Do you leak urine when you cough, sneeze, or laugh? These actions, many of which can be involuntary, put extra pressure on the bladder and can cause urine to escape from the urethra in those with stress incontinence.
While stress incontinence is very common (affecting around a third of all adult women at some point in their lives), the symptoms can be embarrassing and difficult to live with. Many women struggle to talk about their symptoms, which prevents them from getting the help they need to manage their condition.
Here at Jude, we are passionate about destigmatising urinary incontinence by providing valuable resources. In this article, we'll provide you with nine ways to manage and prevent stress incontinence so that you can feel confident as you go about your day-to-day activities.
A Closer Look at Stress Incontinence
Urine leakage caused by physical actions, such as laughing, coughing, lifting, running, and sneezing, is referred to as stress urinary incontinence. Despite what you may think when you hear the name 'stress incontinence', this type of incontinence is not caused by mental stress.
Rather, it is caused by the urinary sphincter not adequately closing the bladder outlet when extra abdominal pressure occurs and leading to pee to escaping during those physical actions.
Symptoms
Stress incontinence means that you leak urine when there’s extra pressure on your bladder - like when you cough, sneeze, laugh, run or lift. These leaks usually happen in the day and are linked to movement or effort.
If you are experiencing leaks at night, that's more often a sign of urge incontinence or mixed incontinence, not stress incontinence.
Causes
Stress incontinence is primarily caused by weakened pelvic floor muscles, which are the muscles responsible for supporting your bladder and urethra. The pelvic floor muscles also help control the release of urine through the urinary sphincter.
Pregnancy and Postpartum
Pregnancy and birth stretch and sometimes injure the pelvic floor muscles that support your bladder. This is one of the most common reasons women first notice stress incontinence.
Menopause
Falling oestrogen during menopause can thin and weaken the tissues around your bladder and urethra, making leaks more likely.
Chronic Cough and/or Smoking
A long-term cough, often caused by smoking or conditions like asthma, puts repeated strain on the pelvic floor and can lead to leaks.
High-Impact Sport
Running, trampolining, CrossFit or heavy lifting without good pelvic floor strength can increase downward pressure and trigger leaks.
Pelvic Surgery
Operations like a hysterectomy can sometimes alter pelvic support structures, leaving the bladder and urethra less well supported.
Obesity
Carrying extra weight adds pressure inside the abdomen, which in turn stresses the bladder and pelvic floor muscles.
Finally there are other, less common ways that you pelvic floor muscles can be damaged - ie. if you are in an accident or fall from a significant height.
How is Stress Incontinence Diagnosed?
If you suspect you may be experiencing symptoms of stress incontinence, you should make an appointment to see your GP. They will usually start with a physical exam and ask about your symptoms.
You may be asked to keep a bladder diary for a few days or do a pad test to measure leaks. A simple cough stress test during a pelvic exam can also confirm stress incontinence.
If the cause isn’t clear, or symptoms are severe, you might be referred to a specialist or for urodynamic testing.
How is Stress Incontinence Treated?
There are various treatments available for stress incontinence - from exercises you can easily do at home, to surgical options. Speaking with your GP about what they feel is suitable for you and your medical history is important, but typically women will be offered the following treatment 'ladder'.
Pelvic Floor Muscle Training
This is the gold-standard first step. A supervised programme for at least three months helps you learn proper technique and stick with it - daily practice is key.
Apps like Squeezy can help you remember to do your pelvic floor exercises and start building them into your routine as a daily habit.
Vaginal Support Devices and Pessaries
These can provide extra support to the bladder and urethra, particularly useful during exercise or high-impact activity.
Topical Oestrogen
For women after menopause, vaginal oestrogen can strengthen and improve the tissues that support the bladder and urethra. Your GP will be able to prescribe this for you.
Surgery
If your symptoms don’t improve with other treatments, surgery may be the next option to try and your GP can make a referral for you.
Typically, the most common forms of surgery for stress incontinence are:
Mid-urethral sling: a strip of synthetic mesh or your own tissue supports the urethra. It’s usually very effective, but mesh complications have been reported so it's important to weigh up the risks with your specialist.
Colposuspension: stitches lift the bladder neck into a better position. It has high success rates but involves a longer recovery and may not suit every woman's lifestyle.
9 Ways to Manage and Prevent Stress Incontinence
Fortunately, there are plenty of ways to manage and prevent stress incontinence. Urine leaks don't need to ruin or rule your life! Here are just a few of our top prevention and management tips for urinary incontinence.
1. Wear leak-proof underwear
Wearing leak-proof pants can give you the confidence you need to go about your daily life without the worry of urine leakage getting in your way. Our leak-proof incontinence pants are designed to hold up to 8 teaspoons of pee, allowing you to stay dry even if you do have a few leaks throughout the day.
While incontinence underwear won't cure stress incontinence, it acts as an effective management tool and allows you to live a 'normal' life without constantly stressing about whether or not you're leaking. The best part about them is that they are comfortable and affordable!
2. Try pelvic floor muscle training
Kegel exercises can help strengthen your pelvic floor muscles, which will give you greater control over your bladder. You can find pelvic floor exercises online or you could go to a physiotherapist, who can help guide you through these exercises and explain the proper techniques. Seeing a pelvic floor physiotherapist can also ensure that the exercises are tailored to your pelvic floor and what it needs.
Most of these exercises consist of contracting and relaxing the pelvic muscles in various positions.
3. Keep a bladder diary
Many urinary incontinence experts recommend keeping a bladder diary so you can keep track of the number of leaks you experience each day and when they happen.
Not only will this help you identify potential triggers of your incontinence, but your bladder diary will also be a useful tool for your doctor. Your GP or urologist can use this information when it comes to providing a diagnosis and offering treatment options.
Just remember to also keep track of what you eat and drink as this may help you identify irritants.
4. Healthy lifestyle changes
Improving your overall health may help minimise your incontinence symptoms. You can start by eating a healthier diet and ensuring you drink plenty of water throughout the day.
While lifting heavy weights may trigger your incontinence, you can still participate in gentle exercises like walking, cycling, and swimming.
Maintaining a healthy weight can also reduce any unnecessary pressure on your bladder.
5. Stay away from bladder irritants
Did you know that caffeinated drinks like tea and coffee can cause bladder irritation? While bladder irritants are more important to consider in overactive bladder ( a condition where you experience urgency and frequent toilet trips), avoiding them can also be helpful in those with stress incontinence. Moderation is key and it is best to find out what triggers your bladder the most. Examples of potential bladder irritants include::
6. Avoid lifting
While you may struggle to avoid laughing, sneezing, and coughing, you can avoid things like running and lifting heavy weights. Any physical exertion that results in pee leaks should be avoided when possible if you want to manage your incontinence symptoms.
Luckily, there are plenty of other exercises you can do that don't put too much pressure on your bladder.
7. Wear incontinence pads
Jude's incontinence pads are ideal if you experience medium leaks and gushes. These comfy, absorbent pads are made from plant-based materials and are perfect for everyday wear. You'll stay dry as you go about your day and will hardly even notice the fact that you're wearing a pad thanks to the slim and comfortable design.
8. Treat constipation
Treating chronic constipation has been proven to greatly improve stress incontinence. Constipation puts extra strain on your bladder and the surrounding muscles, so it's important that you maintain healthy bowel movements if you want to manage your stress urinary incontinence.
9. Manage your stress levels
While stress is not a direct cause of incontinence, your stress and anxiety might be making your urinary incontinence worse. Anxiety-induced urination is quite common in women of all ages, so make sure you take the time to manage your stress levels.
You could try relaxation techniques like taking warm baths, reading a book, or joining a yoga class. Try to keep a positive mindset and find ways to unwind after a busy day.
Surgery for Stress Incontinence
If you've tried all the management and prevention tips and find that they're not working, you could be a candidate for surgery. While surgery can help fix stress incontinence, it doesn't treat urge incontinence, so you may still experience urgency to pee after surgery if you have mixed incontinence.
Surgery is performed to strengthen the bladder and urethra by either lifting the sagging bladder, placing a sling around the urethra, or injecting material around the urethra.
Surgery also comes with its risks, including difficulty urinating, injury to the bladder, and infection. Make sure you consider all the risks and consult with your doctor before opting for surgery.
Pelvic Floor Starter Plan
Many of us know we should be doing our pelvic floor exercises, but the reality is that they can be hard to remember to do - and tricky, if you aren't sure where to start or know how to 'find' these muscles. This pelvic floor starter plan will help set you up for success and build the habit of doing them into your day to day life.
Step 1: Find your Pelvic Floor Muscles!
Imagine you’re stopping a wee mid-flow — that’s the feeling you’re aiming for (but don’t practise this on the toilet).
Step 2: Try these Exercises
• Slow squeezes: hold for 5 seconds, relax for 5, repeat x10.
• Quick squeezes: squeeze and release quickly, repeat x10.
Do three sets a day, spread through your day.
Try not to hold your breath, clench your bum or thighs, or forget to fully relax between squeezes when doing these exercises.
Step 3: Track your progress
Don't forget to keep track of your progress! Keeping a log will help you to establish your pelvic floor exercises into your everyday routine.
Use a simple tick chart, make notes on your phone, or use an app like Squeezy to stay on top of your daily practice.
Top tip: Why not set a phone reminder to do your exercises at convenient moments in your day?
FAQs
What are the other types of urinary incontinence?
Stress incontinence is just one type of urinary incontinence. Other types include:
Urge incontinence - preceded by a sudden urge to urinate
Mixed incontinence - a mixture of stress incontinence and urge incontinence
Overflow incontinence - you constantly leak urine because your bladder doesn't empty properly
Functional incontinence - you don't make it to the bathroom in time because of a physical or mental barrier
What are the risk factors for urinary incontinence?
Some of the risk factors for urinary incontinence include:
Menopause
Obesity
Smoking
Recurrent urinary tract infections
Pregnancy
Constipation
Overactive bladder
Diabetes
Will stress incontinence symptoms go away on their own?
No, unfortunately, incontinence symptoms are likely to get worse if not treated properly. It is very unlikely that symptoms will go away on their own, so be sure to implement preventative and management techniques. If you do exercises that support your pelvic floor however, then you may notice improvement through this alone.
When should I see a doctor about my stress incontinence symptoms?
If you are experiencing stress incontinence symptoms, you should make an appointment with your GP as soon as possible. Your GP will be able to diagnose your condition, provide treatment options, and recommend a specialist if need be.
When you arrive at your appointment with your GP, they will most likely ask you about your medical history and how long you've been experiencing urinary incontinence. They may conduct a physical exam to try to determine the cause of your incontinence.
Final Thoughts
Despite what you may think are embarrassing symptoms, stress incontinence is nothing to be ashamed of. Thousands of women around the world experience urine leakage and it is about time this topic became less stigmatised.
Here at Jude, we aim to break taboos surrounding urinary incontinence by sharing helpful resources and developing effective incontinence products, such as our leak-proof pants and bladder support supplements.
Try to keep a positive mindset surrounding your stress incontinence and rest assured that plenty of women are going through the same thing as you. Through management and prevention techniques, you should be able to alleviate your symptoms!
