According to the International Continence Society (ICS), incontinence is the “involuntary loss of urine that is a social or hygienic problem and is objectively demonstrable.” Urinary incontinence is most commonly a result of bladder dysfunction, sphincter dysfunction, or a combination of both. An estimated 30 to 40 percent of middle-aged women and 50 percent of older women experience urinary leakage.
The problem is less common in men, but does increase with age. Even so, older men experience severe urinary incontinence at only about half the rate of women. Despite the prevalence of this health problem, it is still a “don’t ask, don’t tell” issue.
“In our study of nurses, less than 50 percent of the women who had incontinence reported it to their doctors,” says Mary Townsend, an epidemiologist at Brigham and Women’s Hospital in Boston.
It is a sensitive issue, for sure, but what is the cause of urinary incontinence? Leaks are more common in women who are older, heavier, or smokers, and in those who have had more children, diabetes, or a hysterectomy.
Caffeine may also be a cause of urinary incontinence
“We found a moderate increased risk of developing at least weekly incontinence in caffeine consumers, but only in women who consumed at least 450 milligrams a day,” says Townsend. You’d get 420 mg in one Starbucks venti coffee (24 ounces) and 520 mg in two tall coffees (12 ounces each).
“Caffeine was related only to urgency incontinence—leaks that occur with a sudden need to go to the bathroom—not with stress incontinence,” she notes. That’s a leak that typically occurs with coughing or exercise.
Caffeine is linked to urinary incontinence in men, too. In a nationally representative study of U.S. adults during 2005-2008, men who consumed at least 250 mg or more of caffeine a day were 72 percent more likely to experience moderate to severe urinary incontinence than men who consumed little daily caffeine.
Avoiding caffeine may help. In a small 2014 study in the United Kingdom, eleven women newly diagnosed with an overly active bladder consumed caffeinated drinks for two weeks and decaffeinated drinks for two weeks in random order while keeping three-day diaries about their symptoms. Their sense of urgency and their frequency of urination declined significantly during the weeks consuming decaffeinated beverages. More research with larger numbers of patients is needed.
How might caffeine cause urinary incontinence?
It may be a diuretic.
A diuretic increases the amount of urine created by the kidneys. The most commonly known diuretics include coffee, tea, and beer.
“And in animal studies, caffeine increases the force of muscle contractions in the bladder,” says Townsend. “So the combination may lead to urgency.”
Three ways to treat urinary incontinence naturally
1. Kegel Excercises
Training women to contract their pelvic-floor muscles—using Kegel exercises—makes a difference. Kegel exercises are usually recommended during pregnancy, but are also useful for decreasing urinary incontinence.
- Locate the correct pelvic floor muscles by stopping urination mid-stream. Regularly stopping urination is not recommended, as it can weaken the pelvic floor muscles, however it is a great way to locate the correct muscles.
- With an empty bladder, tighten your pelvic floor muscles and hold the contraction for five seconds, followed by five seconds of relaxation. Repeat this four or five times in a row, and eventually work up to maintaining the contraction for ten seconds.
- Try to breathe normally and focus just on the pelvic floor muscles.
- The goal is to work up to ten repetitions, three times per day.
2. Losing weight
Obesity is possibly a major cause of urinary incontinence, with demonstrated associations between body mass index (BMI) and risk of urinary incontinence. For overweight patients, losing weight is the number one recommendation for treating urinary incontinence.
Walking or other moderate exercise may lower the risk, especially of stress incontinence, says Townsend, “in part by maintaining a healthy weight and possibly also by strengthening the pelvic-floor muscles.”
So for caffeine lovers, the news is not all bad. It is worth noting, though, that caffeine consumption, in conjunction with other risk factors, may increase your chances of developing urinary incontinence.
Do you know someone with urinary incontinence? What has helped?
Sources: Am. J. Obstet. Gynecol. 194: 339, 2006; J. Urol. 185: 1775, 2011; Int. Urogynecol. J. 24: 605, 2013; Cochrane Database Syst. Rev.: CD005654, 2010; N. Engl. J. Med. 360: 481, 2009; J. Urol. 189: 2170, 2013; J. Wound Ostomy Continence Nurs. 41: 371, 2014.
This post was originally published in 2014 and is updated regularly.