Incontinence: Types, Causes, Symptoms, and Treatment Options
Incontinence, or the involuntary passage of urine or stool, is a condition that affects millions of people worldwide. While it is often under-discussed due to stigma or embarrassment, it is surprisingly common and can impact individuals of all ages and genders. Incontinence is not simply a “normal” part of aging or childbirth—it is a medical condition with proven treatment options. At Femina Physical Therapy, we want you to know that effective, compassionate care is available. Many patients see life-changing improvements through pelvic floor physical therapy, including those women seeking urinary incontinence treatment in Los Angeles and Atlanta, leaking bladder treatment, and treatment for urine leakage in women. We believe that everyone deserves to feel confident, comfortable, and in control of their body. Through advanced pelvic floor therapy and evidence-based methods, urine leakage treatment can often be achieved without surgery or long-term medication. This article explores the types, causes, symptoms, and treatment for urine leakage in women, helping individuals reclaim their quality of life.
What Is Incontinence?
Incontinence refers to the loss of bladder or bowel control, resulting in leakage that may be occasional or frequent. It occurs when the muscles and nerves responsible for controlling the bladder, urethra, or rectum do not function properly. Incontinence is not a disease itself but rather a symptom of an underlying condition or imbalance within the body.
While this condition is common, it should never be ignored. Left untreated, urinary incontinence can affect physical health, emotional well-being, and daily life activities. Fortunately, a wide range of strategies—such as pelvic floor physical therapy, behavioral techniques, and specialized urine leakage treatment—are available to address the root causes and restore bladder control.
Types of Incontinence
- Stress Urinary Incontinence—is an involuntary loss of urine with physical exertion (while coughing, sneezing, lifting, positional changes, etc.). This occurs due to a weak urethral sphincter mechanism during a rise in intra-abdominal pressure. This type occurs when physical activity or exertion—such as coughing, sneezing, laughing, or exercising—puts pressure on the bladder, leading to leakage. Stress incontinence is often linked to weakened pelvic floor muscles.
- Urge Urinary Incontinence—The involuntary loss of urine that occurs alongside a sudden, intense urge to urinate, often caused by an overactive or unstable bladder. This may lead to leakage even when the bladder isn’t full, due to involuntary bladder contractions, and can significantly impact daily life, confidence, and quality of sleep.
- Overflow Incontinence—A loss of urine associated with an overdistension of the bladder. It occurs when the bladder doesn’t empty completely, leading to frequent dribbling or unexpected leakage. It is less common but can occur due to nerve issues, blockages, or weakened bladder muscles. Some accompanying symptoms include reduced urine stream, difficulty initiating a stream, and tenderness above the pubic region.
- Fecal Incontinence or Accidental Bowel Leakage—This refers to the inability to control bowel movements, resulting in the involuntary leakage of stool or gas from the anus. This condition may involve the loss of either solid or liquid stool and can be caused by factors such as weakness of the anal sphincter, neurological or musculoskeletal dysfunction, radiation treatment, or cognitive impairment.
- Mixed incontinence is the combination of both stress urinary incontinence and urge urinary incontinence, meaning leakage may occur with physical activity, such as coughing or exercising, as well as with a sudden, strong urge to urinate. Many women experience this condition, which can be especially challenging because it involves both pelvic floor muscle weakness and bladder overactivity.
- Light bladder leakage is a mild form of urinary incontinence that involves a small, occasional loss of urine, often with coughing, sneezing, or physical activity. While the leakage may seem minor, it can still be frustrating and affect daily confidence.
Causes of Incontinence
Understanding what contributes to bladder or bowel leakage is an important first step in creating an effective, personalized treatment plan. There are many possible causes of incontinence, and they can vary depending on the type and severity of the condition. Common causes include:
- Pelvic Floor Muscle Weakness is one of the most common causes of incontinence. It often develops after pregnancy, childbirth, pelvic surgery, or with natural aging, when the muscles that support the bladder and bowel lose strength. This weakness can lead to bladder leaks, bowel leakage, or difficulty controlling gas, but targeted pelvic floor physical therapy can help restore strength and control.
- Hormonal Changes—play a significant role in bladder health and control. After menopause, lower estrogen levels can weaken the pelvic tissues and reduce support for the bladder and urethra, increasing the risk of leakage. With pelvic floor physical therapy, women can improve muscle function and tissue support to better manage incontinence related to hormonal shifts.
- Neurological Conditions—can interfere with the communication between the brain, spinal cord, and bladder, making it difficult to control urination or bowel movements. Disorders such as multiple sclerosis, Parkinson’s disease, stroke, or spinal cord injury may lead to involuntary leakage or urgency. At Femina Physical Therapy, treatment focuses on improving pelvic floor strength and coordination to help manage incontinence related to neurological dysfunction.
- Lifestyle Factors—Obesity, smoking, excessive caffeine or alcohol intake, and chronic coughing can all increase risk.
- Pelvic Organ Prolapse—can significantly increase the risk of developing incontinence. Obesity, smoking, chronic coughing, or excessive intake of caffeine and alcohol place extra pressure on the bladder and weaken pelvic floor support over time. By making healthy lifestyle changes alongside pelvic floor physical therapy, many women can reduce leakage and improve bladder control.
- Urinary Tract Infections (UTIs) are a common cause of temporary incontinence. When the bladder becomes irritated or inflamed, it can trigger strong urges to urinate and occasional leakage. Treating the infection and supporting bladder health with pelvic floor therapy can help restore normal control and prevent recurrent issues.
- Medications – can sometimes contribute to bladder leakage or urgency. Diuretics, sedatives, and certain blood pressure drugs may increase urine production or affect muscle control, making it harder to manage continence. At Femina Physical Therapy, we work with patients to address these side effects through pelvic floor training and supportive strategies for better bladder control.
Symptoms of Incontinence
Recognizing the signs of incontinence is the first step toward effective treatment. Common symptoms include:
- Leakage of urine when coughing, sneezing, laughing, or exercising.
- Sudden, intense urges to urinate followed by leakage.
- Frequent urination, sometimes with only small amounts expelled.
- Difficulty making it to the bathroom in time.
- Nighttime leakage or waking frequently to urinate.
- Involuntary loss of stool or gas.
- Avoidance of social, physical, or intimate activities due to fear of leakage.
In addition to the physical impact, many individuals experience emotional distress, embarrassment, anxiety, or isolation as a result of incontinence.
How Pelvic Floor Physical Therapy Can Help
Pelvic floor physical therapy (PFPT) is a highly effective, non-invasive treatment for urinary and fecal incontinence. Since the pelvic floor muscles support the bladder and bowel, weakness, overactivity, or poor coordination in these muscles can lead to leakage. At Femina Physical Therapy, our specialists use techniques such as targeted exercises, biofeedback, manual therapy, and bladder training to restore muscle function, improve bladder control, and enhance quality of life.
Pelvic floor physical therapists use specialized techniques:
- Evaluating Muscle Strength and Coordination is the first step in pelvic floor physical therapy. A therapist carefully assesses whether the pelvic muscles are too weak, too tight, or not activating in the correct sequence. This evaluation helps create a personalized treatment plan to restore proper muscle function and reduce incontinence symptoms.
- Teaching correct exercises is a key part of pelvic floor physical therapy. While many people are familiar with Kegels, therapists ensure patients are activating the right muscles and progressing to more advanced pelvic floor training when appropriate. Proper technique builds strength, endurance, and coordination, which helps improve bladder and bowel control.
- Utilize biofeedback—it is a valuable tool in pelvic floor physical therapy that uses sensors to provide real-time information about muscle activity. This feedback helps patients see when their pelvic floor muscles are contracting or relaxing incorrectly. By improving awareness and control, biofeedback makes pelvic floor training more effective in reducing incontinence.
- Incorporate electrical stimulation—a gentle therapy used to help patients who have difficulty contracting their pelvic floor muscles on their own. Low-level currents stimulate the muscles, making it easier to activate and strengthen them during training. This technique supports muscle re-education, improves coordination, and enhances bladder and bowel control.
- Manual therapy involves hands-on techniques that address tension, scar tissue, or restrictions in the pelvic floor muscles. By improving blood flow and restoring healthy muscle tone, this approach helps reduce pain and improve muscle function. When combined with targeted exercises, manual therapy supports better bladder and bowel control.
- Guided bladder training is a structured approach that helps patients improve bladder capacity and regain control over urinary urges. Through customized voiding schedules and urge-suppression strategies, patients learn to gradually increase the time between bathroom visits. This method reduces frequency, urgency, and leakage, making daily life more comfortable and predictable.
7. Bowel Retraining & Dysfunction. At FeminaPT, pelvic floor therapy addresses bowel-related incontinence by restoring healthy habits. Care may include toileting schedules, diet and hydration adjustments, muscle relaxation techniques, and, when needed, biofeedback or manual therapy. The goal is improved coordination, reduced symptoms, and restored control.
Treatment Options at Femina Physical Therapy
At Femina PT, we specialize in comprehensive, individualized care for incontinence. Our approach is designed to address not just the symptoms but also the root causes of leakage. Treatment may include:
2. SoftWave Shockwave Therapy (Los Angeles locations only)
5. Pilates and Core Integration
7. Dry Needle Therapy (Atlanta location only)
8. Yoga-based Therapy
This holistic approach ensures that each patient receives care that aligns with their unique symptoms, lifestyle, and goals.
Frequently Asked Questions
1. What is the main cause of incontinence?
Incontinence can result from weakened or overactive pelvic floor muscles, nerve issues, hip dysfunctions, or lifestyle factors like chronic coughing or obesity. A professional assessment helps identify the exact cause for proper treatment.
2. What is urinary incontinence?
Urinary incontinence is the involuntary leakage of urine caused by issues with bladder control, pelvic floor muscles, or nerve signals. It can range from occasional small leaks to frequent, uncontrollable episodes, but effective treatments are available.
3. How to stop incontinence?
Incontinence can often be managed or resolved through pelvic floor physical therapy, lifestyle changes, and bladder training. In more persistent cases, additional medical treatments may be recommended by a specialist.
4. Do men experience incontinence too?
Yes, men can also experience incontinence, often due to prostate surgery, pelvic floor weakness, or other medical conditions. Pelvic floor therapy is effective for both men and women.
5. What’s the difference between stress and urge incontinence?
Stress incontinence happens when pressure on the bladder (like coughing or exercising) causes leakage. Urge incontinence involves a sudden, overwhelming urge to urinate followed by involuntary leakage.
6. Does UTI cause incontinence?
Yes, urinary tract infections (UTIs) can cause temporary incontinence by irritating the bladder and increasing urgency or frequency. Once the infection is treated, these symptoms usually improve. In some cases, people will continue to feel urinary tract infection symptoms without an infection present. The top-line treatment for this is pelvic floor physical therapy.
7. Is surgery the only solution for incontinence?
No, many people successfully manage or resolve incontinence through physical therapy, exercises, and non-invasive treatments. Surgery is usually considered only when conservative methods are not effective.
8. What is the best surgery for incontinence?
The most common surgical options for incontinence include slings, bladder neck suspension, and artificial sphincter implants, depending on the type and severity of leakage. Surgery is usually recommended only when conservative treatments like physical therapy are not effective.
Our team of dedicated physical therapists provides compassionate, one-on-one care, specializing in pelvic health and women’s wellness.