Do you feel like you have a weak bladder? You may leak a bit of pee (urine) when you laugh, or sometimes the urge to pee comes on so suddenly that you wet yourself. This loss of bladder control is medically known as urinary incontinence, and it’s a common problem.
It’s particularly common in women, due in part to differences in the female body and things like childbirth and the menopause affecting your bladder and pelvic muscles (read more about common types of urinary incontinence in women.
But there are also some lesser-known causes of a weak bladder. If you don’t know why it’s happening, you may feel frustrated. But there is help available. So read on to learn about some of the more unusual causes of a weak bladder – and what you can do about it.
Irritable bowel syndrome (IBS)
Irritable bowel syndrome (IBS) is a digestive condition, but if it causes constipation (a common IBS symptom), it can sometimes lead to urinary incontinence. This is because constipation can affect your bladder control: an over-full bowel puts more pressure on your bladder, which can cause an urgent need to pee. So if you have constipation with IBS, you may get temporary or long-term leaking of pee.
Some research has also shown that IBS is linked to overactive bladder syndrome, although the connection between these conditions isn’t fully understood. This is when your bladder muscles squeeze (contract) too often, causing urinary incontinence.
Thankfully, however, there are many effective treatments available for both IBS and constipation, which you can get from a pharmacy or your doctor.
Thrush, a common yeast infection caused by a fungus called Candida albicans, can also lead you to pee more. Symptoms of thrush include vaginal discharge and irritation, and soreness and stinging when you pee. In some cases, the infection can also get into your bladder and urinary tract, where it can cause symptoms similar to cystitis – including a frequent and urgent need to pee.
If you think you may have thrush, speak to your pharmacist or doctor, as treatment is usually simple and effective. However, it’s not common to get a candida infection in your urinary tract, so if it’s also causing urinary symptoms you might need different treatment, or a urine sample to check for other more common causes of urinary tract infections (UTIs).
There are some prescribed medicines that can not only increase the amount of pee you make, but also affect the way you store and pass pee.
Don’t just stop taking your medication though – always talk to your doctor first. They can tell you whether it’s sensible or safe for you to stop.
Medicines that can affect bladder control include:
- angiotensin-converting enzyme (ACE) inhibitors – used to treat high blood pressure
- water tablets (diuretics) – used to treat fluid retention (oedema) and heart failure
- selective serotonin reuptake inhibitors (SSRIs) – used to treat depression
- hormone replacement therapy (HRT) – used to treat symptoms of menopause
- some sedatives – used to treat anxiety and sleep problems. These can cause problems emptying your bladder, which can lead to a build up of pressure and leaking (see a doctor urgently if you can’t pass urine)
If the nerves that control your bladder are damaged or don’t work as well as they should, it can lead to bladder weakness and urinary incontinence. Nerve problems can be caused by neurological conditions such as multiple sclerosis (MS) and Parkinson’s disease, as well as diabetes.
Ensuring that these conditions are treated and as well-controlled as possible can help to prevent nerve damage and any associated bladder problems. Unfortunately, once nerve damage has happened, it can be hard or impossible to reverse, but your doctor may be able to recommend medication or other interventions to manage your symptoms and stop them getting worse.
Premenstrual syndrome (PMS)
Hormone changes happen normally during each of your monthly menstrual cycles, including the rise in progesterone that can trigger symptoms of premenstrual syndrome (PMS) before your period. And while it isn’t conclusively proven, it’s thought that these changes may also affect how your bladder muscles work.
If you think your menstrual cycle may be affecting your bladder, speak to your doctor. There are lots of general treatments for PMS, which can help you manage your symptoms so they don't interfere with your daily life – read more about treating PMS.
Sometimes, having an operation such as the removal of your womb (hysterectomy) can cause urinary incontinence. This can be because of a bladder prolapse – where your bladder ‘falls’ and pushes into your vagina – or, in rare cases, damage to the nerves around your pelvis and bladder (pelvic autonomic nerves).
If you’re getting urinary incontinence after having surgery, speak to your doctor. It may settle by itself over time, or you may need treatment to help with your symptoms. Your doctor can also discuss whether you need a review by the surgeon who performed your operation.
Your health questions answered
Can holding onto pee cause incontinence?
Answered by: Dr Roger Henderson
“If you occasionally find yourself desperate to pee before you actually go to the toilet, this is unlikely to cause any problems. However, if you frequently ignore the urge to pee and allow your bladder to get too full, this can put pressure on your pelvic floor muscles – and if these are weakened over time, it can lead to bladder leaks. It’s also thought that not peeing when your body wants to may increase your risk of UTIs, although more evidence is needed before we can say this is definitely the case.”
I have a problem with my thyroid gland. Could this cause incontinence?
Answered by: Dr Roger Henderson
“Your thyroid gland plays an important part in regulating how your body works. There’s some evidence that an overactive thyroid (hyperthyroidism) can cause bladder problems such as urge incontinence and a frequent need to pee – but it’s uncommon. Remember that urinary incontinence and thyroid problems are both very common, and they can happen at the same time without being linked in any way. If you have an overactive thyroid and you’re getting urinary symptoms, make sure you’ve had a recent blood test to check that your thyroid levels are normal.”