Urinary Incontinence in Older Adults

Sophie Bebeau

Written by Sophie Bebeau on Mon Apr 24 2023.

Older couple smiling.

Urinary incontinence is common among older adults, particularly women, and can disrupt their lives if it's not managed. It’s important to know that incontinence is nothing to be ashamed of. As people age, the incidence of urinary incontinence increases.

Getting older makes our bodies more susceptible to developing this issue due to changes in anatomy, hormones, and lifestyle. Other factors like chronic health conditions, medications, and even choices such as smoking can also increase the risk of urinary incontinence.

Understanding the signs and symptoms of urinary incontinence can help older adults receive timely treatment and prevent this condition from becoming more severe with time. If you or a loved one have urinary incontinence, understand that you aren’t alone and solutions are available to help manage it.

What is Urinary Incontinence?

Urinary incontinence is a medical condition in which you can no longer control the bladder and/or urinary sphincter. While it can affect people of all ages, it is more common in adults over 65.

The more common symptom is an involuntary leakage of urine or difficulty holding urine for a long period due to weakened muscles in the bladder or weakened nerves that control them. The most common types of urinary incontinence are:

  • Stress incontinence - involuntary leakage with certain activities such as coughing or sneezing

  • Urge incontinence - the sudden urge to urinate with a sudden loss of urine

  • Overflow incontinence - urine leakage due to incomplete emptying of the bladder

Depending on the cause, symptoms may be mild or severe, and long-term management is important to keep symptoms manageable.

What Causes Urinary Incontinence in Older Adults?

Many things can cause urinary incontinence in older adults, but it is often a symptom of aging. As our bodies age, our hormones change, and our muscles weaken, leading to less bladder control. Lifestyle changes that occur as we age can also contribute to incontinence.

Women tend to get urinary incontinence more than men. Around 40% of women over 65 with incontinence have it due to hormonal changes during menopause.

Common causes of urinary incontinence in older adults are:

  • Weakening pelvic floor muscles

  • Damage to nerves that control the bladder due to chronic illnesses like multiple sclerosis or diabetes

  • constipation

  • Too much alcohol or caffeine

  • Eating foods that irritate the bladder

  • Certain medications, including blood pressure medication, heart medication, and sedatives

  • Pelvic organ prolapse (this is when the bladder, rectum, or uterus shifts out of its normal place in the body)

In women, urinary incontinence can be caused by:

For men, it can be caused by: 

  • Inflammation of the prostate gland

  • Damaged nerves or muscles from surgery

  • Enlarged prostate

How to Manage Urinary Incontinence

Most urinary incontinence can be managed with lifestyle changes. Here are a few simple things you can do to help manage urinary incontinence.

Incontinence Products

A wide variety of products are available to help manage urinary incontinence daily.

  • Incontinence pads are similar to sanitary napkins used for menstruation but are specifically designed for urinary incontinence. Pads come in a variety of shapes and absorbencies and are comfortable and discreet.

  • Adult diapers and pull-ups are the next step up from incontinence pads. They can offer more complete protection for those with heavier incontinence.

Shop adult diapers and pull-ups.

  • Disposable or washable underpads and mattress covers can be used around the house on furniture, in the car, or on a wheelchair to help discreetly soak up any bladder leakage, making messes much easier to clean up.

Shop underpads and mattress covers.

Pelvic Floor Exercises

Performing pelvic floor exercises, also known as Kegels, can effectively manage urinary incontinence. Pelvic floor exercises involve tightening and releasing the muscles around your pelvic area, which helps give you a better command of your bladder and increases bladder capacity, so you feel more in control. And pelvic floor exercises aren't just for women—these exercises can be done by men too! Get a step-by-step guide to performing pelvic floor exercises here.

Double Voiding

Double voiding is the practice of urinating, waiting a few minutes, and then trying to urinate again. This can help your body learn to empty your bladder fully and avoid bladder overflow. Just remember not to sit on the toilet for longer than 10 minutes to prevent developing hemorrhoids.

Schedule Your Bathroom Breaks

Instead of waiting for the urge to go, train your bladder to void more consistently by scheduling a bathroom break every two to four hours. This may be difficult at first, especially if you have an overactive bladder. You can start by trying to hold off going to the bathroom for five to ten minutes whenever you feel the urge. Work your way up to intervals of two to four hours between bathroom breaks, and your body will start to adjust to this schedule.

Limit Jumping, Lifting, and High-Impact Exercise

Jumping and lifting heavier objects and doing high-impact exercises like jogging puts extra pressure on the bladder and abdomen, which causes the pelvic floor muscles to release and leak urine. Try lower-impact exercises like pilates, yoga, swimming, or walking.

Don't Strain When Going Number 2

The average bowel movement shouldn't take more than a few minutes, so if you spend more than that on the toilet, you are likely constipated. In addition, when you strain during a bowel movement, the pelvic floor muscles weaken, exacerbating urinary incontinence. 

Click here for tips on relieving constipation.

Cut Back on Caffeine

Caffeine and alcohol are both major bladder irritants that can worsen incontinence. If it's not possible to completely eliminate those daily cups of coffee or caffeinated tea, begin by cutting back to just one cup a day. Try replacing caffeinated drinks with flavored water and decaf herbal teas. 

Cut Back on Alcohol

Cutting alcohol from your regular life can also make a big difference in curbing bladder leakage. Alcohol is a diuretic, which means it increases urine production. This means when you drink alcohol, you tend to urinate more frequently, which can exacerbate incontinence symptoms.

Limit Bladder-Irritating Foods

Like caffeinated drinks and alcohol, many foods can irritate the bladder and cause bladder leakage to worsen. Spicy and acidic foods are particularly irritating to the bladder and should be avoided. Other common foods to avoid include artificial sweeteners, soda, honey, and chocolate. Read Carewell's 8 Diet Tips to Help Manage an Overactive Bladder to get more ideas on managing urinary incontinence with dietary changes.

Stop Smoking

There are many, many reasons to stop smoking. Quitting the habit can reduce the risk of premature death and even add up to 10 years to your life! Smoking also irritates the bladder and can increase symptoms of urinary incontinence. Plus, excessive coughing can weaken the pelvic floor muscles and make bladder leakage worse.

Lose Excess Weight

Carrying around extra weight can weaken your pelvic floor muscles and make you more prone to bladder leakage. If you are overweight, lifestyle changes like altering your diet to include less sugar and less processed food and regular exercise is a good start to losing weight. Talk to your doctor if you are concerned about your weight and need guidance.

Drink A Lot of Water

Many people with urinary incontinence limit their water intake for fear of causing bladder leakage. Though it may seem counterintuitive, drinking more water during the day actually helps with urine leakage! Limiting water intake causes the bladder to have reduced capacity, meaning it can't hold as much liquid. Staying well hydrated is an important part of keeping your bladder healthy and can also reduce constipation. Drink six to eight glasses of water (or other decaffeinated and no-sugar liquids) daily.

Medical Treatments for Urinary Incontinence

If lifestyle changes do not help control your urinary incontinence, a doctor can recommend different medical treatments. 

Some common medical treatments for urinary incontinence are:

  • Medications: Several different types of medications can help with urinary incontinence. Different medications may be prescribed depending on the type of urinary incontinence you're experiencing. Some common medications used to help control incontinence include Botox injections, muscle relaxants, and alpha-blockers. 

  • Bulking agents: A bulking agent is a gel injected by a doctor into the wall of the urethra, the tube your urine travels through. This can help to reduce stress incontinence.

  • Vaginal estrogen cream: A low dose of estrogen cream can be applied to the vaginal walls and/or urethral area, which will help lessen the urge to urinate.

  • Catheter: A catheter is a medical device that drains urine from your bladder into a container outside your body. There are several types of catheter options, including external catheters, intermittent catheters, indwelling catheters, and suprapubic catheters. Learn more about different types of catheters and how to choose the best one for you here.

  • Urethral insert. A urethral insert is a small plug inserted into the urethra that blocks bladder leakage. The insert is removed during urination and then replaced. Urethral inserts can lead to urinary tract infections, so they are not a popular treatment choice.

  • Vaginal pessary ring. A vaginal pessary ring is a soft, silicone ring inserted into the vagina to help support the muscles around the uterus or bladder and helps decrease leakage.

  • Electrical stimulation. Electrical stimulation is done by inserting an electrode into the vagina and sending a mild electric current to the pelvic muscles. This essentially produces a strong Kegel exercise and helps strengthen your pelvic floor muscles.

  • Surgery. The most common surgical procedure for urinary incontinence is done by inserting a sling made of synthetic material or a strip of body tissues into the body to support the urethra. Other types of surgery can be performed depending on the type and cause of the incontinence.

When to See Your Doctor

Most cases of bladder leakage in older adults develop as part of normal aging, but if you are experiencing a sudden loss of bladder control or feel nothing is helping to manage it, it's time to see a doctor to rule out any medical issues. A doctor can have your urine tested to detect things like urinary tract infections or other abnormalities.

Make sure to schedule an appointment with your doctor right away if you have the following:

  • painful urination

  • cloudy urine

  • blood in the urine

  • the urge to urinate more than eight times a day

  • difficulty starting to urinate

  • a strong urge to urinate but only able to void small amounts

  • a sudden onset of bladder leakage that didn't exist before


Urinary incontinence can be an uncomfortable part of aging, but there are many ways to manage this condition. If you're experiencing urinary incontinence, consider some basic lifestyle changes to help control bladder leakage. Lifestyle changes that can help control bladder leakage include avoiding foods and drinks that may irritate the bladder, maintaining a healthy weight, doing pelvic floor exercises, avoiding constipation, and more.

Various medical treatments are available to help manage any underlying physical problems contributing to incontinence. However, if these measures do not provide enough relief or symptoms become more severe or frequent, it is important to speak with a doctor for further evaluation and advice on how best to manage your situation.

Need Help Finding the Right Products to Manage Your Urinary Incontinence?

If you need more information about managing urinary incontinence and bladder leakage, check out Carewell's archive of helpful articles about things like the best types of incontinence products, talking about incontinence with loved ones, and expert advice from Carewell's medical consultants.

Carewell's team of Care Specialists is also available to help you with any of your questions about managing incontinence and selecting the products that fit your lifestyle. Care Specialists are available 24 hours a day, 7 days a week.

Call (800) 696-CARE, email support@carewell.com, or click the live chat feature at the bottom of the page. We are passionate about serving caregivers and would love to help you find the products that make your life easier!

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Sophie Bebeau
Sophie Bebeau

Sophie Bebeau is a writer, graphic designer, poet, and multidisciplinary artist living in Green Bay, Wisconsin. When she’s not writing or making things for the internet, she can be found cross-stitching, writing poetry, and snuggling on the couch with a cup of tea and her husband, son, and dog, Buttercup.