Urinary incontinence in women under 40

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Bladder issues aren't only manifesting in older women. Younger, active women can have them too. Are you one of them? Many women, no matter their age, deal with the awkward problem of peeing when they don't want to. Over 13 million Americans have this issue, and women are more likely to have it than men, says the Agency for Healthcare Research and Quality.

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According to Pamela Moalli, MD, a professor of urogynecology at the University of Pittsburgh Magee-Womens Research Institute, incontinence problems among teens and young women are often linked to sports injuries. She notes, "About 20% of college athletes report leakage of urine during sports activities."

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Moalli emphasizes that women engaged in high-impact sports face the highest risk, including parachuters, gymnasts, and runners. "In these sports, you're hitting the ground hard, which can damage pelvic muscles and connective tissue that support the bladder."

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Niall Galloway, MD, FRCS, professor of urology and director of the Emory Continence Center at Emory University School of Medicine in Atlanta, points out that many young women have pre-existing biological factors that increase their vulnerability. "It runs in families," he states. "Just as bad eyesight runs in families, weak pelvic muscles can too. It's not that they've been overdoing it with exercise. It's just that they've reached the tolerance of their own tissues."

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For these girls and women, Galloway suggests a simple solution such as wearing a tampon or pessary (a device similar to a diaphragm) during exercise. "They just need a little something to support those pelvic tissues, something to put pressure on the urethra."

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What is urinary incontinence?

When you leak urine while coughing, laughing, sneezing, running, or simply standing in line at the grocery store–you’re experiencing urinary incontinence. This is the most common type of urinary incontinence in women under 40.

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As women get older, lower levels of estrogen, especially after menopause, can make the lining of the urethra (the tube carrying urine out of the bladder) thinner. The muscles around the pelvic area may also weaken with age, a condition called "pelvic relaxation." This can lead to an increased chance of urinary incontinence, where urine leaks involuntarily.

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What causes urinary incontinence?

You and your doctor might talk about why you're having trouble controlling your bladder. Here are some possible reasons:

• Pregnancy and childbirth: When you're pregnant, the baby puts pressure on your bladder, which can lead to incontinence. Giving birth vaginally can also stretch and weaken the muscles that help control your bladder.
• Active lifestyle: Running, sports (soccer, gymnastics, basketball), and high-intensity workouts (CrossFit) can cause urinary incontinence.
• Genetics: Just as bad eyesight runs in families, weak pelvic muscles can too.
• Urinary tract infections (UTIs): These infections can cause temporary incontinence.
• Medications: Some medicines, like diuretics (water pills), can cause bladder incontinence.
• Nerve damage: If a disease or injury is affecting the nerves that control your bladder, it could lead to incontinence.
• Tumors in the urinary tract: Growths anywhere in your urinary tract can be a cause.
• Constipation: If you're constipated, it can put more pressure on your bladder.
• Side effects of hysterectomy: This is when the uterus is surgically removed, and it can sometimes lead to bladder control issues.
• Using too many diuretics: Caffeine (found in coffee, tea, sodas, and energy drinks), vitamin C, and chocolate can make you produce more urine, possibly making incontinence worse.

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How to treat urinary incontinence (medically and naturally)

As mentioned in the intro, you don’t have to feel alone in this struggle. More than 50% of women report urinary incontinence (and that’s only including the women talking about it). Now, let’s get into the treatment options for urinary incontinence.

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Related post: (In-depth) What are the different types of urinary incontinence?

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How to naturally treat (or cure) urinary incontinence:

• Pelvic Floor Exercises
• Fluid Management (NOT recommended)
• Lifestyle Changes
• Bladder Training

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Healthy habits to help with urinary incontinence:

• Lose extra weight
• Eat more fiber
• Decrease sugar and caffeine
• Quit smoking

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Can medications be used to treat urinary incontinence?

There are over 20 prescription medications available to treat urinary incontinence. Several of these medications can cause dehydration and drowsiness. At Epiphany Women’s Health, we do not recommend the use of medications for urinary incontinence. There is a far more effective treatment option that does not involve the risk or symptoms that can be caused by medication taken for urinary incontinence.

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Although this is our stance, every woman has unique circumstances and you should consult your provider.

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Devices used to treat urinary incontinence in women:

• Vaginal Pessary
• Urethral Inserts

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Surgery and procedures to treat urinary incontinence

• Sling Procedure
• Injectable Bulking Agents
• Retropubic Colposuspension
• Inflatable Artificial Sphincter

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The most effective way to treat urinary incontinence

The O-Shot® (Platelet-Rich Plasma injection) for urinary incontinence

Traditionally, surgical procedures were common for managing stress incontinence, but the O-Shot® offers an alternative approach. Developed over a decade ago, the O-Shot® involves injecting platelet-rich plasma (PRP), derived from the woman's own blood, back into her body. PRP, containing highly active growth factors, stimulates cell and tissue regeneration, benefiting the area around the urethra causing stress incontinence.

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How the O-Shot® works:

Platelet-rich plasma is obtained by separating blood into plasma, platelets, and red blood cells. A centrifuge (spinning device) is used to separate the blood. The platelets and plasma are removed via a syringe and used for the treatment. The injection, administered near the urethra (pee tube), prompts the bone marrow to create new blood vessels and tissues. Over several days, weeks, and months, this new tissue develops, potentially treating urinary incontinence.

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Urinary incontinence is caused by weakening tissue around the urethra. If your muscles, ligaments, and tissues that support the bladder have lost strength or tension, the bladder and urethra are unsupported, leading to leakage.

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The O-Shot® helps create fresh, revitalized tissue that supports the bladder and urethra. This gives women better control and helps reduce urinary incontinence.

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FAQs About O-Shot®:

Is the O-Shot® FDA approved? 

Procedures are not approved or disapproved by the FDA. The FDA (Food and Drug Administration) monitors the safety of foods and drugs produced in the United States. 

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Since the O-Shot® is neither a food nor a drug the FDA is not involved, in the same way, that hysterectomies, c-sections, and PRP injections for sports-related injuries are not “approved by the FDA”. With that in mind, the procedure itself is not FDA-approved, but the kits used for the O-Shot® contain FDA-approved components.

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Can anyone administer the O-Shot®? 

No. Proper training and certification are required to administer the O-Shot® safely. Every provider at Epiphany Women’s Health is certified to administer the O-Shot®. You can verify this by visiting the Cellular Medicine Association.

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Next steps to treat urinary incontinence

If you find it uncomfortable to talk about incontinence, remember that more than 50% of women are struggling with urinary incontinence. You’re not alone. When you’re at Epiphany Women’s Health, you’re in a judgment-free zone. We are here to get you back on top of your game and living your best life. No more peeing your pants!

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If you’re ready to take the first step toward treating urinary incontinence, please book an appointment today!