The emotional toll of female incontinence

The family dinner was going well - until a condition known as female incontinence got in the way. 

The middle-aged woman has urge incontinence, sometimes called overactive bladder (OAB). As the name suggests, when the urge to go to the toilet comes, it often can't be controlled. 

She leaked urine through her clothes and on to her son and daughter-in-law's upholstered dining room chair, an embarrassment that didn't go unnoticed. 

After the clean-up, even with her daughter-in-law and other family members assuring her that everything was fine, the woman was so humiliated she now has trouble accepting invitations. 

Urinary incontinence is primarily a physical problem, affecting an estimated three million UK adults. However, incontinence can also take an emotional toll on a person.

Emotional toll of female incontinence

When you have female incontinence, you may avoid social situations and even sexual intimacy, and that in turn can lead to withdrawal and depression. 

"Incontinence is embarrassing," says Dr Jennifer Anger, an assistant professor of urology. 

However, if you get a medical evaluation when you first notice symptoms of female incontinence, your doctor can suggest a host of treatments that will improve or eliminate the condition. 

"Older women think it's a normal part of ageing," Anger says, clarifying that it is not. While the condition does affect older women more than younger, it doesn't have to be a side effect of ageing.

Female incontinence and depression

Depression is more common in women with female incontinence, according to several studies. In one study, published in a 2005 issue of Obstetrics & Gynecology, researchers found that nearly three times as many women with female incontinence had depression compared to those without the condition. 

They surveyed nearly 6,000 women, between 30 and 90 years old, with more than 40% of them reporting some degree of female incontinence. 

Another study, published in Social Science Medicine in 2005, found that urinary incontinence is associated with depression in both women and men. If a woman is incontinent, her husband is also more likely to be depressed, the researchers found.

Female incontinence impact on quality of life

Not surprisingly, the more severe the urinary incontinence, the greater the impact on quality of life, report French researchers who evaluated 556 women with female incontinence and compared them to more than 2,000 women without the condition. These women had lower self-esteem, impaired well-being and reduced sexuality compared to the women without female incontinence. 

Urinary incontinence in severe forms should be considered a disability, the French researchers conclude in their report, published in a 2006 issue of Neurourology and Urodynamics.

Female urge incontinence

While all types of female incontinence can cause emotional distress, urge incontinence is far more distressing, says Dr Halina Zyczynski, an associate professor of obstetrics and gynaecology and a specialist in female incontinence.