The Truth about Incontinence Leaks Out

Do you ever leak or dribble urine when you stand up after sitting for a while? Do you have trouble holding your urine when you lift a bag of groceries or other heavy items? You may think this happens because you are "out of shape," but even top athletes can have the type of leaking called incontinence.

Urinary incontinence is defined as the uncontrolled loss of urine; in other words, the person can't hold back the urine before getting to a restroom. Women are affected more often than men, but both sexes can have this problem.

The most common type of urinary incontinence is stress urinary incontinence (SUI). This is loss of urine during coughing, sneezing, laughing, running, jumping, heavy lifting, exercise, or a sudden change of positions. Another type of urinary incontinence is called urge incontinence. Urge incontinence is loss of urine that happens when there's a strong desire to urinate (called urgency). These two types of incontinence can occur alone or together. When a person has both types, they have mixed incontinence.

The bladder is the body's holding tank for urine. The urine collects in the bladder until the bladder is full enough to signal the urge to go to the bathroom. When the muscles and ligaments that help hold and support the bladder (pelvic floor muscles) become injured, weak, or overstretched, urine can leak out in small--or sometimes large--amounts.

Loss of urine can happen in anyone's life at any age, but it is most common in women after childbirth and in men after prostate problems. Recently, a large number of young, physically fit women who had not had babies were found to have urine leakage. If this problem was not caused by muscle weakness after pregnancy, why would athletic women have urinary leakage?

In the past, some people thought incontinence in female athletes was caused by exercising too much, eating disorders, or a combination of both. These can cause hormonal changes that affect the muscles of the pelvic floor. In particular, decreased amounts of the hormone estrogen can cause the muscles to lose their tone (muscle tightness). The result is poor support of the bladder with leakage of urine.

Researchers used surveys and interviews to ask about incontinence among women who were college athletes. The results were compared with those of women in the same age range (15 to 39 years) who were not athletes.

After studying 660 female athletes on college national teams and 765 nonathletes, it was discovered that symptoms of both stress and urge incontinence occur in female athletes. In fact, athletic women were more likely to have both kinds of urinary incontinence than nonathletic women of the same age. There was one difference between the two groups. The frequency of incontinence was much higher in athletes who had eating disorders such as anorexia (loss of appetite and refusal to eat).

The problem of urine leakage can be treated successfully. This is true whether or not the woman is athletic, has had children, or has an eating disorder. Treatment depends on the cause of the incontinence. When there is damage or weakness of the muscles, treatment may include pelvic floor muscle exercises, electrical stimulation, or surgery. In the case of decreased hormones from excessive exercising and eating disorders, treatment is more involved, including medical advice, and nutrition and psychological counseling.

Reference: 

Kari BØ, and Jorun Sundgot Borgen. Prevalence of Stress and Urge Urinary Incontinence in Elite Athletes and Controls. In Medicine & Science in Sports & Exercise. November 2001. Vol. 33. No. 11. Pp. 1797-1802.

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