Today I am introducing you to Part III of our series questioning the “normal” parts on aging. We are tackling leaking ie issues with bladder control. Ever wake up in the night frustrated because you have to pee? Stay tuned, this one is for you.
I hear a lot of my older clients complain about have to get up multiple times per night to go to the bathroom. Having to get up multiple times and then trying to fall back asleep can be a huge pain and can have a huge damper on your quality of sleep. This can cause you to feel tired all the time and to never really feel rested.
So many older adults think that this is a normal part of aging and that it is something that they just need to deal with.
Let’s start from the beginning…
Whenever we are talking about having to go to the bathroom more often than we would prefer, the term for it is “urinary incontinence” or UI for short. It is commonly thought of as an over-activity of the bladder which is telling you you have to go to the bathroom over and over and over aging. There are several types of UI, with stress UI and urge UI being the most common. UI in general is more common in women than men, not to say that men don’t suffer from this as well!
Stress UI refers to when you cough or sneeze and you leak. This is because the pressure in your gut is greater than the pressure around your bladder (Doumouchtsis & Chrysanthopoulou, 2013). Your bladder can’t hold on anymore and urine leaks out. Think about if you are coughing or sneezing. This is more common in young and middle aged persons, especially women.
Urge UI is when all of a sudden you need to go to the bathroom RIGHT NOW. You get the urge to go to the bathroom and it’s immediate (Doumouchtsis & Chrysanthopoulou, 2013). If you don’t get there fast enough, you leak. This is more common in older women.
The most common type of UI seen with older adults is called nocturia ie having to get up what seems like every 5 minutes to go to the bathroom.
So I know that you’re wondering – is it a normal part of aging?
I’m going to put this into the tentative NO category.
And here’s my justification.
Nocturia, which is the most common form of bladder issue, happens to 24% of women and 21% of men between the ages of 65-84 (Ranson & Saffrey, 2015). This does increase more once you get into the 85+ category. What this means is that only 1 in 4 older adults have issues with their bladder! That isn’t everyone and therefore I can’t say that it’s a normal part of aging.
It is however, a risk factor.
As we get older, we are more likely to get it. But that is true with a lot of different conditions that accumulate across our lifetime. Heart disease is more common as we get older but we don’t say that it’s a normal part of aging.
What makes aging a risk factor?
There’s a couple of things that make you more like to have issues with controlling your bladder as you get older. As we get older, our organs in general are less efficient. This inefficiency can cause problems with going to the bathroom, known as voiding. As well, what controls our bladder is largely MUSCLES. Just like we talked about last week in our article on weakness, we lose our muscle strength gradually as we get older but these muscles can be trained! That loss doesn’t have to be dramatic. That being said, as we get older, we are more likely to have issues.
There are solutions – it isn’t something we have to live with.
Research has been done that showed that many older women thought it was a normal part of aging and so didn’t get help for it for, on average, 4 YEARS! 4 years!
Why is this such a big deal?
UI is a HUGE deal and one that unfortunately doesn’t get talked about a lot. People can be embarrassed to talk about problems that they’re having – and I totally understand, it isn’t easy. People who are struggling with UI issues are more like to be lonely, be isolated, and reduce their sexual activity (Erekson et al., 2015; Noguchi, Chan, Cumming, Blyth, & Naganathan, 2016). This can put a damper on the quality of your life. So although these conversations could be challenging – I encourage you to have them…. It’s definitely worth it!
It’s not just the emotional stuff.
People who are struggling with bladder issues are more likely to have falls or trouble doing day to day tasks (Erekson et al., 2015). The risk of breaking a bone is also increased if you have UI symptoms. This is probably because when you have to get up at night or rush to the bathroom, you’re more likely to trip on something in your house or wherever the bathroom is you’re trying to get to.
Therefore … yes, it is a big deal!
What can you do about it?
I’m glad you asked! There are multiple ways that you can try to work through bladder issues to improve, or in some cases, cure it. I hope that you will talk to your doctor to open up a discussion about what is going on in your case and work together to find out the best solution.
That being said taking a bladder diary that includes how much water you’re drinking, when, and how often you are going to the bathroom can start to shed some light on what might be a possible trigger (Stenzelius et al., 2015). Training of the muscles around your bladder (called your pelvic floor) has also been shown to be a way of improving symptoms. Some physiotherapists have done training on pelvic floor rehabilitation and can give you exercises to train the muscles around your bladder (Stenzelius et al., 2015). There are also medications (that will come with side effects hence talk to your doctor or pharmacist) and in extreme cases there is surgery that is done (Doumouchtsis & Chrysanthopoulou, 2013).
What I hope you get out of this article is that issues with leaking doesn’t have to be something that you deal with because it’s “normal”! There are things that can be done! Talk to your doctor and begin looking into ways to help. Even if your symptoms improve rather than go away, imagine the relief of not having worrying about where every bathroom in a mile radius is.
Stay tuned as we continue exploring and challenging things that we too often don’t talk about because we think it is the “normal” thing that happens as we age. Sign up for our newsletter to get notified of our new articles!
Doumouchtsis, S. K., & Chrysanthopoulou, E. L. (2013). Urogenital consequences in ageing women. Best Practice & Research.Clinical Obstetrics & Gynaecology, 27(5), 699-714. doi:10.1016/j.bpobgyn.2013.03.007 [doi]
Erekson, E. A., Ciarleglio, M. M., Hanissian, P. D., Strohbehn, K., Bynum, J. P., & Fried, T. R. (2015). Functional disability and compromised mobility among older women with urinary incontinence. Female Pelvic Medicine & Reconstructive Surgery, 21(3), 170-175. doi:10.1097/SPV.0000000000000136 [doi]
Noguchi, N., Chan, L., Cumming, R. G., Blyth, F. M., & Naganathan, V. (2016). A systematic review of the association between lower urinary tract symptoms and falls, injuries, and fractures in community-dwelling older men. The Aging Male : The Official Journal of the International Society for the Study of the Aging Male, , 1-7. doi:10.3109/13685538.2016.1169399 [doi]
Ranson, R. N., & Saffrey, M. J. (2015). Neurogenic mechanisms in bladder and bowel ageing. Biogerontology, 16(2), 265-284. doi:10.1007/s10522-015-9554-3 [doi]
Stenzelius, K., Molander, U., Odeberg, J., Hammarstrom, M., Franzen, K., Midlov, P., . . . Andersson, G. (2015). The effect of conservative treatment of urinary incontinence among older and frail older people: A systematic review. Age and Ageing, 44(5), 736-744. doi:10.1093/ageing/afv070 [doi]