There are physical outcomes of urinary incontinence, like rashes or an increased risk of urinary tract infections.
What about the mental health impacts of stress urinary incontinence? This condition, which is when urine leaks following pressure on the bladder—like that caused by coughing, sneezing, laughing, exercising or lifting something heavy—also impacts quality of life. Social, work and personal relationships can be affected.1
Here are the mental health impacts of incontinence, and what you can do about them.
What is SUI?
SUI, or stress urinary incontinence, is one form of the condition known as incontinence. Since continence is the ability to control your bladder and bowel, incontinence is the involuntary loss of bladder and bowel control.2 While we are referring specifically to stress urinary incontinence, there are certainly mental health impacts for anyone dealing with any form of incontinence.
In the case of the involuntary loss of urine, known as urinary incontinence, there are different types:1
1. Stress urinary incontinence: leakage when you exert pressure on your bladder by coughing, sneezing, etc.
2. Urge incontinence: when you have a sudden, intense urge to urinate followed by an involuntary loss of urine. That might mean needing to pee often, or through the night.
3. Overflow incontinence: when you experience frequent or constant dribbling because your bladder doesn’t empty completely.
4. Functional incontinence: when a physical or mental condition keeps you from making it to the toilet in time. One example is when severe arthritis prevents you from unbuttoning your pants quickly enough.
5. Mixed incontinence: when you have more than one condition, most commonly stress and urge incontinence.
Some people also suffer from fecal incontinence, the involuntary loss of feces from the bowel.
Why Does SUI Happen?
To understand why incontinence occurs, it helps to know how the urinary system works.
Urine is stored in your bladder, an organ of elastic tissue that stretches as it fills. When it’s time to pee, muscle fibers squeeze to empty it.
The urethra is the tube that carries urine out of your body, and it is surrounded by sphincter muscles that keep it closed and keep the urine inside the bladder.
The pelvic floor consists of muscles and tissues that hold your bladder and urethra in place within the pelvis—along with other important pelvic organs.
When it’s time to pee, your brain lets your bladder know it’s time. The muscles contract while the sphincter muscles of your urethra relax and open. Pee comes out through the urethra and the bladder is emptied.
Stress urinary incontinence happens when urine leaks out due to sudden pressure on the bladder and urethra, causing the sphincter muscle to open briefly. It can happen in mild cases with sudden forceful activities—like exercising, sneezing, laughing or coughing—but in more severe cases it may leak with something as simple as standing up or bending over.3
Here’s another way to think of it: Urologist David Ginsberg from the Keck School of Medicine of USC explains that the bladder is like a reservoir, and the muscles that control urine’s exit are like the dam.4
In the case of stress urinary incontinence, there are risk factors like being overweight, smoking and family history. Women are more likely to have this condition largely due to pregnancy, childbirth, menopause and normal female anatomy.
For instance, a vaginal delivery of your child can weaken the muscles needed for bladder control and damage the supportive tissue of the pelvic floor. After menopause, women produce less of the hormone estrogen, which helps keep the lining of the bladder and urethra healthy.1
The Mental Health Impacts Of SUI
It’s estimated that 1 in 3 women suffer from stress urinary incontinence at some point in their lives. Besides physical side effects like the possibility of urinary tract infections, there are many other impacts. People with incontinence often limit social outings, worried about being near a bathroom or being embarrassed about a leak in public.
They may stop exercising, playing sports, or change the way they live in some other way. They may change relationships with friends and family, be uncomfortable with their body, and even avoid sex because they are worried they will leak and be embarrassed.3
Here are some research findings on the mental health impacts of SUI:
- Incontinence can indirectly affect the physical, psychological and social aspects of both men and women because it may significantly interfere with family and social life.5
- SUI has a negative impact on quality of life in both the physical and mental health domains. Along with some other urinary dysfunctions, it is an independent risk factor for anxiety and depression and may cause significant work limitations.6
- Women with SUI had a “significantly higher” prevalence of symptoms of anxiety and depression and worse health-related quality of life on all domains.7
- Psychological harm caused by urine leakage during sexual intercourse may decrease women’s sexual interest and behavior, and may actually affect the sexual function of their male partners.8
Finally, one study concluded that “almost inevitably every form of incontinence has psychological consequences.” Researchers stated that shame and insecurity result from the involuntary leaks, which in the long term can lead to avoiding social contacts and possibly to depression and isolation.
The same study placed importance on consideration of a woman’s psychosomatics—which means her physical illness or condition being aggravated by mental factors like stress. Taking that into account is important because it can make a treatment plan more effective.9
What Can I Do About SUI?
That’s a snapshot of how worrying about incontinence impacts the lives of many women. Despite these negative effects, many women still do not seek treatment.6
So what can you do about your SUI? The first step is to understand that incontinence is not a natural part of aging, or of having children, or of being a woman! There are treatment options available, so it’s vital to see a doctor to have your incontinence properly diagnosed and treated.
Here’s one way.
Remember our example of the bladder being a reservoir and the muscles controlling urine’s exit being a dam? The dam can be built up! 4 Strengthening the muscles in the pelvic floor can help.
Pelvic floor muscles exercises like Kegels are proven to help. These are sometimes done following training by a pelvic floor physical therapist or consultation with a pelvic floor occupational therapist.
Research has proven that pelvic floor exercises help keep pelvic floor muscles “fit,” and can be used as an effective treatment for women suffering with stress urinary incontinence. In fact, pelvic floor exercises are a benefit in treating other conditions like pelvic organ prolapse, and can also be incorporated into your exercise program to prevent these types of pelvic floor issues.
There are also products available to non-invasively treat incontinence by helping you perform Kegels correctly. The INNOVO Urinary Incontinence Kit—cleared by the FDA—is a pair of “smart shorts” designed to strengthen your pelvic floor muscles from the inside out. Using the kit, you perform 180 perfect Kegels in 30 minutes. Subscribe to the INNOVO newsletter to receive a $20 discount code for your purchase!
A clinical study guided by the FDA had amazing results: 87% of women were defined as dry after just 12 weeks, and 90% of users would recommend the therapy to others.
Some medications may help, but there are other alternative therapies to treat stress urinary incontinence too. Products and devices can help manage the symptoms, such as absorbent pads, a pessary (a vaginal insert designed to help SUI), or a urethral insert, a small tampon-like disposable device inserted into the urethra to act as a barrier to prevent leakage.
There are also medications available, and in some instances, surgery is suggested. The most common procedure is known as the sling procedure, in which a surgeon uses mesh to build a sling or hammock that supports the urethra.
Urethral slings have several advantages that have made them among the most common types of surgery to correct SUI. This procedure can be completed in as little as 30 minutes, with discharge typically occurring the same day. There’s minimal pain and the recovery time is short.10
You may feel uncomfortable or embarrassed discussing incontinence. But if it’s frequent or is affecting your quality of life, it’s important to seek medical advice. Don’t let urinary incontinence cause you to restrict your activities, limit your social interactions, and negatively impact your quality of life. There’s even a risk of falling as you rush to the toilet, or it could be an indication of a more serious underlying condition.1
Get Help for Your SUI
Don’t suffer in silence with incontinence. Stress urinary incontinence can negatively impact your life, so don’t hide your symptoms from your physician. There are treatment options available, so use our Physician Finder to find a doctor near you with expertise in women’s health, who can diagnose your incontinence and set you on a treatment path.
