11 Reasons Why You’re Leaking

Urinary incontinence is the involuntary leakage of urine. There are many reasons why Urinary Incontinence occurs that aren’t age or postpartum related. Urinary leakage isn’t a “normal” part of aging or postpartum and can indicate something serious going on. If your leakage has occurred suddenly or has dramatically increased suddenly, make sure you have a chat with your healthcare provider. Here are 11 reasons why you might be leaking:

1. Urinary Tract Infections (UTIs): Infections can irritate the bladder, causing increased urgency and frequency of urination. UTIs range from no symptoms to pelvic pain, burning, foul smelling urine, sudden onset of leakage, urinary frequency, back pain, abdominal pain and even knee pain. The filtration system of the urine is a pure and closed system, thus the urine should always be clear. Cloudy urine, as we call it in Chinese Medicine, can indicate some invasion of the system, like a UTI. 

2. Prostate Issues: Inflammation of the prostate can create pressure on the bladder and the urethra. Conditions such as benign prostatic hyperplasia (BPH) or prostate cancer can cause urinary incontinence in men. 

3. Neurological Conditions: Conditions like multiple sclerosis, Parkinson's disease, or stroke can affect nerve signals involved in bladder control. There is hope for clients who have a concomitant neurological disorder that impacts the urinary system. Scalp acupuncture combined with pelvic acupuncture has shown success in supporting clients with neurological conditions and urinary leakage.

4. Medications: Some medications can have side effects that impact bladder function, such as diuretics or medications that relax the bladder sphincter. Often there are other pharmaceuticals that may not have the same side effects. It is worth a conversation with your provider to discuss benefits versus risks. Quality of life is a consideration for medication changes.

5. Bladder Pathologies: Interstitial cystitis, bladder stones, or bladder tumors can contribute to urinary incontinence. They may be correlated with pain, but might not be. 

6. Pelvic Floor Trauma: Issues with the muscles and tissues supporting the bladder and urethra, often due to injury or surgery, can lead to incontinence. Old injuries that occurred years ago can be a contributing factor.

7. Obesity: Excess weight can put additional pressure on the bladder and pelvic floor, contributing to incontinence.

8. Chronic Coughing: Conditions like chronic bronchitis or emphysema can lead to stress incontinence due to increased abdominal pressure from frequent coughing. This is due to pressure being created in the trunk and the muscles of *usually* the pelvic floor and abdomen being weak against that pressure.

9. Diabetes: High blood sugar levels can cause bladder dysfunction and increase the risk of urinary incontinence.

10. Stress: Chronic stress can alter the chemicals in the brain, including lowering levels of serotonin, which is involved in mood regulation and cognition. Researchers have found a link between low levels of serotonin and an overactive bladder.

11. Prolapse:  Bladder, uterine or rectal prolapse can change the position of or put pressure on the bladder leading to a mechanical change in the pelvic organ system causing leakage. 

Let’s talk about those “normal” leakage considerations:

Pregnancy and Childbirth: Two factors come into play during pregnancy and childbirth. The first is hormonal changes, which include the release of relaxin to relax the uterus and supporting ligaments to allow a baby to grow and eventually be delivered. The second is physical stress, the weight of the baby on the bladder can cause leakage. Unfortunately, complications, longer healing times and multiple pregnancies are risk factors for the pelvic floor weakening over time. 

Aging: Over time, the musculature of the pelvic floor and the tonicity of the bladder can weaken, thus the pelvic floor can not support the fluid and the bladder cannot hold the fluid, yielding leakage. The older one gets, the more likely weakening and overstretching will occur due to hormonal and physical changes. 

But let’s first remember: LEAKAGE ISN’T NORMAL! It is vital to work with your physician to determine the source of the leakage and to treat that condition. Treating the root pathology isn’t just important to your pelvic health, but to your overall health. If there is a generalized pelvic floor weakness or dysfunction, then your Pelvic Care Acupuncturist and Pelvic PT can help support you on your journey to bring suppleness and qi back to the pelvic floor.