Who is at risk of incontinence?
Incontinence can happen to anybody. It’s not a condition in its own right but rather a consequence of something else, with causes ranging from pregnancy to prostate problems and from menopause to mild infections.
What is incontinence?
Incontinence1 is the involuntary loss of control of your bladder or bowels, meaning that you pass urine or faeces when you don’t intend to.
That can have a significant impact on your life. It may lead to embarrassing situations that dent your confidence and deter you from leaving home. It may mean more frequent washing of clothes and bedsheets, which becomes very tiresome. And it may lead to painful skin irritation and infections.
Incontinence has a significant psychological impact.2 If you’re living with incontinence, you may struggle with feelings of isolation, dependence, loss of control and frustration with your body. If you’re caring for someone with incontinence, you may feel stressed and overwhelmed by the unwelcome changes incontinence brings to your relationship, time, responsibilities and budget.
What causes incontinence?
Staying continent (in control of your bladder and bowels) involves your brain, nerves and muscles.3
Nerves send signals between your brain and your bladder or bowels. When they signal that it’s time to go to the toilet, your nerves tell the muscles around your bladder and bowel to relax and release urine or faeces. Then the muscles tense up once more, enabling you to hold onto any further urine and faeces until your next trip to the toilet.
But many things can damage those nerves and muscles, disrupting their ability to communicate, coordinate and control your bladder and bowel movements.
During pregnancy, the body undergoes significant hormonal and physical changes, which put pressure on the bladder and weaken the pelvic floor muscles.
The pelvic floor muscles support the pelvic organs, namely the bladder, uterus and bowel.4 As a baby grows, the enlarged uterus presses on the bladder, making stress incontinence more common – that’s when extra pressure like sneezing, laughing, coughing or exercising pushes urine out of the bladder.
That happens to more than a third of women in their first pregnancy and more than three-quarters of women during subsequent pregnancies.5
Though most women recover well from childbirth, 1 in 3 women who have ever had a baby wet themselves.6
The stretching involved in giving birth (both vaginally and by caesarean) can weaken the pelvic floor muscles and affect the nerves7 – and that can make it more difficult to stay continent. Risk factors include a large baby, prolonged labour, use of forceps or episiotomy.8
Menopause weakens the pelvic floor muscles and makes women more prone to urinary tract infections, which can make incontinence more likely.9
Often other health needs begin to show themselves around this age, such as diabetes or weight gain, both of which also increase the likelihood of incontinence. Some birth injuries may show themselves for the first time too, with birth-related bowel problems sometimes occurring with the onset of menopause.
The prostate is a small gland that sits around the male urethra (the tube that carries urine from the bladder). As men reach middle age, the prostate enlarges and presses on the urethra. This is known as benign prostate hyperplasia (BPH).10 It is not cancer but it can obstruct or block the flow of urine and make it difficult to completely empty the bladder.
Prostate cancer itself begins when abnormal cells in the prostate start growing in an uncontrolled way.11 About 1 in 10 men will develop prostate cancer before the age of 75.12
Urinary incontinence is a common side effect of prostate cancer surgery or radiotherapy. In most cases, this improves after a few months though, for some men, it remains a long-term problem.13
Neurological disorders like dementia, Parkinson’s disease, diabetes-related neuropathy, and stroke can all lead to incontinence by affecting the nerve pathways between the bladder or bowel and the brain.14 Many of these conditions become more common with age.
Other risk factors
There are several other risk factors for incontinence, including:
Urinary tract infections, which may lead to a frequent or urgent need to urinate 15
Arthritis – joint stiffness and loss of mobility may make it difficult to get to the toilet in time or to remove clothes fast enough 16
Mental health difficulties – confused thinking, medications, or drinking large amounts of caffeine or alcohol (bladder irritants) may trigger incontinence 17
Chronic heart failure – symptoms and treatments may lead to incontinence 18
Disability – it may be hard to recognise the need for the toilet, get there in time or remove clothing. 19
How do you live well with incontinence?
Maybe you recognise one or more of those risk factors as having contributed to your incontinence. What should you do?
The first step is to get help. While 1 in 4 Australians live with incontinence, 20 few ask for help. Yet help is available both to ease symptoms of incontinence and to manage the consequences.
As a first step, talk to your GP or call the National Continence Helpline on 1800 33 00 66 and speak to a continence advisor. There are many different ways to treat incontinence, depending on the underlying cause. Physiotherapists will often recommend exercises to strengthen your pelvic floor.21
The next step is to ensure you have the right absorbent products (by which we mean the right style, absorbency and size) and the right skin care routine to help maintain your skin’s health (skin integrity). Use our product finder to find the right items for your needs. You can even order some free samples.
With the right support, it is possible to live well with incontinence. We’re here to help you do that.
This website does not provide medical advice. The information, including but not limited to, text, graphics, images, and other material contained on this website, is for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new healthcare regimen. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
1. Continence Foundation of Australia, Understanding Incontinence, https://www.continence.org.au/incontinence/understanding-incontinence, [Accessed 1 June 2023]
2. Continence Foundation of Australia, Psychological Impact, https://www.continence.org.au/life-incontinence/caring-someone/psychological-impact, [Accessed 1 June 2023]
3. Johns Hopkins Medicine, Bladder and Bowel Dysfunction, https://www.hopkinsmedicine.org/health/conditions-and-diseases/bladder-and-bowel-dysfunction, [Accessed 1 June 2023]
4. Pregnancy, Birth and Baby, Incontinence During Pregnancy, https://www.pregnancybirthbaby.org.au/incontinence-during-pregnancy, [Accessed 1 June 2023]
5. UCLA Health, Childbirth and Incontinence, https://www.uclahealth.org/medical-services/womens-pelvic-health/patient-education/childbirth-incontinence, [Accessed 1 June 2023]
6. Continence Foundation of Australia, Pregnancy and Childbirth, https://www.continence.org.au/incontinence/who-it-affects/women/pregnancy-and-childbirth, [Accessed 1 June 2023]
7. Continence Foundation of Australia, Pregnancy and Childbirth, https://www.continence.org.au/incontinence/who-it-affects/women/pregnancy-and-childbirth, [Accessed 1 June 2023]
8. UCLA Health, Childbirth and Incontinence, https://www.uclahealth.org/medical-services/womens-pelvic-health/patient-education/childbirth-incontinence, [Accessed 1 June 2023]
9. Continence Foundation of Australia, Menopause, https://www.continence.org.au/who-it-affects/women/menopause, [Accessed 1 June 2023]
10. Cancer Council NSW, About Prostate Cancer, https://www.cancercouncil.com.au/prostate-cancer/about-prostate-cancer/, [Accessed 1 June 2023]
11. Cancer Council NSW, About Prostate Cancer, https://www.cancercouncil.com.au/prostate-cancer/about-prostate-cancer/, [Accessed 1 June 2023]
12. Cancer Council NSW, About Prostate Cancer, https://www.cancercouncil.com.au/prostate-cancer/about-prostate-cancer/, [Accessed 1 June 2023]
13. Cancer Council NSW, Urinary Problems, https://www.cancercouncil.com.au/prostate-cancer/managing-side-effects/urinary-problems/, [Accessed 1 June 2023]
14. Continence Foundation of Australia, Medical Conditions, https://www.continence.org.au/incontinence/medical-conditions, [Accessed 1 June 2023]
15. Continence Foundation of Australia, Urinary Tract Infections, https://www.continence.org.au/urinary-tract-infection-uti, [Accessed 1 June 2023]
16. Continence Foundation of Australia, Arthritis, https://www.continence.org.au/incontinence/medical-conditions/arthritis, [Accessed 1 June 2023]
17. Continence Foundation of Australia, Mental Health, https://www.continence.org.au/incontinence/medical-conditions/mental-health, [Accessed 1 June 2023]
18. Continence Foundation of Australia, Chronic Heart Failure, https://www.continence.org.au/who-it-affects/medical-conditions/chronic-heart-failure, [Accessed 1 June 2023]
19. Continence Foundation of Australia, Functional Incontinence, https://www.continence.org.au/types-incontinence/urinary-incontinence/functional-incontinence, [Accessed 1 June 2023]
20. Continence Foundation of Australia, Understanding Incontinence, https://www.continence.org.au/incontinence/understanding-incontinence, [Accessed 1 June 2023]
21. Continence Foundation of Australia, Pelvic Floor Muscles in Women, https://www.continence.org.au/who-it-affects/women/female-pelvic-floor-muscles, [Accessed 1 June 2023]