More than 423 million adults around the world suffer from some form of urinary incontinence (UI)1. Taking a closer look at the figures, it shows that more than 12.4% of all women have UI, as opposed to just over 5% of men. So, why do more women than men have UI, and what makes them more likely to get it? We will answer those questions here, as well as offer solutions for improving the lives of women with UI.
Pregnancy and Childbirth
As a matter of fact, for over a third of mothers, UI is a natural consequence of pregnancy and childbirth. Developing foetuses put pressure on the bladder, while vaginal birth weakens the pelvic floor muscles2. It is no wonder that over half of pregnant women report stress UI in the third trimester, or that over 20% of women who deliver vaginally report postpartum UI3,4.
The stress and stigma surrounding UI can make motherhood less enjoyable, especially for new mothers. However, there is research that suggests that regular pelvic floor muscle training during and after pregnancy helps to reduce UI symptoms5.
UI affects about 33% of older women, but only about 15% to 20% of older men6. Why? Some experts say that the difference lies in menopause.
All women undergo menopause, usually between the ages of 45 and 55. It is characterized by a drop in oestrogen and progesterone, as well as a loss of menstrual periods and fertility. The hormonal changes in menopause also cause some women to experience hot flashes, night sweats, and irritability7.
According to a recent survey, between 8% and 27% of menopausal women also experience UI as part of their symptoms8. The lining of the urethra thins and the pelvic floor muscles weaken, leaving women more prone to leaks9. And while some experts think that the oestrogen receptors in the urinary tract play a role in this degenerative process, the link between menopause and UI remains unclear: oestrogen therapy does little to improve UI symptoms in menopausal women10.
Pelvic floor muscle training, urinating before sex and avoiding tight trousers have been shown to alleviate UI symptoms in menopausal women. Nevertheless, more research is needed before we can truly determine why menopause brings UI to so many women.
Increased Risk of UTIs
Women are 30 times more likely than men to get UTIs, and between 40% and 60% of women experience a UTI in their lifetime11,12. This is primarily due to the fact that a woman’s urethra is shorter than a man’s, which allows bacteria to pass more easily into the bladder and cause infection13. Female urethras are also closer to the rectum and the vagina, both of which contain bacteria that could cause a UTI.
One of the most common symptoms of a UTI is urge UI, or the sudden and strong need to urinate14. Individuals with a UTI may also have to urinate more frequently than normal or feel a burning sensation when they urinate.
Unlike UI caused by pregnancy, childbirth, and menopause, UI as a result of a UTI normally resolves after the UTI has been treated with antibiotics. Prevention differs as well, as it consists of preventing UTIs rather than UI. Cranberry juice has shown to decrease UTIs in women over a 12-month period, especially in women who have recurring UTIs15. Other common prevention tips are drinking plenty of water, avoiding constipation, and urinating regularly.
Solutions for Women with UI
Stigma still surrounds UI in women. Several studies have shown that women with UI are likely to establish stricter routines that assure them access to a bathroom, sacrificing hobbies and friendship16. Likewise, women with UI are also more likely to develop mental health disorders, such as depression, due to the stress associated with their condition17.
But it doesn’t have to be this way. At iD, we strive to give businesses, professionals, caregivers, and individuals the resources necessary to give those with UI a better quality of life. For women especially, our iD Light pads offer maximum absorption without the bulk. And as for absorbent underwear, our iD Intime pants provide security and comfort with a smooth, breathable, real-underwear feel.
1 I. Milsom. “How big is the problem? Incontinence in numbers.” Gothenburg Continence Research Center, 2018. Source: http://www.gfiforum.com/Upload/43b34997-7408-4fa6-9547-72488e668060/I%20Milsom%20-%20Incontinence%20in%20numbers.pdf
2 G. Rortveit, A.K. Daltveit, Y.S. Hannestad, & S. Hunskaar. “Urinary Incontinence After Vaginal Delivery or Cesarean Section.” The New England Journal of Medicine, 2003. Source: https://www.nejm.org/doi/full/10.1056/NEJMoa021788
3 S. J. Brown, S. Donath, C. MacArthur, E. A. McDonald, & A. H. Krastev. “Urinary incontinence in nulliparous women before and during pregnancy: prevalence, incidence, and associated risk factors.” International Urogynecology Journal, Feb. 2010. Source: https://link.springer.com/article/10.1007/s00192-009-1011-x#Sec9
4 G. Rortveit, A.K. Daltveit, Y.S. Hannestad, & S. Hunskaar.
5 S. Mørkved & K. Bø. “Effect of pelvic floor muscle training during pregnancy and after childbirth on prevention and treatment of urinary incontinence: a systematic review.” British Journal of Sports Medicine, 2013. Source: https://bjsm.bmj.com/content/48/4/299.short
6 J. Lazare. “No Gender Discrimination: Urinary Incontinence Affects Both Men and Women.” Aging Well, 2011. Source: https://www.todaysgeriatricmedicine.com/archive/fall2011_p14.shtml
7 J. Huizen. “Everything You Should Know About Menopause.” Healthline, 17 Jan. 2019. Source: https://www.healthline.com/health/menopause
8 G. Legendre, V. Ringa, A. Fauconnier, & X. Fritel. “Menopause, hormone treatment, and urinary incontinence at midlife.” Maturitas, Jan. 2013. Source: https://www.sciencedirect.com/science/article/pii/S0378512212003386
9 “Urinary Incontinence.” Menopause.org, n.d. Source: https://www.menopause.org/for-women/sexual-health-menopause-online/causes-of-sexual-problems/urinary-incontinence
10 L. E. Waetjen & P. L. Dwyer. “Estrogen therapy and urinary incontinence: what is the evidence and what do we tell our patients?” International Urogynecology Journal, Oct. 2006. Source: https://link.springer.com/article/10.1007/s00192-006-0080-3
11 C. W. Tan & M. P. Chlebicki. “Urinary tract infections in adults.” Singapore Medical Journal, Sep. 2016. Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5027397/
12 A. Al-Badr & G. Al-Shaikh. “Recurrent Urinary Tract Infections Management in Women.” Sultan Qaboos University Medical Journal, Aug. 2013. Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3749018/
13 “Urinary Tract Infection.” American Academy of Family Physicians, n.d. Source: https://familydoctor.org/condition/urinary-tract-infections/
14 “Urge incontinence.” Continence Foundation of Australia, n.d. Source: https://www.continence.org.au/pages/urge-incontinence.html
15 R.G. Jepson & J. C. Craig. “A systematic review of the evidence for cranberries and blueberries in UTI prevention.” Molecular Nutrition and Food Research, 2007. Source: https://onlinelibrary.wiley.com/doi/abs/10.1002/mnfr.200600275
16 K. S. Coyne, M. Kvasz, A. M. Ireland, I. Milsom, Z. S. Kopp, & C. R. Chapple. “Urinary Incontinence and its Relationship to Mental Health and Health-Related Quality of Life in Men and Women in Sweden, the United Kingdom, and the United States.” European Urology, Jan. 2012. Source: https://www.sciencedirect.com/science/article/pii/S0302283811007871
17 N. Y. Siddiqui, P. J. Levin, A. Phadtare, &. R. Pietrobon. “Perceptions about female urinary incontinence: a systematic review.” International Urogynecology Journal, 2014. Source: https://link.springer.com/article/10.1007/s00192-013-2276-7