Urinary incontinence is the unintentional leakage of urine from the bladder. While it can affect anyone at any age, it is more common in women. It’s a myth that only older adults experience incontinence – many younger women, including those who are pregnant or who participate in high-impact sports like jogging, also report symptoms.

What Type of Incontinence Do You Have?

There are two main types of urinary incontinence:

• Stress incontinence: Leakage of urine during physical activities that put pressure on the bladder, such as coughing, laughing, sneezing. bending over or exercising.
• Urgency incontinence (overactive bladder): A sudden and overwhelming urge to urinate that results in leakage of urine before reaching the toilet.

Many women experience both stress and urgency incontinence, which is referred to as  mixed incontinence.

Look at the box below to see what type you have.

The prevalence of fecal incontinence is two times higher in women with urinary incontinence (Obstet Gynecol 2013;122:539–545). 

Another Type: Overflow Incontinence (More Common in Men)

Overflow incontinence is typically seen in men and is often due to a blockage in the urethra, such as an enlarged prostate. This blockage prevents the bladder from emptying properly. Symptoms include:

• Interrupted or weak urine stream (start and stop urinating),
• dribbling after urination,
• continuous leakage of small amounts of urine,
• a sensation of incomplete bladder emptying or persistent bladder fullness.

Types of Urinary Incontinence

Reasons for Stress Incontinence

Stress incontinence is urine leakage of urine caused by physical exertion – like coughing, laughing, bending, jumping or jogging. It’s most common in women aged 25–49. Here’s why it happens:

Weak Pelvic Floor Muscles

• When abdominal pressure increases (e.g., from years of age). It occurs if the sphincter and pelvic floor muscles are not strong enough to hold the urine in when the pressure in the abdomen increases (as happens when you laugh or cough). No one knows exactly why these muscles may become weak; some women notice the problem after childbirth, especially after a vaginal birth. Women with stress incontinence often have leakage of urine during sex, usually at penetration (when the penis enters).

Genetics

• Family history is a strong factor – some women inherit weaker collagen (tiny strengthening fibres of muscles) or pelvic tissues.
• This may explain why stress incontinence tends to run in families (Clin Genet 2023;104:22–62).

Obesity

• Being overweight increases abdominal pressure, straining pelvic floor and bladder muscles, so if you are obese you double the chance of pelvic floor weakness (Female Pelvic Med Reconstr Surg 2022;28:181–187).
• Obese individuals have double the risk, though the weakness may be due to pressure, not muscle damage.

Pregnancy and Childbirth 

• Vaginal delivery can damage pelvic nerves and muscles, leading to weakness and stress incontinence.
• Women who have had Caesarean sections may not develop incontinence  (J Int Urogynecol J 2021;32:1633–1652).

Hysterectomy

• Women who’ve had a hysterectomy are at greater risk of incontinence in middle age.

Menopause

• Postmenopausal changes, like reduced levels of oestrogen, may weaken pelvic muscles and thin vaginal and bladder tissues.
• However, factors like age, weight and prior gynaecologic surgeries might play a larger role than hormones alone.

High-Impact Sports

• Activities with repetitive ground impact, like jogging, basketball, volleyball, can damage the pelvic floor. Interestingly, women parachutists in the US Air Force have developed incontinence because the impact of landing has damaged their pelvic floor.
• Swimming and cycling may be gentler options.

Heavy Lifting

• Lifting without proper posture strains the pelvic muscles.
• Correct technique includes tightening the pelvic floor and lifting with your legs, not your back.

Smoking 

• Smoking, even past use, doubles your risk – likely due to chronic coughing and connective tissue damage.

Medications

• Some drugs, especially alpha-blockers (e.g., prazosin, doxazosin), antidepressants (e.g., fluoxetine), and muscle relaxants, can weaken bladder control mechanisms.

Reasons for Urgency Incontinence and Overactive Bladder

Urgency incontinence involves a sudden, intense urge to urinate, often leading to urine leakage.  It’s caused by overactive bladder (OAB).

• The bladder muscle (detrusor) contracts inappropriately – before the bladder is full.
• Symptoms include frequency (more than eight times a day), urgency (sudden urge to urinate), nocturia (getting up at night to urinate) and possibly urine leakage.

Reasons for Mixed Incontinence

Mixed incontinence includes symptoms of both stress and urgency incontinence.

• One type may be more dominant than the other.
• Management typically addresses both pelvic muscle weakness and bladder overactivity.

First published on embarrassingproblems.com
Reviewed and edited by Dr Diane K. Newman
Last updated: July 2025 by Dr Diane K. Newman