6 Things Most Women Over 50 Are Never Told About Bladder Leaks
It's one of the most common health issues for women after 50, and one of the least talked about. Here's what the research actually says.
She plans her errands around which stores have a restroom near the entrance. She reaches for the dark pants more often than she used to. She laughs a little more carefully at dinner with friends.
And she has never mentioned any of it to her doctor.
If that picture feels familiar, she is far from alone. Bladder leaks affect millions of American women, yet most of them deal with it quietly, on their own, for years.
1It's far more common than anyone admits
In a national poll of more than 1,000 women aged 50 to 80, run by the University of Michigan with AARP, nearly half said they had experienced urine leakage.[1]
Yet two-thirds of the women with leaks had never talked to a doctor about it.[1] Which means most women who live with it assume they are the only ones.
2"Just part of getting older" is a myth
Many women see leaks as a normal side effect of age, something to put up with. The experts behind the poll disagree. One of the University of Michigan doctors involved called incontinence "not an inevitable part of aging."[1]
Leaks become more common with age. That's not the same as being normal. And that difference matters, because what is considered normal rarely gets looked at.
3Most women quietly reorganize their lives around it
The same poll shows how women cope:[1]
- 59% buy special pads or undergarments
- 16% cut back on how much they drink
- 15% change what they wear to hide accidents
About one-third of the women with leaks have an episode almost every day, and nearly half worry it will get worse with age.[1] Coughing, sneezing and laughing are the most common triggers, along with not reaching a restroom in time.
Curious about the newer research on bladder health?
Watch the Free Video →4Kegels help, but only when they're done right
Pelvic floor exercises (Kegels) are one of the most common recommendations, and 38% of the women in the poll had tried them.[1]
But they are harder to do correctly than they sound. In a well-known study published in the American Journal of Obstetrics & Gynecology, only about half of the women given brief verbal instructions performed an ideal Kegel. About 1 in 4 used a technique that could actually make leaks worse.[2]
A pelvic floor physical therapist can check your technique, often in a single visit.
5Menopause changes the tissues around the bladder
As estrogen levels drop after menopause, the tissues of the urinary tract change too. Doctors call this the genitourinary syndrome of menopause. Its possible symptoms include urgency, needing to go more often, and repeated urinary tract infections.[3]
It is common, it is underdiagnosed, and there are effective treatments, which is one more reason to bring it up at the next appointment.
6The bladder isn't sterile, and scientists are paying attention
For a long time, healthy urine was believed to be sterile. Researchers have since found that this isn't the case. The bladder has its own community of bacteria, now called the urinary microbiome.[4]
A 2014 study published in the journal mBio compared women with and without urgency incontinence. Their urinary bacteria were different: for example, women with urgency incontinence had less Lactobacillus, a type of bacteria generally considered beneficial.[4]
Researchers are still working out what this means. But it has opened a new way of looking at bladder health, beyond muscles alone.
Want to learn more about the urinary microbiome?
A free video presentation goes deeper into the urinary microbiome and bladder health in women, and introduces a supplement with probiotics developed around this idea.
Whatever you decide, don't stay silent
- Leaks are a medical issue, not a personal failing. Bring them up with your doctor, even briefly.
- Ask whether pelvic floor physical therapy is right for you.
- If your symptoms change suddenly, or you see blood or feel pain, see a doctor promptly.
- University of Michigan National Poll on Healthy Aging / AARP (2018). Half of women over 50 experience incontinence, but most haven't talked to a doctor.
- Bump RC et al. Assessment of Kegel pelvic muscle exercise performance after brief verbal instruction. American Journal of Obstetrics & Gynecology, 1991. PubMed.
- Genitourinary syndrome of menopause: common problem, effective treatments. Cleveland Clinic Journal of Medicine, 2018. ccjm.org.
- Pearce MM et al. The female urinary microbiome: a comparison of women with and without urgency urinary incontinence. mBio, 2014. PubMed.