What Causes Stress Incontinence?

Not often talked about, but if you are a sufferer then knowing why it happens can help.


Of course it is not confined to menopause, many women first experience this after giving birth, but stress incontinence occurs when an activity, such as coughing or sneezing, causes a small amount of urine to leak from the urethra, which is the tube urine passes through.

It is the most common type of incontinence suffered by women, especially at menopause and post menopause.

What causes it?

With stress incontinence, movements and activities such as coughing, sneezing, and lifting put greater abdominal pressure on the bladder. That causes the leakage of urine.

A number of things can contribute to stress incontinence. For instance, it can result from weak muscles in the pelvic floor or a weak sphincter muscle at the neck of the bladder. A problem with the way the sphincter muscle opens and closes can also result in stress incontinence.

Chronic coughing, smoking, and obesity may also lead to the condition and stress incontinence, especially in women, is often caused by physical changes to the body.

Things that can cause these changes include:

  • Pregnancy and childbirth
  • Menstruation
  • Menopause
  • Pelvic surgery eg hysterectomy
  • Problems with muscles in the bladder and the urethra
  • Weakened muscles around the bladder

In cases of stress incontinence, the muscles in the pelvis can weaken. This can cause the bladder to drop down into a position that prevents the urethra from closing completely. The result is a leakage of urine.

What are the symptoms?

No prizes for guessing that the main symptom of stress incontinence is a leakage of urine at times of physical movement or activity. You can experience urine leaking from laughing, coughing, sneezing lifting, or exercise.

The leakage may be as little as a drop or two, or may be a “squirt,” or even a stream of urine.

How is it treated?

Self-help techniques and aids can be used to treat mild stress incontinence. In addition, there are a number of treatments available for stress incontinence:

Your GP may suggest you make simple changes to your lifestyle to improve your symptoms. These changes can help improve your condition, regardless of the type of urinary incontinence you have.

For example, your GP may recommend:

  • reducing your caffeine intake – caffeine is found in tea, coffee and cola, and can increase the amount of urine your body produces
  • altering how much fluid you drink a day – drinking too much or too little can make incontinence worse
  • losing weight if you are overweight or obese – use the healthy weight calculator to find out if you’re a healthy weight for your height
  • Pelvic floor muscle training

Your pelvic floor muscles are the muscles you use to control the flow of urine as you urinate. They surround the bladder and urethra, the tube that carries urine from the bladder outside the body.

Weak or damaged pelvic floor muscles can cause urinary incontinence, so exercising these muscles is often recommended.

Your GP may refer you to a specialist to start a programme of pelvic floor muscle training who will assess whether you’re able to squeeze (contract) your pelvic floor muscles and by how much.

If you can contract your pelvic floor muscles, you’ll be given an individual exercise programme based on your assessment. Your programme should include doing a minimum of 8 muscle contractions at least 3 times a day and the recommended exercises for at least 3 months. If the exercises are helping after this time, you can keep on doing them.

Research suggests women who complete pelvic floor muscle training experience fewer leaking episodes and report a better quality of life.

Helpful information: 

Although many women are reluctant to consult their doctor for what they see as an embarrassing problem, it really is much more common than you think. The rise of the number of products available to help with bladder weakness from pads, disposable pants and washable knickers with inbuilt protection show that you are definitely not alone.

Self help methods such as losing weight, checking your diet or doing Kegel type exercises can all help.

If you are also experiencing hormone imbalance then you may find a combination cream like 20-1 with both progesterone and oestrogen can be helpful too. Don’t forget that ‘stress incontinence’ can also be related to stress itself so check your stress levels too.