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Causes of urinary incontinence and ways you can manage it

The Journal

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June 23, 2025

Urinary incontinence is a common and often distressing issue, particularly among adults over 60. Although it's not an inevitable part of ageing, the likelihood of experiencing incontinence does increase with age, influenced by a range of physical, medical and lifestyle factors.

What physiological changes contribute to the problem?

Thinning around the bladder: "In post-menopausal women, without extra oestrogen, the vagina and bladder base become 'atrophic' and become thin and more prone to irritation," explains Mr Gans Thiagamoorthy, consultant gynaecologist and certified urogynaecologist at Nuffield Health Woking Hospital.

Reduced bladder capacity: "Our bladder capacity reduces the older we get, and so does our sleep density," highlights Miss Sushma Srikrishna, a consultant urogynaecologist and obstetrician at London Bridge Hospital, part of HCA Healthcare UK.

"So, we have a double whammy, where your bladder cannot fill as well as it used to, and when your bladder starts filling (which it does, even overnight) and your sleep is also not as dense. This causes many people to wake up several times to pee overnight."

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