Bladder control problems in women

Also known as urinary incontinence or urinary leakage

Bladder control problems (when you pee unexpectedly) are common in women.

Key points about bladder control problems in women

  1. In Aotearoa New Zealand, it is estimated that almost 200,000 women have urinary leakage at least twice a month.
  2. Bladder control problems are 4 times more common in women than men, with many women experiencing some degree of lost control over their urinary actions.
  3. Two-thirds of women who experience bladder control problems do not seek help as they see this as a normal female problem and think nothing can be done about it.
  4. However, 7 out of 10 women with bladder control problems can experience significant improvement or become completely dry with the right diagnosis and treatment.

What causes bladder control problems in women?

Factors that contribute to bladder control problems include:

  • pregnancy and childbirth
  • constipation
  • medications, including prescribed medicines, over-the-counter medicines and herbal supplements 
  • chronic cough
  • urinary infection
  • diseases that affect your nervous system and muscular control
  • diabetes
  • obesity
  • reduction in hormones after menopause (when your period stops).

What are the signs of bladder control problems?

The 2 types of incontinence most common in women are stress incontinence and urge incontinence. 

Stress incontinence
is the spontaneous, uncontrolled leakage of small amounts of pee when you exert yourself, such as by coughing, sneezing, straining, lifting or playing sport (without any desire to go to the toilet).

Urge incontinence
causes a sudden, overwhelming urge to pee. If you can't get to the toilet in time but pee a bit, you have urge incontinence. This is often referred to as an overactive bladder. 

Mixed incontinence is when you have both stress and urge incontinence.

Under-active bladder is when your bladder muscle is weak and does not squeeze strongly enough when you pee. This can lead to slow or incomplete bladder emptying. It can be associated with other symptoms such as urinary incontinence and bladder infections.

What can I do if I have bladder control problems?

Bladder control problems don't have to hamper your lifestyle. Talk to your doctor, pelvic floor physiotherapist, continence nurse or midwife for advice.

Issues with bladder control can be annoying but there are a few simple measures that can help if you have mild-to-moderate bladder control problems. A surgical fix should always be a last resort.

  • Reduce coffee, tea and alcohol intake.
  • Reduce intake of bladder irritants such as fizzy drinks, fruit juices and artificial sweeteners.
  • Learn the right way to do the correct pelvic floor exercises for you from a pelvic floor specialist. Note: Different exercises are used for different conditions and it is important to know which will help you.
  • Once you know the correct pelvic floor exercises for you, do them often – these can strengthen the muscles that empty your bladder. About 7 out of 10 women with stress incontinence can become dry or significantly improve by doing pelvic floor exercises.
  • Train your bladder to hold more pee without leaks. Bladder training is sometimes combined with medicine (see below).
  • Use continence products to help you manage leaks.

See self-care for bladder control problems for more detailed information on pelvic floor exercises and bladder training. 

Medicines

If you have ongoing problems with urinary incontinence that are not helped by the self-care measures above, your doctor may prescribe you an anticholinergic medicine, such as oxybutynin, solifenacin or tolterodine. These act on your bladder muscles to help improve bladder control.

Support

Continence NZ Information and education on continence topics. Also, a free helpline phone 0800 650 659.

Learn more

Bladder control problems in women Continence NZ
Promoting good bladder and bowel health  Continence NZ
Urinary problems Ministry of Health, NZ

Credits: Health Navigator Editorial Team . Reviewed By: Andreea Dumitru, Senior RN, Capital & Coast & Lower Hutt and ACC Treatment Safety team Last reviewed: 28 Oct 2021