Incontinence - The Silent Epidemic

The severity of urinary incontinence varies hugely between women. Some women find they loose urine occasionally when they cough or sneeze while others find it occurs frequently through the day. Women are willing to put up with different degrees of incontinence, but it is important for them to know that help is available and they don’t need to let it restrict their lifestyle.

Stress incontinence is the most common type of urinary incontinence. It occurs when the bladder neck is weakened and urine leaks out unintentionally. An overactive bladder is the other main cause of urinary incontinence. As the most common type of incontinence women experience after having a baby is stress incontinence, this will be discussed in the article.

What causes urinary incontinence?

While one in five women will experience urinary incontinence this rises to one in three women who have had a baby. While we know pregnancy and childbirth are major risk factors for incontinence the cause is likely to be due to many factors. Simply being a woman puts you at greater risk of urinary incontinence than a man. Women who have never had children are still four times more likely than men to have stress incontinence. As women get older their chance of developing stress incontinence increases. It is still quite a common belief amongst women and some health professionals that vaginal birth is the major cause of urinary incontinence. The reality is, however, that pregnancy itself is a major cause. It appears that the hormones of pregnancy such as ‘relaxin’ are largely to blame. This hormone acts to relax the connective tissues during pregnancy and they never quite return to their original state. As the pregnancy advances the weight of the baby stretches the pelvic floor muscles. During the birth the baby moves down through the birth canal (vagina), stretching the muscles and nerves that help to keep the bladder shut. This can all lead to the muscles being weak and unable to prevent the bladder from leaking, particularly when coughing, sneezing, heavy lifting or exercise. Some women it would appear are more susceptible to this occurring, but the difficulty is in correctly identifying these women. Many researchers have attempted to find the specific event that causes the incontinence but it is unlikely to be one thing. The commonly quoted risks for developing incontinence include large babies and difficult births such as those that require forceps delivery. Long periods of pushing during the last part of labour also seem to put women at increased risk.