Incontinence in women usually occurs because of problems with muscles that help hold or release urine or feces. Growing older does not cause incontinence, but often there are factors related to the aging process that lead to incontinence, such as muscle weakening, hormone changes, physical limitations and certain diseases.
During pregnancy, the added weight and pressure of the baby can weaken pelvic floor muscles, which affects your ability to control your bladder. Sometimes the position of your bladder and urethra can change because of the position of the baby, which can cause problems. Vaginal delivery and an episiotomy (the cut that widens the opening for the baby) can contribute to the weakening of bladder control muscles. Although some incontinence problems with pregnancy are short-term, weakening of pelvic muscles and nerves can also cause incontinence later in life.
Menopause (when your periods stop completely) can lead to urinary control problems for some women. The female hormone estrogen helps keep the lining of the bladder and urethra supple and healthy. During menopause, the amount of estrogen in your body starts decreasing. This lack of estrogen may cause changes in bladder and urinary tissues, and can weaken bladder control muscles. Incontinence is also related to a number of different life events or physical problems:
- fistula - an abnormal connection between organs or structures in the pelvic area
- chronic constipation - large, hard stools become lodged in the rectum, allowing watery stool to leak out, and weakening rectal muscles
- neurologic injury or neuromuscular disorders such as multiple sclerosis
- medical conditions such as stroke, diabetes, chronic lung disease, estrogen depletion, pelvic muscle weakness
- medications - incontinence is a side effect of certain medications
- physical limitations, such as arthritis or obesity
- mental limitations such as cognitive impairment or Alzheimer’s disease
- lifestyle and activity, including smoking and high impact activities.