Can stress cause incontinence?
Stress doesn’t just take a toll on your mental wellbeing; it also affects your body. Physical symptoms include headaches, upset stomach, fatigue, insomnia, frequent colds, infections, and even cardiovascular disease. But did you know that poor mental health can also be a factor in incontinence?
Stress as a trigger
Research has shown that there is a strong link between stress and incontinence. According to the Continence Foundation of Australia, “the psychological impact placed on a person with incontinence… cannot be underestimated.” Incontinence is still a topic many of us find difficult to talk about, and our lives can be constrained by worry about accidental leaks.
But it may surprise you to learn that the reverse is also true. Researchers in Norway have found that if you have poor mental health, you are 1.5 to two times more likely to experience incontinence1.
So how does stress lead to an overactive bladder? The truth is that the medical world is yet to find definitive answers, but there are several different theories, including:
- Increased sensitivity of the nervous system - When your bladder is full it sends a signal via your nerves along the spine to the brain. The brain then sends a signal back to the bladder muscles to contract and the urethral sphincter to relax, so the bladder can empty. But when you’re stressed, your nervous system is overloaded. It reacts more intensely and rapidly to triggers, including the reflex to urinate.
- Muscle tension - It’s not just your jaw that clenches when you’re stressed. That muscle tension is felt throughout the body, including in the muscles around the bladder, increasing the urge to urinate.
- Chemical changes - Chronic stress can alter the chemicals in your brain, including lowering levels of a neurotransmitter called serotonin involved in mood regulation and cognition. Researchers have now found a link between low levels of serotonin and an overactive bladder.2
Incontinence and stress versus “stress incontinence”
You may have heard of a type of incontinence called “stress incontinence.” This doesn’t refer to the psychological stress we are talking about here, instead it is incontinence caused by physical stress on the body. Stress incontinence can happen when there is sudden pressure on the bladder during activities such as coughing, laughing, jumping and sex, resulting in bladder leakage. You can watch this Easily Explained by MoliCare video on stress incontinence to learn more.
What you can do
Which comes first: stress or incontinence? Incontinence can be a major source of stress and anxiety for many people. And stress can cause incontinence. So how do you interrupt the vicious cycle?
Here are some of the ways proven to help reduce stress:
- Get enough sleep – being well rested is a restorative mood booster, helping you cope with life’s challenges.
- Eat healthily – there is lots of evidence linking mood and the food and drink we put into our bodies.
- Make time for regular exercise to produce feel-good endorphins.
- Get outside – being in nature can lower blood pressure and stress hormones.
- Be mindful – mindfulness practice can help you to enjoy the here and now, instead of pondering on the past or worrying about the future.
- Finally, reduce the stress caused by bladder leakage. Cutting down on bladder irritants such as caffeine and alcohol, doing pelvic floor exercises, bladder training and managing your fluid intake have all been proven to reduce incontinence. Also helpful: use discreet, superabsorbent products that free you to live your life without worrying about embarrassing leaks.
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1. Felde, G., Ebbeseb, M. and Hunskaar, S., 2015. Anxiety and depression associated with urinary incontinence. A 10-year follow-up study from the Norwegian HUNT study (EPINCONT). Neurourology and Urodynamics, 36(2), pp.322-328.
2. Okamoto T, Imai A, Hatakeyama S, et al. Serum serotonin level as an independent factor for overactive bladder: Results from the community based cross-sectional study in Japan. Presented at the EAU 2021 virtual conference, July 8-12, 2021. Abstract P0014.