrassing, it is important to remember that bowel leakage is common and manageable. Approximately 18 million adults – 9% of women and 8% of men experience it in some form. The incidence of bowel leakage increases with age.
Many people resort to altering their lives to cope with bowel leakage, but it could be as easy as finding the right undergarment to help manage the condition and give your confidence a boost. Our product finder page is a great start.
As every person’s body is different, talking to your doctor about your specific symptoms offers the best chance of managing, reducing or even eliminating leaks.
Risk factors for bowel leakage
Muscles and nerves of the rectum and anus must work together to hold stool, signal when it’s full, and release the stool. There are many reasons why this may not happen. Some of the most common reasons include:
- Chronic constipation (causes the muscles of the anus to stretch and weaken)
- Constipation due to “overflow” that can occur when stool becomes backed up and unformed stool leaks around the blockage
- Diarrhea as a result of Irritable Bowel Syndrome (IBS), Irritable Bowel Disease (IBD), diet, drugs, etc.
- Neurological disability or nerve disorders (e.g. Multiple Sclerosis, stroke, spinal cord injury, etc.)
- Cognitive impairment
- Obstetric abnormalities
- Colo-rectal injury and surgery
Irritable bowel syndrome (IBS) vs. bowel incontinence
Irritable bowel syndrome is a gastrointestinal disorder resulting in symptoms including abdominal pain, diarrhea or constipation, bloating, bowel urgency, the feeling of incomplete evacuation of stool after a bowel movement, and bowel incontinence.¹
Between 10–15% of Americans experience irritable bowel syndrome, many of whom experience bowel incontinence as a result.² There are a variety of treatment options for IBS that help improve individual symptoms. Talk to your doctor if you have symptoms of IBS such as bowel incontinence.
1. Irritable Bowel Syndrome. (n.d.). Retrieved February 2016 from http://uclacns.org/patients/disease-information/irritable-bowel-syndrome-ibs/
2. Wald, Arnold M.D. Clinical Manifestations and Diagnosis of Irritable Bowel Syndrome in Adults. (2014, November 14). Retrieved from http://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-irritable-bowel-syndrome-in-adults
Products for bowel incontinence
Depend® offers a range of products and absorbency levels depending on the amount of leakage you experience. For light to moderate amount of leakage, you can choose from the full range of Depend® FIT-FLEX Underwear products. But for considerable and higher amounts of leakage, Depend® Adjustable Underwear offers maximum absorbency and worry-free odor control. It’s designed to be changed two ways: stepping in and out of it like regular underwear, or opening the side perforations for easy changing without having to remove pants and shoes. Use our product finder to locate the product for you.
Products for IBS
For mild IBS any Depend® FIT-FLEX® Underwear product for Women or any Silhouette® Active Fit® product will offer good balance of protection and comfort in a pull-on style, just like regular underwear. For considerable and higher amount of leakage, Depend® FIT-FLEX® Underwear Maximum for Women and Depend® Protection with Tabs offers maximum absorbency with side barriers to protect against leakage and four refastenable tabs for discreet, easy removal. To find the best product for your needs, use our product finder.
How to talk to your doctor about incontinence
Since every person’s body is different, getting advice specific to yours offers the best chance of managing, reducing or even eliminating leaks. Remember, bladder and bowel leakage are symptoms that are not new to your doctor. To make the conversation easier, write down and share the following things: when you leak, how often you leak, how much you leak, any triggers or activities that cause you to leak, and why you feel this is bothersome. This will help your doctor determine the best option for treatment.
How to talk to your family about incontinence
Consider recruiting the emotional support of your family and sharing what you are doing about your symptoms and what you have learned. Their empathy and support will help you be more empowered, proactive and prevent the tendency to develop coping behavior that may not be in your best wellness interest.
The more you know about incontinence, the more you can live your life and not your condition. Here are some online sources and organizations to learn more:
DEPEND® Emails. Our emails contain articles and advice for maintaining your lifestyle, latest products and FAQs.
National Association for Continence. A national, non-profit organization dedicated to destigmatizing incontinence, promoting preventive measures and motivating individuals to seek treatment.
WebMD.com. The leading online source for trustworthy and timely health and medical news and information.
MayoClinic.org. The online site for one of the most highly respected medical practices in the world.Read More About this Topic