Urinary Incontinence in Women: Symptoms, Causes & Types

Urinary health is something most women don’t think about until they start having problems. Two common issues that many women face, especially as they get older, are urinary incontinence and vaginal prolapse. While these might be uncomfortable to talk about, knowing more about them can help you recognise the signs and take action to improve your quality of life.

What is Urinary Incontinence?

Urinary incontinence is the involuntary leaking of urine. It means you can’t always control your bladder, and urine may escape when you don’t want it to. This could happen when you cough, laugh, or sneeze or when you feel a sudden urge to go to the bathroom but don’t make it in time.

Types of Urinary Incontinence

• Stress incontinence: This happens when urine leaks because of pressure on your bladder, often due to physical movements like sneezing, laughing, or lifting something heavy.
• Urge incontinence: This is when you feel a sudden urge to urinate, and you can't hold it long enough to make it to the bathroom. Some people call this "overactive bladder."
• Mixed incontinence: This is when someone has symptoms of both stress and urge incontinence.

Causes of Urinary Incontinence

Urinary incontinence can happen for several reasons. Some of the most common causes include:

• Pregnancy and childbirth: The muscles around the bladder can weaken during pregnancy or after childbirth, making it harder to control your bladder.
• Ageing: As we get older, the muscles in the bladder and around the pelvic area can weaken, leading to bladder control problems.
• Menopause: After menopause, the body produces less estrogen, which can affect the bladder and urethra, making it harder to control urination.
• Certain medical conditions: Health conditions like obesity, diabetes, or even chronic coughing from smoking can increase the chances of developing incontinence.

What is Vaginal Prolapse?

Vaginal prolapse occurs when the muscles and tissues supporting the vagina weaken, causing the pelvic organs, like the bladder, uterus, or rectum, to drop or press into the vaginal area. This can lead to a feeling of heaviness or pressure in the pelvis, discomfort during sex, and in some cases, issues with urination or bowel movements.

Types of vaginal prolapse

• Cystocele (bladder prolapse): This happens when the bladder drops and pushes into the vaginal wall.
• Rectocele (rectal prolapse): This occurs when the rectum bulges into the vagina.
• Uterine prolapse: This is when the uterus drops into the vaginal canal.

Causes of Vaginal Prolapse

Vaginal prolapse is often caused by a weakening of the pelvic floor muscles, which can happen due to:

• Childbirth: Giving birth, especially vaginally, can put a lot of strain on the pelvic floor muscles, which may weaken over time.
• Ageing and menopause: As estrogen levels drop with age, tissues in the pelvic area can become less firm and more prone to sagging.
• Chronic pressure: Straining from heavy lifting, chronic coughing, or constipation can weaken the pelvic muscles and lead to prolapse.
• Previous pelvic surgery: Some women who have had surgeries like a hysterectomy may develop prolapse as the pelvic area shifts after the procedure.

Signs and Symptoms

Both urinary incontinence and vaginal prolapse can affect daily life, but they have different signs and symptoms. Recognising these symptoms early can help you get the right treatment sooner.

For Urinary Incontinence

• Urine leaks when you laugh, sneeze, or exercise.
• A sudden urge to urinate and not make it to the bathroom in time.
• Waking up multiple times during the night to go to the bathroom.

For Vaginal Prolapse

• A heavy or pulling sensation in the pelvis.
• Feeling like something is falling out of your vagina.
• Discomfort or pain during sex.
• Trouble urinating or having bowel movements.
• Frequent urinary tract infections (UTIs).

Treatment Options

Both urinary incontinence and vaginal prolapse can be treated, and there are many options available.

For urinary incontinence

• Lifestyle changes: Losing weight, cutting back on caffeine, or doing pelvic floor exercises (Kegel exercises) can help strengthen the muscles that control urination.
• Bladder training: This involves learning how to hold urine for longer periods and training your bladder to go at regular intervals.
• Medications: Some medications can help calm an overactive bladder or strengthen the muscles around the urethra.
• Surgery: In severe cases, surgery might be an option to provide support to the bladder or urethra.

For vaginal prolapse

• Pelvic floor exercises: Kegel exercises can help strengthen the muscles in the pelvic area, which can provide support for the organs and reduce symptoms.
• Pessary: A pessary is a device inserted into the vagina to support the pelvic organs. It can help relieve pressure and discomfort.
• Surgery: In more severe cases, surgery may be recommended to repair the weakened muscles and tissues.

When to See a Doctor

If you’re experiencing symptoms of urinary incontinence or vaginal prolapse, it’s important to see a healthcare provider. While these conditions are common, they aren’t something you have to live with. Many women find relief from symptoms with the right treatment. A doctor can evaluate your symptoms, offer advice, and help you choose the best treatment for your needs.

Preventing Urinary and Pelvic Health Issues

Although not all causes of urinary incontinence and vaginal prolapse are preventable, there are some steps you can take to lower your risk:

• Do pelvic floor exercises regularly: Strengthening the muscles that support your bladder and pelvic organs can help prevent incontinence and prolapse.
• Maintain a healthy weight: Excess weight puts pressure on the bladder and pelvic area, increasing the risk of both conditions.
• Avoid heavy lifting: If you need to lift something, use proper lifting techniques and avoid putting unnecessary strain on your pelvic muscles.
• Treat constipation: Straining during bowel movements can weaken the pelvic floor muscles. Eat a high-fibre diet and drink plenty of water to keep things moving smoothly.

Outlook

Urinary incontinence and vaginal prolapse are more common than most people realise, but they are not something you have to endure in silence. These conditions are treatable, and many women find significant improvement in their quality of life with the right care. If you’re noticing any symptoms or changes in your urinary health, don’t hesitate to talk to a doctor. There’s no need to feel embarrassed—taking steps to address these issues is an important part of staying healthy.

Frequently Asked Questions

Can lifestyle changes alone effectively manage urinary incontinence?

For mild cases, lifestyle changes such as regular pelvic floor exercises, avoiding bladder irritants like caffeine, and maintaining a healthy weight can help reduce symptoms. However, more severe cases may require additional treatments, so it’s best to consult with a healthcare provider.

Are there specific exercises other than Kegels that can help with pelvic floor strengthening?

Yes, in addition to Kegels, exercises like squats, bridge lifts, and yoga poses that target the pelvic area can help strengthen the muscles. A physical therapist specialising in pelvic floor health can provide a tailored exercise plan.

Can vaginal prolapse affect sexual function?

Yes, vaginal prolapse can cause discomfort during sex or reduce sexual satisfaction. However, many women experience improvements in sexual function after receiving appropriate treatment for prolapse.

Is urinary incontinence only a concern for older women?

No, while urinary incontinence is more common in older women, it can affect women of all ages. Factors like pregnancy, childbirth, and certain medical conditions can contribute to urinary incontinence in younger women as well.

How can I tell if I have vaginal prolapse or if it's something else?

Common signs of vaginal prolapse include a feeling of heaviness in the pelvis, a visible bulge from the vagina, or discomfort during daily activities. However, only a healthcare provider can make an accurate diagnosis, so it’s essential to seek medical advice if you have concerns.