Everything You Think You Know About Pee Leaks

We asked urogynecologist Dr. Fenwa Milhouse—from the hit TLC show Dr. Down Below—to give us the lowdown on the most common misconceptions she hears from her patients.

LEAKS ARE AN UNAVOIDABLE PART OF GETTING OLDER

While it’s most common in women over 50, urinary incontinence can happen at any age—and it’s not a necessary or normal part of getting older, says Milhouse.

“There are a host of things that happen to our bodies that we just put up with because we assume it’s part of being a woman—that it’s a burden we have to carry,” she says.

Pee leaks tend to fall into this category, which is why many women don’t bother bringing it up to their doctors and assume they have to suffer in silence.

DRINKING LESS WATER WILL REDUCE LEAKAGE

“People always want to cut off water,” says Milhouse. “But paradoxically, if you dehydrate yourself, it won’t help your leakage.” Concentrated urine, she explains, is a bladder irritant, and that can increase urgency and frequency.

Instead, if you have an overactive bladder or urge leakage, cutting back on beverages like coffee, tea, alcohol and carbonated drinks (which can irritate your bladder and cause you to want to pee more frequently) will likely help.

PREGNANCY AND CHILDBIRTH ALWAYS CAUSE INCONTINENCE

By some estimates, as many as half of new moms experience postpartum urinary incontinence. “Pregnancy and childbirth are risk factors for incontinence, particularly stress incontinence,” says Milhouse.

A combination of hormonal changes, a still-enlarged uterus and weakened muscles around the pelvis following the strain of childbirth can make bladder control difficult during the weeks and months following delivery. But incontinence isn’t exclusively a problem for those who have given birth. “Women who’ve never had babies can get it, and women who’ve had several babies can be dry,” Milhouse adds.

TREATMENT USUALLY INVOLVES SURGERY

“Surgery is not the only option, and I don’t go to it as a first option for patients who come to me having never tried anything else,” says Milhouse. In fact, there is a range of treatment options, the most suitable depending on the type of incontinence you’re experiencing.

They include pelvic floor exercises, eliminating foods and drinks that can be triggering and medications. “I advocate for and recommend conservative options first,” she says. And for most women, there are successful (non-surgical) treatment options.

INCONTINENCE IS NOT A BIG DEAL

“Because it’s not lifeor-death, it’s easy to shrug it off,” says Milhouse. But incontinence can be a big deal for many women. “It increases the risk of depression and sexual dysfunction,” she says. It can also promote anxiety and social isolation if you’re avoiding playing sports, going to a movie or even going out for dinner for fear of not being able to get to the washroom in time. Milhouse notes that it’s important to acknowledge the impact incontinence can have on an individual’s quality of life.