Urinary incontinence: What’s your type?

Leaks. Dribbles. Strong — and inconvenient — urges to go. If you’ve experienced signs of incontinence like these, it can be embarrassing. But it’s not some rare condition that only affects a certain type of person. It’s actually really common.

What you’re dealing with is a common condition called urinary incontinence, or UI, and it happens when you lose control of your bladder. In fact, 25 million American adults experience some type of UI, and up to 75% of women over the age of 65 experience some kind of urine leakage.  

Not all types of UI are the same, according to the National Institute on Aging. Understanding the type of UI you have can be an important step toward finding the right solution. Incontinence can interfere with work, your social life, family events, and even your sex life, experts say.   

That’s why it’s always a good idea to talk about with your doctor, something most women and men with incontinence aren’t doing.  

Many adults with UI feel it’s simply an unfortunate and embarrassing side effect of aging they just have to deal with. But UI can often be treated with strengthening exercises, n, or other medical treatments. 

Here are the five most common types of UI that affect women and men, what their causes are, and what you (or your doctor) can do to ease your symptoms. 

Looking for a primary care provider or urologist? Go to hmsa.com and use Find a Doctor to locate one near you.

1. Stress incontinence: Unexpected leaks at inconvenient moments

If you’ve ever experienced a leak when you laugh, cough, sneeze, jump, or lift a heavy object, you likely have stress incontinence. For people with severe stress incontinence, even bending over or getting up from a chair can lead to leakage.  

Stress incontinence is the most common type of incontinence in women under the age of 60, and it accounts for more than 50% of the cases, according to the National Association for Continence (NAC). Though it’s rarer in men, they can have it  too. 

The cause: If you have stress incontinence, that’s due to weakness in your pelvic floor — the muscle and connective tissue that supports your bladder and urethra (the tube that carries urine from your bladder to the outside of your body). Another reason: You might have weakness of the urethral sphincter, the ring of muscle that normally keeps your urethra shut tight until you decide it’s time to urinate.  

Here are some of the reasons your pelvic floor may be weakened that can boost your risk of stress incontinence: 

• Aging. 
• An enlarged prostate gland (men only). 
• Being overweight or obese. 
• Certain medications (ex. ACE inhibitors). 
• Pregnancy and childbirth. 
• Prostate surgery. 
• Smoking. 
• Surgery involving your lower back and pelvic area. 

The fix: You can ease your leaks with some straightforward lifestyle changes. These include:  

• Not drinking large amounts of fluid at one time. 
• Pelvic floor exercises (like Kegels). 
• Skipping beverages that act as diuretics (like caffeinated or alcoholic drinks). 
• Surgery. 

For women, vaginal estrogen cream and inserts — used in the urethra or vagina — may also help prevent leaking.

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2. Urge incontinence and overactive bladder: Suddenly, you’ve got to go

If you get sudden, strong, out-of-the-blue urges to urinate, you may have an overactive bladder. If you release urine at unwanted times as a result, it’s called urge incontinence. About 40% of women and 30% of men experience urge incontinence at some point.  

The cause: Uncontrolled spasms of your detrusor muscle—the muscle tissue inside the wall of your bladder. Irritation (such as from certain foods or drinks), inflammation, and urinary tract infections can send this balloon-shaped muscle into contractions.

Medications, such as diuretics, can contribute to urge incontinence and overactive bladder, too. So can a loss of nervous-system control caused by health conditions like diabetes, stroke, Parkinson’s disease, multiple sclerosis, and Alzheimer’s disease.

The fix: Avoiding bladder irritants like caffeine, alcohol, and spicy or acidic foods and drinks may help. So can a bladder-retraining program that helps you regain control of the ability to hold it until you’re ready to go. Medications, injections, and nerve-stimulation procedures that relax your bladder muscle may help, too. 

3. Mixed incontinence: Stress plus urge incontinence

According to the NAC, a common source of urinary continence is a combination of stress and urge incontinence. In most cases of mixed incontinence, one type will be more prominent and bothersome. The best approach to dealing with mixed incontinence, the NAC states, is usually to address the more serious condition. That’s a great reason to work with your doctor to find a solution for your incontinence. 

Did you know HMSA members have access to personalized support to help you manage your health and well-being? Learn more here.

4. Functional incontinence: Getting to the bathroom in time

Functional incontinence is most common among older adults and those with disabilities or who are recovering from injuries.  

The cause: It happens when your bladder control is healthy and normal, but other factors can get in the way of getting to the bathroom in a timely manner. Factors that can slow you down include arthritis, as well as hand and finger dexterity problems, that can make opening doors, opening toilet seats, and being able to work buttons and zippers more difficult. 

The fix: Make reaching the bathroom and using the toilet as easy as possible. Here are some options: 

• Add grab bars and/or a raised toilet seat for easier sitting down. 
• Clear obstacles and clutter out of the path to the bathroom. 
• Keep the bathroom door open and a light on when not in use. 
• Wear elastic-waist pants. 

5. Overflow incontinence: When urinating is difficult

For about 1 in 20 people with ongoing incontinence problems, the cause is urinary retention due to a blockage or bladder muscles that don’t contract enough. This leads to overflow incontinence—frequent leaks because your bladder is overly full.

The cause: There are quite a few causes of overflow incontinence. Here are some examples:  

• Childbirth.  
• Diabetes. 
• Infections. 
• Multiple sclerosis and polio. 
• Neurological problems.  
• Stroke. 

Also, pelvic injuries can damage nerves involved with urination or block your urethra, leading to urinary retention. In men, an enlarged prostate gland may also contribute to the problem by pressing on your urethra. 

The fix: Your doctor can determine the cause and recommend solutions including lifestyle changes, bladder retraining, medications, and surgery. 

See our sources: 
Urinary incontinence in older adults: National Institute on Aging 
Urinary incontinence population stat: Johns Hopkins Medicine 
Urinary incontinence stat on women: Mayo Clinic Health System  
Stress incontinence in women: The National Association for Continence 
Urge incontinence stats: Cleveland Clinic 
Mixed urinary incontinence: StatPearls 

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