Stress Continence – Myths & Facts

Stress incontinence is a common form of continence and often experienced by women over the age of 40, with as many as 1 in 5 women over this age having some degree of the condition. In a 2016 talkhealth survey of 1,200 women interested in bladder continence, 66% said they experience bladder leakage when they cough or laugh.

There are lots of health conditions that can cause stress continence such as chronic coughing, smoking, obesity, diabetes, old age, pregnancy, child birth and menopause.

Stress Continence is usually caused by weak muscles that are used to prevent urination (including the pelvic floor muscles and the urethral sphincter). When the bladder is put under pressure (such as when you cough, laugh, sneeze or exercise) the bladder cannot withstand the pressure and as a result urine leakage can occur.

There are many myths surrounding stress continence, with 5 of the most common ones below!

Myth 1 - Small bladders lead to problems - FALSE.

There is no such thing as a small bladder as everyone’s bladder is about the same size (unless you’ve had surgery to reduce the size of your bladder for some reason, eg cancer). The typical human bladder has a capacity to hold about 1-1.5 pints of urine, stretching in size from about 2 inches to 6 inches long. Any leakage of urine will be down to muscle weakness, an infection or some sort of neurological condition and not because your bladder is small!

Myth 2 - If you drink less it will help – FALSE.

It’s never a good idea to cut back on fluids as it can lead to dehydration. Yet in the talkhealth bladder survey 54% said they avoid drinking too much to limit the number of times they need to go to the toilet. Perhaps try drinking more fluids when you are in easy reach of a toilet to avoid any accidents. Experts agree that certain drinks will aggravate incontinence, so it’s best, if possible, to avoid or reduce caffeine, fizzy drinks, fruit juices, some herbal teas and alcohol.

Myth 3 - Holding on and not going for a wee can cause continence issues – FALSE.

If you hold on for a wee it’s not going to lead to incontinence. In fact, some experts believe holding on for a wee if you do have incontinence problems can help to train the bladder to work more efficiently.

Myth 4 - Pelvic floor exercises only work for women – FALSE.

Experts also recommend pelvic floor exercises for men as well as women. They can be done anywhere: standing, squatting or lying down. (See below for information on how to do pelvic floor exercises.) Despite experts recommending pelvic floor exercises the talkhealth survey that 49% of participants do not undertake pelvic floor exercises to help with their incontinence.

Myth 5 - You just have to learn to live with stress continence – FALSE.

There are a number of non-surgical treatments available, and if these don’t work then there are options to have a surgical procedure.

Some of the treatments to consider which may help your stress continence include:

  1. Lifestyle changes – these may include reducing your caffeine intake, and the amount of fluid you drink (and could mean drinking more or less). If you are overweight, you might want to consider losing weight. Carrying extra weight, especially around the middle puts stress and pressure on the muscles of the pelvic floor which can lead them to become weak and saggy. As a result, urine leakage may be experienced.

  2. Pelvic floor training – your pelvic floor muscles play an important role in controlling the flow of urine. If you talk with your doctor, they will be able to provide you with an exercise programme designed to strengthen the pelvic floor muscles. You can try the following exercises which may help:

    - Squeeze in the muscles around your back passage (as if you are trying to stop yourself from passing wind)
    - Then squeeze the urethra muscles (as if stopping your wee)
    - Hold this in for a count of 10 then relax for a count of 10
    - Work up to three sets of 8-10 repetitions each day

    If you find it difficult to remember when to do these exercises, try doing them on the way to/from work (if you drive) when stopped at traffic lights. Or maybe as part of your morning routine when you’ve showered and are cleaning your teeth. Soon, the exercises will become habit forming.

    There are lots of pelvic floor toners available to buy that monitor and provide feedback on your pelvic floor exercises, which you may find motivational.

  3. Incontinence products – there are lots of pads and liners available to help with stress continence whether that’s every day, or just when you exercise, for example. These can help to avoid those embarrassing leaks.

  4. Medication – if your stress continence is not improving or if it’s getting worse, you should talk to your doctor as there are prescription products that may help.

  5. Surgery - there are a number of different types of surgery available which include Tapes (a tape inserted into the vagina which is used to hold the urethra in the correct position, reducing the leaks), Colposuspension (a procedure to lift the neck of the bladder and stitching it in position) and urethral bulking agents (a substance injected into the walls of the urethra in women which increases the size of the urethral walls allowing the urethra to stay closed with more force).

When considering a treatment for your stress incontinence, it is advisable to make an appointment with your doctor to discuss the options. Your surgery or clinic may also have a doctor with a special interest in urology, or men’s or women’s health, so it’s worth asking when you telephone to make an appointment if you can see a doctor with a special interest.

You may like to talk to others who are also living with stress continence in the talkbladder forum, which is free to join.

Information contained in this Articles page has been written by talkhealth based on available medical evidence. The content however should never be considered a substitute for medical advice. You should always seek medical advice before changing your treatment routine. talkhealth does not endorse any specific products, brands or treatments.

Information written by the talkhealth team

Last revised: 18 September 2017
Next review: 18 September 2020