Women and urine leakage? Affects even younger + causes and treatment, what helps?

Spontaneous urine leakage in women is not an uncommon condition.
Why does it occur?
How can it be influenced and treated?
How can not only experienced but also young women help themselves?

Urine leakage is a social and hygienic problem. It affects women in particular to a large extent. It does not avoid younger women or women who are active in sports. It can lead to loss of self-confidence, embarrassment and even depression.

Involuntary leakage of urine is technically called incontinence. It occurs not only in the elderly, but also in young people or even in people who are active in sports.

This problem will not resolve itself. However, do not become desperate or depressed. The sooner you see a doctor, the more effective the treatment.

Incidence of incontinence in women in the table

According to some estimates, up to 50% of women are thought to have experienced occasional urine leakage. Up to 20% of them required treatment.

Incontinence affects more than 15% of the population in the country. It can occur at any age.

Causes or factors influencing the development of incontinence include:

• pelvic surgery
• certain injuries
• tumour
• age
• childbirth
• obesity
• urinary tract infections
• faecal incontinence

Urinary tract infections are a particular problem for women. Read also our magazine article:
Urinary tract infections are a particular problem for the fairer sex in summer

Types of incontinence

Urinary leakage is divided into several types, which differ from each other in manifestation and cause. Some are typical for a certain age or gender.

Classification of incontinence according to the International Society of Incontinence (table)

Transient incontinence can also be caused by medications such as certain hypnotics, diuretics, spasmolytics or antiparkinsonian drugs.

Incontinence is classified into three grades according to severity (Ingelmann-Sundberg classification)

1. Grade - droplet leakage with increased intra-abdominal pressure
2. grade - leakage with minimal increase in intra-abdominal pressure
3. grade - constant leakage, unrelated to physical activity

Learn what else can lead to an inability to hold urine.

Urgent urinary incontinence

Affects men and women in the post-menopausal period. It is also often associated with the term overactive bladder.

Urinary leakage is accompanied by a sudden, urgent feeling to urinate. Frequent daytime and nighttime urination also occur. Causes that trigger urge incontinence may include urinary tract infections, a tumor or an enlarged prostate.

Stress incontinence

This is the spontaneous, passive passage of urine when the intra-abdominal pressure is increased. It mainly affects women. It occurs when the pressure in the bladder exceeds the strength of the bladder sphincter. It occurs most often between the ages of 45 and 55.

It is typically caused by leakage of urine when lifting heavy objects, coughing or sneezing. It is associated with hypermobility of the urethra or weakening of the urethral sphincter. The most common causes include weakening of the pelvic floor, for example by frequent childbirth.

Other causes may be a decrease in sex hormones at menopause, weakening of the sphincter or a condition after trauma.

Mixed incontinence

It is a combination of stress and urge incontinence. It often occurs in the elderly.

Reflex incontinence

It is caused by nerve diseases. It irritates the reflex that is responsible for excretion. It manifests itself in uncoordinated and intermittent urination.

Incontinence from overflow

It is caused by impaired contractility (tightness) of the bladder. Due to overfilling of the bladder, frequent or even continuous urine outflow occurs.

Warning signs of incipient incontinence

Don't take occasional incontinence and its accompanying symptoms lightly. They won't go away on their own. On the contrary - they are likely to get worse. So don't hesitate to put yourself in the hands of a urologist who, if caught early, can solve or at least alleviate your incipient problem.

Phenomena that can lead to incontinence:

• frequent daytime and nighttime urination
• frequent urinary tract infections
• frequent constipation
• intense and urgent urinary urgency
• urge to urinate even with a small bladder filling
• leakage of urine in a horizontal position
• inability to interrupt the flow of urine
• occasional leakage of urine when coughing or sneezing

Urinary leakage and menopause

Hot flushes, urinary tract infections, sleep problems, as well as unwanted urine leakage. These are just some of the inconveniences experienced by almost every woman during menopause.

Climacterium is the name given to the period when there is a gradual decline in ovarian function. Associated with this is menopause, which is the term for the loss of regular menstrual bleeding.

You may also be interested in the article.

Hormonal changes, such as a drop in estrogen levels, also affect the abdominal and pelvic muscles. These are weakened by these changes.

Since the pelvic floor muscles are involved in controlling the bladder, their weakening is also reflected in the urination and the entire excretory system. Frequent urges to urinate or difficulty holding urine may occur. The position and elasticity of the bladder also change, which also affects the control of excretion.

Other factors that contribute to incontinence during menopause include frequent urinary tract infections caused by increased mucosal dryness.

Weight gain is also often present during menopause, another factor that affects the already weakened intra-abdominal and pelvic floor muscles.

Pregnancy-related urine leakage

The changes in a woman's body that occur during pregnancy also affect the ability to retain urine. Of course, the weight of the fetus also matters.

Even childbirth affects the strength of the bladder and pelvic floor. The degree of impairment depends on the method and duration of the birth itself. In particular, repeated births in short succession weaken the pelvic floor and the support apparatus of the urethra, which can result in unwanted urine leaks.

Incontinence also affects young women

Urinary leakage also occurs in young women. Quite often, it can bother even the fit ones.

How is this possible?

Excessive physical exertion puts a lot of pressure on the muscles of the pelvic floor. These are overstretched and subsequently weakened. This is especially the case in strength sports such as crossfit or fitness.

This can also include sports where jumps are frequent, such as volleyball or basketball. Thus, regular intense physical exertion can also be the cause of a leakage problem.

Diagnosis of incontinence in women

In today's age of examination methods, incontinence can be objectively evaluated and thus proceed to appropriate treatment.

The medical history, i.e. the interview with the patient, is important for the diagnosis. Previous problems, as well as the social situation and workload, are examined. Previous illnesses are also important.

The doctor may ask you to fill in a so-called micturition diary, where you record information such as fluid intake or the number of episodes of incontinence. This will provide clearer information about the intensity and nature of the disease.

Information about the incontinence itself may include information about the nature and type of activity during which urine leaks. The frequency and amount of involuntary urine leakage are also important.

A gynaecological examination is also important. This assesses the shape of the external urethra or signs of inflammation. It also looks for possible muscle weakness in the genital area and pelvic floor.

In women, the elasticity of the urethra is an important factor.

The doctor may ask you to do things such as coughing or pushing on the pelvic floor. Many examination procedures can be uncomfortable for the patient and cause a feeling of shame.

However, these methods are needed for the doctor to assess urine leakage and the strength of pelvic floor tightness. Rehabilitation exercises are then based on this.

Urinalysis may point to a urinary tract infection, i.e. inflammation of the urinary tract. These inflammations are common in women and are one of the factors influencing or even triggering the development of incontinence.

There are several methods and examination procedures that can be used to determine the anatomical condition of the ureter or the urine flow. The aim of the examination is to confirm the presence of incontinence, determine the type, cause and subsequent treatment.

Treatment of incontinence in women

In the first instance, do not hesitate to contact your doctor at the first sign of incontinence. The sooner you seek professional help, the greater the likelihood of successful treatment.

Since this is an intimate problem, many women procrastinate. This is the most common mistake they make.

Certain measures are recommended for women who suffer from urinary leakage. These include lifestyle modifications, limiting caffeine, cigarettes or weight management for obesity.

Obesity increases intra-abdominal and intravesical pressure - the pressure in the bladder. Fat deposits stretch and weaken the pelvic floor.

After the condition is evaluated by a physician, certain measures and treatment are approached. The solution may be surgical or non-surgical - i.e. conservative.

With conservative treatment, the most common problem is the low cooperation of patients, who are often discouraged by the time involved.

For incontinence occurring at the menopause, estrogen treatment is increasingly used. In this period, the lack of estrogen in a woman results in a weakening of the bladder, urethra and vagina. The mucosa is more prone to damage and inflammation.

Other drugs that the doctor may prescribe include so-called anticholinergics, beta 3-mimetics or duloxetine.

What helps with urine leakage besides medication?

Exercises to strengthen the pelvic floor

The pelvic floor and part of the urethra are made up of striated muscles. These are muscles that are controlled by willpower. When exercised regularly, they become stronger, just like other muscles. Results are usually seen after about 2 months of regular exercise.

Exercises of this nature can be a kind of strengthening and prevention. However, they are no substitute for a visit to the urologist when the problem is genuine and exercises of this kind require the cooperation of a specialist physiotherapist.

Incontinence problems belong in the hands of a doctor. If they occur, do not hesitate to contact professional help. The exercises we present are not a substitute for a visit to a doctor.

Pelvic floor strengthening exercises:

Exercise 1

During urination, try contracting your muscles to stop urinating. If you have succeeded, you have mastered the first exercise. You can practise this muscle contraction throughout the day, but outside of urination so as not to interfere with its progress.

Exercise 2

Try to tighten the rectum. You can check that this exercise is correct by placing your finger on the perineum, the area between the rectum and the genital organ. Watch for movement.

Exercise 3

Withdraw the vagina. Again, check the effect with a finger that you gently insert into the vagina. Later, it is no longer necessary to check the effectiveness of the exercises in this way. After the first exercise, you will understand the system and mechanism of these exercises.

Exercise 4

Kneel down and sit on your heels. Raise your arms above your head and slowly raise yourself up. Later you can move your pelvis sideways as well as forwards and backwards.

Exercise 5

Sit down and put a ball between your feet and squeeze it.

Exercise 6

Sit on a chair and put a smaller ball between your knees. Squeeze the ball with your knees.

Incontinence aids

Last but not least, there are a number of special incontinence aids on the market to make life with this health problem easier. Many hygiene aids offer comfort, a feeling of dryness and eliminate unwanted odours.

Overcoming the feeling of shame and living a full life is possible thanks to modern sanitary aids. Of course, you can seek advice and information from your doctor or pharmacist.