More than half of U.S. women over the age of 50 suffer at some point in their life from stress incontinence. Treatments are available.

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The occasional dribble. Some bothersome tinkle. And the downright pee-pee or piddle.

Whatever hush-hush code words they use to describe it, more than half of U.S. women over the age of 50 suffer at some point in their life from unintentional, unexpected and often embarrassing urine leakage – known medically as stress incontinence, according to Seattle specialists with Swedish Medical Center.

Typically, it happens when stressed pelvic muscles around the bladder, urethra and sphincter are weakened. The result? A simple sneeze, random cough or laugh, light jog or basic yoga stretch that can compromise the body’s ability to hold back urine – and it sneaks out.

Factor in athletic girls as young as their teens and 20- to 40-somethings who have pregnancy-related pelvic damage, diabetes, obesity, aging muscle tissues or other potential triggers, and the number of females affected by stress incontinence can be startlingly high.

In Seattle and around the country, numbers are especially difficult to pinpoint because many women loathe talking about it – even to their doctor. Some consider it embarrassing; others have spent years – if not decades – dealing with stress incontinence on their own by using sanitary pads and limiting their physical activity.

But Swedish Medical Group’s Dr. Eleanor Friele says there is something new to help women with what she says her patients sometimes call “problems down there.”  The Nurse Navigator in the Pelvic Health program through Swedish Medical Center is just a phone call away for patients who want to tap into a network of nearly three dozen Puget Sound-area health care experts in women’s’ urinary, gynecological and colorectal specialties at the expansive range of primary campuses, local clinics and related affiliates.

It starts by patients picking up the phone and “talking with our nurse care coordinator who guides them through the system,” says Dr. Friele. Designed to take awkwardness out of the process, the Nurse Navigator asks questions to help move patients toward appropriate specialists and tests to determine the right diagnosis and solutions for their needs.

“For a lot of people, stress incontinence is unnerving or even embarrassing,” says Dr. Friele. “Patients sometimes call and say, `I don’t know who to see, but I have a problem.’ ”

What’s stopping them?

“People aren’t willing to work on a problem until it truly interferes with their life,” says Dr. Friele.

Dr. Lora Plaskon, a urologist in female pelvic medicine and reconstructive surgery at Issaquah-based Athena Women’s Health calls this line “a threshold of bother. When your bladder control crosses that threshold, that’s when it becomes time to get a (medical) referral.”

Part of the Swedish Nurse Navigator network, Dr. Plaskon says many of her patients are “40 to 50 years old, working women hitting menopause, who had a little problem with leakage before, just coughing or sneezing. Now maybe they’ve gone from one liner a day to three or four.”

Dr. Plaskon asks women: “Are you avoiding intimacy? Is it getting to the point where you can’t just bend over to pick up the cat?”

What many patients don’t know about stress incontinence is that it’s more than just inconvenient and awkward.

“A lot of women are reticent when it comes to bladder issues because it seems minor,” says Dr. Plaskon. “In reality, third-party payers (medical insurers) see it as a serious health problem.”

Women begin limiting activity due to stress incontinence, she says. “They’re not exercising. Then the dominoes start to fall. When it starts to limit your exercise, you add 2 to 5 pounds of weight a year. Now, maybe you’re at 50, you’re possibly obese, at risk for diabetes or bone fractures or depression or coronary problems.”

Dr. Plaskon says many of her current patients are “baby boomers because the prevalence of issues shows up among women in their 50s, 60s and 70s – but these problems start earlier, so we’re targeting younger women to be in preventive mode.

She says it’s important for new moms to work with obstetricians to create a postpartum checklist about “getting that mojo back, enjoying sexual experiences again and not worrying about leaking urine during intimacy.”

Learning more about stress incontinence earlier in their lives is a way women can say “I’m saving my bottom.”

With recommendations that begin via support from the Swedish Nurse Navigator network, treatments for stress incontinence can range from lifestyle changes (losing weight, quit smoking and avoiding spicy foods and carbonated beverages) to physical therapy (pelvic floor strengthening with accurately performed Kegel exercises), and prescription medicines to surgery.

Dr. Plaskon says potential treatments are “not all about surgery.” Nearly 70 percent of patients find more conservative treatments for stress incontinence.

Ultimately, she says, “It’s important to know you don’t have to be supporting Depends.”

Swedish Pelvic Health is a leader in pelvic health disorders. We provide you with coordinated, concierge care through care team collaboration and nurse navigation. Your health care team includes experts in urology, gynecology, colorectal, rehabilitation services, imaging, and pain management.