For thousands of women in the United States, their deepest secret doesn't revolve around their age, but rather an experience that is common among females of all ages: light bladder leakage. For some of these women, the embarrassment associated with a leaky bladder—whether it means tiny drops when they sneeze, a small dribble when they hear running water, or a noticeable wet spot after certain forms of exercise—prevents them from talking to their friends or spouse about it, let alone seeking treatment. Yet in a society where the idea of sex helps sell everything from magazines to television shows, many bladder experts are frustrated. Why are so many women ashamed to talk about bladder leakage? What prevents them from seeking treatment? And, perhaps most importantly, how can women overcome these feelings of embarrassment?
"The reality is that many women are not comfortable talking about their bathroom habits," says Caryn Antos, of the National Association for Continence (NAFC). "But they would be more apt to share their experiences if they knew that bladder leakage is much more prevalent than they realize. While many women feel isolated, as if they're the only one with this problem, the truth is that their friends may very well be living with it, too." In fact, one in four women over the age of 18 experience episodes of involuntary leaking of urine.
Antos recalls a recent example of the "embarrassment factor." Recently, as she was helping to run an NAFC booth outfitted with educational materials, she noticed that few women felt comfortable enough to approach her. "It's a challenge for people to even come up to the booth and pick up materials," she says. "It's as if they're afraid of that ‘scarlet letter.'" Missy Lavender, executive director of The Women's Health Foundation (WHF), has also had a notable experience. In a February 25, 2008 blog entry on the Foundation's website she writes about an encounter with the publisher of a local women's magazine. The publisher asked her, "Why is a nice girl like you talking about things like this?"
The possible explanations behind this idea of embarrassment are complex and varied, say bladder health experts. One answer is age-related; older women, in particular, may be less comfortable talking about this area of their body. They may also be less knowledgeable about how far the treatments for bladder leakage have come in the last 30 years, and this is where the younger women in their lives can step in. For others, it's a cultural thing. Many women don't have a good understanding of their own anatomy, or they may not feel comfortable talking to a male doctor about it. This is where finding a female gynecologist, urogynecologist, or physical therapist can make a big difference.
Another large reason for this way of thinking is the country's culture. "The United States is one of the more reserved countries when it comes to this topic," says Antos. "In Europe, tons of organizations band together for educational purposes—and there's no privacy barrier to break through."
At the end of the day, Antos, Lavender, and other bladder experts urge any woman who experiences bladder leakage to get more information or consult her doctor. "Although bladder leakage itself is not life threatening, it can affect your quality of life if it isn't properly treated," says Antos. "Leaving the problem alone can lead to depression or isolation. In addition, bladder leakage can be a symptom of something else, so it's important for women to find the courage and strength to bring up this topic with their doctor or medical practitioner."