Will incontinence get worse over time?

Urinary leaking has become a common problem among women, but will incontinence get worse over time?  Urinary leaking can occur in different circumstances and different amounts. Often it begins either as a small issue that is easily ignored, or it begins after a specific event such as childbirth. In both cases, the most common response women have is to ignore the symptoms and tell no one.

Once the leaking becomes problematic enough to potentially be evident to others, additional measures may be implemented. Measures like

• Stashing extra clothes in case their clothing gets wet.
• Crossing their legs when they sneeze, cough, or laugh.
• Using panty liners or pads to collect leaking urine.
• Going to the bathroom more often, just in case.

All of these measures help keep symptoms from being discovered, But they don’t address the reason for leaking in the first place.

There can be many causes for urinary leaking. How the symptoms progress depends on the root cause. But in many cases, the symptoms WILL progress, slowly, over time. Unless an intentional correction is made.

Peri-menopause can cause leaking to get worse

Perimenopause is the period leading up to menopause, during which a woman’s hormones begin to fluxuate, and her body begins to undergo changes.

One of the effects of perimenopause is that the tissues of the vagina and urinary tract can become thinner and less flexible, making them more prone to irritation and injury. This can lead to urinary leaking, as well as other symptoms such as vaginal dryness.

Incontinence can get worse over time with poor pressure management.

In some cases, how a woman uses the muscles in her core and trunk can significantly affect the pressures that build up around the bladder and the pelvic floor. Building pressure in the abdomen that pushes downward can affect the position of the bladder, the pressures on the bladder as it fills, and the ability of the pelvic floor muscles to provide closing pressure.

Unintentional habitual pressure on the bladder and pelvic floor can overwhelm the body’s ability to close the urethral opening. And create other urinary problems as well such as dribbling after voiding, or incomplete emptying.

Leaking due to ligament laxity

Ligament laxity can begin for a variety of reasons. Changes in ligament length can begin to compromise the support system inside the pelvis that holds up the bladder and urethra.

This lack of support allows the bladder and urethra to drop down and change the position of the tissue around the urethral opening, making it more difficult to close. Ligament laxity increases with a variety of factors including:

• Multiple births
• Weight gain
• Poor posture
• Pelvic Surgeries (ie. hysterectomy)
• Gravity
• Smoking
• Chronic coughing

Ligaments that have stretched decrease the stability of the pelvic ring and the organs inside over time.

Pelvic Floor Muscle Dysfunction and increased urinary leaking

The pelvic floor muscles are directly involved in the opening and closing of the urethra. If the muscles and surrounding fascia becomes too tight and inflexible it cannot expand to allow the muscles to create closing pressure, if the muscles are too weak, they cannot generate the pressure needed to close the urethra.

Pelvic floor muscles need to be able to both lengthen and contract to work properly. If they develop a pattern of dysfunction, that pattern can build, making symptoms worse.

It is important to recognize that urinary leaking can worsen over time if not properly addressed. Perimenopause, Muscle dysfunction, poor pressure management, ligament laxity, and pelvic floor dysfunction are a few of the possible problems that contribute to urinary leaking. If you are experiencing urinary leaking, reach out to your medical practitioner or a pelvic floor physical therapist to help you identify YOUR contributing factors and help develop treatment to prevent worsening of your symptoms. With the right approach, you may be able to significantly improve your control of urinary leaks.

My practice is in Winston Salem NC. I see some patients virtually, but in-person is even better.

I am located at 501 Shepherd St. Winston Salem NC 27103. For more information, or to schedule an appointment please call the office at 336-414-2050, or email us at office@reliefpt.com.