Is incontinence inevitable as you get older?

Q: I am a postmenopausal 63-year-old woman. I am wondering if the fate of all women my age and older is to wear pads for leakage.

A: Women have told me that when they brought up their incontinence to previous providers, they were told it was a “normal” part of ageing. Imagine if we treated everyone who needed glasses with shame and told them their visual impairment was something they had to live with. Urinary incontinence, the involuntary leakage of urine, is a common and distressing problem for many women of all ages.

There are two main types:

Stress Urinary Incontinence

The loss of urine with physical activity, coughing or sneezing.

Overactive bladder 

This is the strong, sudden urge to empty the bladder with or without leaking urine. There are many therapies for incontinence, from bladder training to surgeries. Making a recommendation for a therapy without a medical history isn’t possible. But here are some basics to know.

— See a medical provider to arrange a urine test and rule out a bladder infection, as this can be a cause of incontinence.

— Be mindful of how much water you drink — the need to drink eight glasses a day is a myth. The more you drink the more you have to empty.

— Wear incontinence pads, not menstrual pads. A menstrual pad (or period underwear) is likely to keep urine next to the skin, which can cause irritation, itching and even skin breakdown.

— Try pelvic floor muscle exercises, also known as Kegel exercises. Some women can learn to do them on their own and others may need help from a pelvic floor physical therapist.

— Weight loss can help reduce leaking for women who are overweight.

— Get a diagnosis. Many gynaecologists, urologists and primary care providers are very knowledgeable about urinary incontinence, but a urogynecologist may be needed for anyone having difficulty getting help and for those with more challenging incontinence issues.

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