For nearly 30 million women in the United States, the simple act of coughing, sneezing or laughing can lead to bladder leakage.

Stress urinary incontinence (SUI) is the most common form of lost bladder control and one of the most unpleasant and distressing problems a woman can face. In most cases, incontinence starts gradually over time and increases, often to the point of causing women to stop doing many of their normal activities. Even everyday occurrences, like sneezing or laughing, can place "stress" on the bladder and trigger an SUI episode.

Factors That Increase the Risk
There are several risk factors that increase a woman's risk of urinary incontinence. They include the following:

• Age. SUI usually begins in women ages 45 to 54 years. However, women of all ages, even 35 and younger, have been known to suffer from bladder leakage.
• Race. It has been suggested that Caucasian women may have shorter urethras, weaker pelvic floor muscles and lower bladder necks than African-American women, thus making them more likely to develop incontinence.
• Pregnancy and childbirth. The weight of the fetus can press on a woman's bladder, causing involuntary leakage. Vaginal delivery involves significant relaxation and lengthening of the pelvic floor muscles to permit the passage of an infant. Urinary incontinence that occurs after childbirth has been associated with the use of forceps, episiotomy and pudendal anesthesia.
• Menopause and depletion of estrogen. Pelvic muscle relaxation accelerates rapidly after menopause and may progress with aging in general. Estrogen depletion has been associated with the thinning of the mucosal lining of the urethra, which can cause leakage.
• Pelvic surgery. Studies have shown that women who have had a hysterectomy are at a 40 percent increased risk of urinary incontinence.
• Caffeine. Caffeine is a diuretic and a bladder irritant, which may affect the ability of the bladder and urethra to contract.
• Smoking. Some studies show that nicotine may have a similar effect on the bladder as caffeine. Women who suffer from "smoker's cough" exert significant pressure on the bladder and urethra, causing bladder leakage. Chronic and frequent coughing may lead to damage of urethral and vaginal supports.
• Obesity. Excessive weight may impair blood flow or nerve innervation to the bladder. Research has shown that urinary incontinence symptoms decrease in women who were morbidly obese but who then had extreme weight loss.
• Medications. High blood pressure medications (diuretics) can adversely affect bladder filling and emptying; antidepressants, sedatives and central nervous system depressants can lead to muscle relaxation.
• High-impact exercise. Women who participate in high-impact activities, such as running or jumping, are more likely to experience bladder leakage. Causes of incontinence may include inadequate abdominal pressure transmission, pelvic floor muscle fatigue and changes in connective tissue or collagen of the pelvic floor muscles.
• Chronic diseases. Diseases such as diabetes, multiple sclerosis, Parkinson's disease and stroke may cause nerve and bladder neuropathy, increasing a person's risk for urinary incontinence.

Resources for Women
The good news is that there are now new treatments available to control SUI. Some tips and suggestions on how to treat and reduce the occurrence of SUI symptoms can be found on a new Web site – the SUI Center site – specifically developed for women with stress urinary incontinence.

The site was created by Dr. Donnica Moore, a physician who is best recognized as the women's health expert on NBC's Later Today Show, which ran from 1999 through 2000. Dr. Donnica has appeared in more than 200 television segments, discussing topics from contraception to infertility and migraines to menopause. Dr. Donnica was also the host of a daily, nationally-syndicated radio show, "Dr. Donnica's Women's Health Report," which still runs daily online. DrDonnica.com was born out of Dr. Donnica's goal of giving women the health information they clearly want, need and deserve.

*Courtesy of ARA Content

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