As you get older, you might notice your bladder getting harder to control. The urge to pee can come on suddenly, and you may struggle to get to the bathroom in time. Or maybe you leak a little urine when you sneeze, laugh or work out. 

This is called urinary incontinence. Anyone can get it, though it’s more common in older adults.¹ And it can be annoying and even embarrassing.  

For some people, it’s a temporary problem. For others, it lasts for years. In either case, it’s important to know that bladder control problems are treatable.² That’s why you should feel 100% comfortable talking about it with your doctor. This will help you find a solution.  
 
“We’re often taught to accept it, especially if it’s something your mom or grandma had,” says Esther Han, DO. She’s an Optum reconstructive urologist at the Center for Advanced Pelvic Medicine and Bladder Health in Arlington, Texas. “While it’s not life-threatening, it does affect your quality of life.”   

In addition, consider bringing up the problem with people you care about. That helps them understand what you’re going through. So, let’s start a conversation. 

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Understanding your risk 

As many as 1 in 3 people experience some degree of urinary incontinence, according to the Urology Care Foundation.³ And older adults are at higher risk, especially women.  

Urinary incontinence happens in part because your bladder muscles weaken as you age.² That makes it harder to hold in urine.  
 
Women are more likely to develop urinary incontinence after childbirth and after menopause. And compared to men, women have a shorter urethra.⁴ (This is the tube that lets urine leave your bladder and body.) So, weakness or damage to the urethra can have a bigger impact.  

For men, bladder problems may be connected to age-related prostate issues. That could be due to treatments for an enlarged prostate or prostate cancer.²  

Both men and women can also have bladder problems that are caused by chronic conditions such as diabetes and obesity.²  

Types of urinary incontinence  

There are many types of incontinence, but a couple of them appear most often. “The two most common types of urinary incontinence I see are called stress incontinence and urge incontinence,” says Dr. Han. 

• Stress incontinence is sudden leakage brought on by an action that increases bladder pressure. You might notice it when you’re laughing with friends or exercising.¹   
• Urge incontinence is a strong need to pee quickly.⁵ You may not be able to make it to a restroom without leaking. 

If you can’t tell which type is affecting you, the answer may be both. “It’s common for patients to have a bit of both types of urinary incontinence,” says Dr. Han. 

How your doctor can help with urinary incontinence  

Some bladder issues go away on their own, says Dr. Han. For example, certain medications can cause short-term incontinence in men and women. So can constipation or urinary tract infections, according to the National Institute on Aging.⁵ 
 
But often these incontinence problems don’t just disappear. For many women, urinary issues stem from age-related changes, says Dr. Han. These may be related to menopause.³  
 
Men being treated for an enlarged prostate gland may have bladder control problems.² So can those who’ve had recent prostate cancer surgery, which can damage nerves and muscles in the area that controls urine flow.⁶ 

Your first step is to talk to your primary care provider. “It’s important to have a health care provider who’s on your side,” says Dr. Han. Don’t be afraid to bring it up. And know that your Optum doctor is ready to listen and connect you to any treatment and support you may need.  

Tell your care team if you’re flying through underwear liners or having accidental leaks. Once you’ve laid out the problem, say you’d like to explore your options. Your provider can help or refer you to a specialist (such as a urologist).  

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Lifestyle solutions to curb bladder issues 

Habit changes can have a big impact on incontinence. Here are a few steps Dr. Han recommends to her patients:   

• Limit food and drinks with caffeine during the day. That includes coffee, tea, colas and chocolate.  
• Avoid drinking liquids several hours before bedtime. 
• Seek help for constipation, which can make bladder symptoms worse. 

It may also be helpful to lose weight if you’re overweight. And avoiding alcohol may help, too.  
 
You may be able to train your bladder to hold urine better. According to the National Institute on Aging, common strategies include:⁵  

• Kegel exercises: Both men and women can benefit from these exercises that strengthen the muscles in your pelvic floor. To start, squeeze the muscles you would use to stop urinating. Try holding for three seconds. Then relax for three seconds and repeat. Work up to three sets of 10 repetitions.⁷ You can do Kegels lying down, sitting or standing.⁷  
   
• Urgency suppression: If you can distract yourself, the need to pee may pass. Try being still, taking deep breaths, and squeezing your pelvic floor muscles. 
   
• Timed voiding: You may be able to stay ahead of the problem by visiting the bathroom on a schedule, regardless of whether you have to go. Start by going once every hour. If that’s working, you can consider lengthening the time between visits. 

These aren’t all things you have to master on your own, says Dr. Han. A pelvic floor physical therapist can help. In therapy, you will work to retrain and strengthen the muscles around your pelvic floor. That will allow your bladder to hold urine better. 

Strategies your doctor might suggest

If lifestyle changes don’t work, your care team may recommend one or more of the following:⁸  

• Medication  
• Injections 
• Electrical stimulation 
• Pessary (for women: this is a small device inserted into the vagina to support the bladder and urethra) 
• Surgery (for women, common surgeries include injections and creating a synthetic sling to support your urethra and bladder.)^9,10 

But surgery is not usually needed. Often, the problem can be resolved with simpler measures.  

If bladder problems are causing you stress, you deserve to get help. And at Optum, your care team wants you to enjoy life. They’re eager to have the conversation, no matter how embarrassed you may feel. Don’t hesitate to bring it up.  

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