At what point should I ask my doctor about incontinence?

The loss of bladder control, or urinary incontinence (UI), affects millions of Americans. However, because of anatomical makeup, it tends to be much more prevalent in women. A study within the last five years by American Urological Association Education and Research Inc., estimates that over half of women will suffer from UI. There is a certain social stigma that comes with it, but it’s important for both men and women to not be too embarrassed to seek help.

Urinary incontinence is broken up into three stages — stress, urge and mixed. Stress incontinence is induced by physical activity such as coughing, sneezing, exercise or even sex. Urge incontinence is spurred by sudden urges with little control. Patients might say, “I feel the urge to pee, but by the time I reach the bathroom, I’ve wet my pants.” Mixed incontinence simply means you have a combination of both stress and urge.

While urologists are the experts when it comes to this issue, gynecologists are usually the first ones women approach when experiencing bladder leakage. The first stages of evaluating UI are actually part of an OB/GYN’s formal training.

There are a variety of factors that can play a part in incontinence — primarily age, medication (some medications are active diuretics), postpartum or childbirth and menopause.

The first step in identifying UI is ruling out a urinary tract infection. After a urinalysis and a urine culture are performed, we ask patients to start a voiding diary, which is a log of when they urinate. It doesn’t have to be a science experiment. Usually, it’s about three days of making note of what, how much and at what times they’re drinking and then tracking what’s coming out. That gives us a lot of information to determine whether this is something that can be behaviorally modified and fixed. For instance, if someone is drinking a lot of caffeine and sugary beverages, those could be a contributing factor. If there’s not a clear behavioral pattern that emerges, the patient could be suffering from a different type of urinary picture where it’s not about the volume of fluids, but more about the urge to pee.

If changing a patient’s behavior does not offer relief, urologists can perform more thorough testing of bladder control.

Treatment in both male and female patients is usually simple. UI is generally managed through behavioral modifications or oral medication, but in some extreme cases patients might need surgery or a more invasive procedure.

Urinary incontinence is not something that can be reversed or cured, but it can certainly be managed. If you think you might have UI, do not be afraid to reach out to your physician, because it can be a major source of unnecessary emotional distress.

Tweet @TheDoctors and let Dr. Ashton know you enjoyed her #SamsClubMag Ask The Doctors feature article.

Dr. Jennifer Ashton is a co-host on the Emmy Award-winning talk show, The Doctors, a practicing board-certi ed OB-GYN and Senior Medical Contributor for ABC News’ GMA. She is affectionately referred to as “your all-in- one ‘BFF’/OB-GYN,” as she combines an Ivy League medical background with a relatable girl’s girl attitude.