Stop worrying, start understanding

Given that bladder weakness affects 1 in 4 women and can happen at any age, you’d think they would teach us about it at school. Certainly, if they did, then most of us seem to have missed that lesson! Anyway, here’s a reminder of how the bladder or urinary system works and why sometimes it doesn’t quite work perfectly.

Are there more women with bladder weakness over the age of 53 or under?


How the urinary system works

The role of your kidneys is to filter unneeded substances from the bloodstream and send them to the bladder, a muscular bag that can stretch to hold up to 500ml when full. At half full, nerves tell the brain that it’s time to urinate and urine passes down the urethra, which is kept closed by two sphincter muscles. The inner sphincter will open when the bladder is full but the outer sphincter muscle can be voluntarily held shut to maintain control over urination. It’s the job of the pelvic floor muscles, which lie beneath the bladder and around the urethra, to keep them working correctly. 1 in 4 women and 1 in 8 men experiences an interruption to this process at some time in their lives.

(Insert labelled diagram of bladder area)

So what are the main causes of bladder weakness?

Could you have weakened pelvic floor muscles?
In the majority of cases, bladder weakness is caused by a weakening of the pelvic floor muscles that keep the urethra closed. Whenever they lose their elasticity, everyday activities such as laughing, coughing, lifting and running can cause a leak. However, they can be strengthened again – visit the exercise area to find helpful information about pelvic floor exercises.

For women in particular, the main causes of bladder weakness result from the changes that take place during pregnancy, childbirth and menopause (visit TENA men for causes of male bladder weakness).

Are you a Mother?

The joys of motherhood are many (despite those first sleepless nights…), but pregnancy and childbirth put your body through all kinds of changes, both hormonal and physical. Bladder weakness is therefore a very common side effect of pregnancy or childbirth. The combination of hormonal changes, pressure on the bladder from the womb and the exertions of childbirth itself can all reduce the efficiency of the pelvic muscles.

Bladder weakness can occur during or soon after pregnancy and even, for some women, long after their children have grown up. For those who experience it around pregnancy, it’s often a temporary condition. Many women have seen real improvements by using the pelvic floor exercises that you’ll find when you go to the exercise area.

Have you experienced the menopause?

Several physical and hormonal changes occur with the menopause. In particular, there’s a reduction in the quantity of oestrogen within the abdominal muscles. This can cause a shift in the position of the bladder, reducing the effectiveness of the muscles that hold it closed.

Are you overweight?

Being overweight can also put extra pressure on abdominal and pelvic muscles, leading to bladder weakness.

Medical conditions

Other causes of bladder weakness include certain medical conditions such as stroke, dementia or diabetes. Often it’s because of damage or interference to nerve passageways preventing the right signals travelling between the brain and the bladder or, in the case of dementia, failure to register those signals. This can lead to either an overactive bladder (the need to go often and frequently) or an under-active bladder (the ineffective emptying of the bladder, causing leakage).

Neurological Damage

Parkinson’s, Alzheimer’s, Spina Bifida, Multiple Sclerosis or brain injury can also affect the way the brain and bladder communicate resulting in an inability to control the bladder or empty it completely

Are you taking prescribed medications for another condition?

Incontinence can be a side effect of certain medications, and some medicines have diuretic properties making you want to urinate more frequently. If you have recently started on or changed medication, and this has coincided with a loss of control, it may be worth arranging a review with your doctor to determine whether it's a possible cause of bladder weakness. Sometimes medications for other conditions can be changed or dosages reduced without altering their effectiveness.

Do you regularly experience urinary infections?

Urinary infections can lead to bladder hypersensitivity. This is when the bladder incorrectly sends urgent signals to your body to empty quickly when it's not completely full.

If you have further questions on causes of bladder weakness, you should consult your health advisor.