November 15, 2016

A Little Leakage Goes a Long Way

By Natalia Gurevich, SWHR Communications Intern

There have been many times when we have hated our bladders. For making us get up to use the bathroom in the middle of the night, or making us stop every hour on the otherwise fun family road trip. However, many of us take our bladder health for granted. Our bladders work hard, and sometimes they aren’t quite as effective as we would hope.  The majority of women, pregnant or not, have at some point in their lives dealt with incontinence, the unintentional loss of urine [1]. Urinary incontinence occurs more often in women than in men because of a variety of contributing factors: pregnancy, vaginal delivery, and menopause. Weak bladder muscles, overactive bladder muscles, and nerve damage may also cause urinary incontinence in women [1]. Incontinence is typically a minor and rare nuisance easily solved. But for some women, incontinence can be a chronic issue that significantly impacts their quality of life, depending on the type of incontinence and the cause.

There are several types of urinary incontinence in women, including stress urinary incontinence where urine leaks after pressure is put on the bladder (ex. coughing, sneezing laughing), urge incontinence where there is an urgent feeling of needing to urinate, overflow incontinence where the bladder is never empty, and mixed incontinence which is having two or more types of incontinence [5]. The most common type of mixed incontinence is stress and urge incontinence together [2, 5].

Female athletes, both amateur and professional often suffer from stress urinary incontinence (SUI), with a few exceptions [2]. Over 41 percent of young female athletes reported at least one episode of stress urinary incontinence during high impact activities [2]. Because female athletes spend time gaining muscle one would think the pelvic muscles would get stronger as a result, but actually the overuse of the pelvic muscles causes them to become weak and fatigue more easily [9].  In addition, approximately 25 percent of women under age 40 experience SUI during physical activity [2].

In 2002, a study published in the International Urogynecology Journal took a sample of 291 elite athletes and dancers, who were on average 23 years old [3]. The study showed a high prevalence of leakage within gymnastics, at 56 percent of participants suffering from incontinence, closely followed by ballet at 43 percent, and aerobics at 40 percent. Other sports like badminton, volleyball, handball, and basketball also had a high occurrence of women with incontinence [3].

Incontinence and other related urinary conditions are often viewed as harmless, but the results can be embarrassing and a constant source of worry and discomfort for the women affected, even leading to social isolation, marital distress, depression. Urinary incontinence is stigmatizing for many women. Almost 90 percent of women with a urinary incontinence don’t discuss it with their healthcare providers [2] and therefore do not get the proper support and treatment they need. And yet, the condition is so common among women, with seven to 37 percent of women between the ages of 20-39 reporting some degree of incontinence [6].

There are numerous treatments available for each type of urinary incontinence including medication, devices, surgery, discipline therapy, or Kegel exercises or pelvic floor exercises, which for the majority of women can be effective.

If you are a woman, and especially if you are an athlete, contact your healthcare provider if you have questions or concerns about your urological health. SWHR’s Interdisciplinary Network on Urologic Health in Women helps to raise awareness of the impact of bladder health on women’s well-being across the lifespan [2]. The network aims to identify and close the gaps in knowledge, research, policy and education and disseminate information and provide support to the general public [2]. Learn more about incontinence from SWHR’s new Urology Network Report here.

References:

  1. http://www.medicinenet.com/urinary_incontinence_in_women/article.htm
  2. Liliana Losada et al., “Expert Panel Recommendations on Lower Urinary Tract Health of Women across their Lifespan.” Journal of Women’s Health. Epub ahead of print (2016).
  3. Thyssen et al., “Urinary incontinence in elite female athletes and dancers.” International Urogynecology Journal. 2002;13(1):15-7.
  4. Simeone et al., “Occurrence rates and predictors of lower urinary tract symptoms and incontinence in female athletes.”Urologia. 2010;77(2):139-46.
  5. https://www.womenshealth.gov/publications/our-publications/fact-sheet/urinary-incontinence.html
  6. “Urinary Incontinence in Women.” National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC). 2 Sept. 2010. <http://kidney.niddk.nih.gov/kudiseases/pubs/uiwomen/>
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4327384/
  8. http://www.webmd.com/urinary-incontinence-oab/types-of-urinary-incontinence
  9. Jacome et al. “Prevalence and impact of urinary incontinence among female athletes.” International Journal of Gynecology & Obstetrics. 2011;114(1):60–63.