A problem women endure in silence: Urinary incontinence

There are some health issues that women have lived with for years, yet are almost never discussed. Sometimes because of shame, sometimes because they are dismissed, and sometimes because they are seen as a natural consequence of being a woman...

Urinary incontinence is one of them.

A woman may experience urinary incontinence for years while coughing, laughing, or exercising. She may hesitate to go out for fear of not making it to the toilet in time. She may use pads constantly or think about toilets first when planning her travels. Yet, despite all this, she may not consult a physician.

Because there is a sentence she is often told, and one she eventually comes to believe herself:

"It is normal to experience such things at this age."

However, the fact that a health issue is common does not mean it is normal.

I encounter this frequently in my practice. Women sometimes come in with a different complaint and do not mention that they have urinary incontinence unless I specifically ask. When I ask, "Do you experience urinary incontinence?" I learn that they have been living with this problem for years. Some describe leaking urine when they laugh, some when they cough, and others when they cannot make it to the toilet in time.

When we perform the necessary evaluations and treat this problem with medication in suitable patients, or with surgical methods in others, the sentence I hear is almost always the same:

"We did not know this was a treatable problem."

This is the point we really need to focus on. Women not only hide their complaints, but sometimes they do not even know that a solution is possible.

Because if a subject cannot be discussed, a solution cannot be found.

Urinary Incontinence Can Have Many Causes

Urinary incontinence does not manifest the same way in every woman.

We call leaking urine while coughing, sneezing, laughing, or lifting weights stress urinary incontinence. In some women, the sudden urge to urinate is so strong that it is impossible to make it to the toilet.

Pregnancies, childbirth, weakening of the pelvic floor muscles, excess weight, chronic coughing, and increased intra-abdominal pressure over many years can lay the groundwork for these problems. Neurological diseases and certain medications can also affect bladder control.

We must not forget the hormonal changes during the perimenopause and menopause periods, in particular.

A decrease in estrogen does not only cause vaginal dryness. It can also affect the tissues in the vagina, urethra, and lower urinary tract. During this period, dryness, burning, a sense of urgency, and recurrent urinary tract infections may occur.

However, not every complaint of urinary incontinence stems from menopause. For the correct treatment, the cause must first be determined.

There Is Treatment for Urinary Incontinence

Today, we have many effective options for the treatment of urinary incontinence.

Pelvic floor muscle exercises, bladder training, lifestyle adjustments, medication for suitable patients, and local vaginal estrogen therapy for certain urogenital complaints associated with menopause can be applied.

Especially in well-selected cases of stress urinary incontinence, we can achieve successful results with surgical procedures that last about half an hour. Some surgeries are performed via the vaginal route, and there is not even a visible surgical scar on the abdominal area.

Of course, not every woman needs surgery. Treatment is determined according to the cause of the complaint and the needs of the woman.

Women Are Not Obliged to Live with Their Complaints

Women's urogenital health issues should be discussed more. Complaints such as urinary incontinence, vaginal dryness, frequent urination, burning during urination, or pain during sexual intercourse are not things to be ashamed of, but health issues that should be evaluated.

No woman has to suppress her laughter, give up exercising, restrict her social life, or use pads constantly because she has urinary incontinence.

If a woman has a complaint, it is important. It should be listened to, the cause should be investigated, and appropriate treatment options should be offered.

Women do not have to endure this in silence. Urinary incontinence is not destiny.

Because problems that are not discussed remain invisible. Problems that are discussed can be resolved.

Prof. Dr. Çiğdem Yayla Abide

Obstetrician and Gynecologist, IVF Treatment