Published on 10th March 2023

If you’ve ever experienced urine leakage or a sudden, uncontrollable urge to pee, then you’re likely one of the 50% of adult women dealing with incontinence of some kind. And let’s face it, it’s a pretty unwelcome, irritating, and often embarrassing reality for those that experience it. 

But incontinence isn’t just about struggling to hold on when you need to go. It comes in many forms, and affects sufferers in a number of different ways. Of course, incontinence of any kind can have an undesirable impact on your daily life, but finding out which type of incontinence you’re dealing with may at least make managing your symptoms a little easier. 

So, if you’re looking for a breakdown of urge incontinence vs stress incontinence, or you want to tell overflow incontinence from reflex incontinence, we’re here to help.

What are the 6 main types of incontinence?

When we think of urinary incontinence, we often associate it with unwanted urine leakage due to an unstoppable urge or brought on by factors such as physical exercise, laughter, or sneezing. And while these are typically the most common ways that incontinence symptoms affect sufferers, that’s not the whole story: there are as many as six different types of incontinence, each with their own causes and symptoms. 

Stress incontinence

The most common type of incontinence, stress incontinence is caused by pressure being put on your bladder when laughing, coughing, sneezing, heavy lifting, or doing other physical activities such as running. The physical strain or ‘stress’ on your body will affect your bladder’s capacity to hold urine (when your muscles weaken) which causes urine to leak involuntarily.

Stress incontinence is most common in women (around 1 in 3 women will experience it, while the number is higher for those aged 65 and older), with pregnancy, childbirth, the menopause, and obesity often being factors. 

What are the symptoms of stress incontinence?

  • Physical activity causing you to pass small amounts of urine frequently.

  • Less strenuous activities such as bending over leading to urine leakage.

  • Leakage occurring during sex.

  • Leaking urine since having a baby.

How to treat stress incontinence

  • Practice pelvic floor exercises (Kegels) to improve pelvic floor strength. 

  • Use bladder training techniques, such as using the bathroom at timed intervals.

  • Maintain a healthy weight and quit smoking.

  • Eat fiber-rich foods and stay hydrated to prevent constipation, which can make incontinence symptoms worse. 

  • Wear incontinence pads to help with leakages.

If your stress incontinence symptoms have started after pregnancy, you can seek advice from your doctor or midwife to help you manage the condition. 

Urge incontinence

Also referred to as an overactive bladder, this type of incontinence occurs when the bladder muscles contract even when the bladder isn’t full, causing a sudden urge to pee often followed by an involuntary loss of urine. Urge incontinence is common, particularly in women and older people, and risk factors include pregnancy and childbirth, hormonal changes caused by the menopause, urinary tract infections (UTIs), and being overweight.

Not being able to control your urge to pee may be a sign of more serious conditions, including neurological disorders or diabetes. However, in most cases, behavior and lifestyle changes can help you regain control.

What are the symptoms of urge incontinence?

  • Feeling a sudden urge to urinate that's difficult to control.

  • A sudden loss of urine after feeling the urge to pee.

  • Increasing urinary frequency, which is usually eight or more times in 24 hours.

  • Waking up to pee at least twice during the night.

How to treat urge incontinence

  • Practice Kegel exercises to strengthen your pelvic floor and increase bladder control.

  • When you feel the urge to go, try to hold it for 5 minutes, and then gradually increase the time you hold it each time.

  • Empty your bladder fully even if you don’t feel the urge.

  • Reduce the amount of caffeine and alcohol you drink.

  • Maintain a healthy weight and give up smoking. 

Overflow incontinence

When the bladder can’t empty fully, it starts to swell, which can cause small amounts of urine to leak even when you don’t feel an urge to go to the bathroom: this is known as overflow incontinence (or chronic urinary retention). There are a number of possible causes, including a blockage in the urinary tract, a weakening of the bladder muscles (which may happen after childbirth), or nerve damage caused by conditions such as Parkinson’s or diabetes. 

In severe cases a catheter may be required to fully empty the bladder, but fortunately there are many steps you can take to manage your symptoms in other ways.

What are the symptoms of overflow incontinence?

  • Having a frequent feeling of fullness in the bladder.

  • Experiencing a sudden release of urine even after going to the bathroom.

  • Having difficulty peeing (or only releasing a small amount of urine) despite having a strong urge to go.

  • A urine stream that stops and restarts during urination.

  • Leaking urine while sleeping.

How to treat overflow incontinence

  • Practice Kegel exercises to strengthen your pelvic floor and increase bladder control.

  • When peeing, try double voiding, which means waiting a few minutes and trying to go again after your first pee. This can help train your bladder to empty completely.

  • Create a bathroom schedule and try to go regularly (such as every 2 to 4 hours) instead of waiting to feel an urge.

  • If changing your peeing habits doesn’t help, seek professional medical advice, as the excess urine sitting in your bladder can develop into bladder stones.

Functional incontinence

Not all types of urinary incontinence are caused by a direct problem in the urinary system. Functional incontinence occurs when another physical or cognitive impairment prevents you from getting to the toilet in time; for instance, arthritis sufferers may find it challenging to unzip their trousers in time.

In other words, the bladder is healthy but other functions (physical and cognitive) are creating barriers when needing to pee. Some medications may add to this, too. Sedatives or treatments that affect your ability to move at a regular pace can make it hard to plan trips to the bathroom or get there in time.

What are the symptoms of functional incontinence?

  • Experiencing urine leakage, usually because something has prevented you from reaching the toilet in time. 

  • Feeling a strong, sudden urge to urinate.

  • Leaking urine despite not feeling a strong urge to go.

  • Leaking urine while sleeping.

How to treat functional incontinence

  • Make sure your bathroom is accessible. Clear any possible hazards that may slow you down on your way there.

  • Wear clothes that are easy to unzip or remove.

  • Create a bathroom schedule and try to go at regular intervals (for example, every 2 to 4 hours).

  • Cut down on fluids such as coffee, tea, fizzy drinks, and alcohol.

  • Limit your fluid intake before bedtime to reduce the likelihood of nighttime leakages. 

Mixed incontinence

When you experience various incontinence symptoms, this is likely to be categorized as mixed incontinence; for example, you may suffer from both stress and urge incontinence symptoms. There are many causes of mixed incontinence, and symptoms may occur as a result of added ‘stress’ on the bladder such as coughing, weakened muscles due to pregnancy and childbirth, or underlying health conditions.

It’s a good idea to keep a diary of your peeing habits. This will provide a better understanding of your symptoms and help you find a suitable treatment for the condition you’re dealing with.

What are the symptoms of mixed incontinence?

  • Experiencing a sudden, involuntary release of urine.

  • Leaking when doing physical activities such as exercise or lifting.

  • Feeling the urge to pee more frequently.

  • Waking up to pee more than once during the night.

How to treat mixed incontinence

  • Incorporate Kegel exercises into your daily routine to improve your pelvic floor strength and bladder control.

  • Practice bladder training techniques to enable you to hold your urine for longer.

  • Avoiding drinking too many caffeinated or alcoholic drinks.

  • Always try to empty your bladder fully when peeing.

Reflex incontinence

An involuntary reflex may cause the bladder to contract automatically when it becomes full. This can happen as a result of damage to the nerves. There are some similarities between reflex incontinence and urge incontinence; however, reflex incontinence generally doesn’t provide a sensation that you need to urinate, which can result in the sudden loss of large amounts of urine. This bladder spasm is sporadic and may happen even when the bladder is empty.

What are the symptoms of reflex incontinence?

  • Leaking large amounts of urine at a time.

  • Experiencing urine leakage without realizing.

  • Loss of bladder control after an injury.

How to treat reflex incontinence

  • Practice Kegel exercises and bladder training techniques to improve bladder control.

  • Schedule bathroom breaks and try to urinate at regular intervals (for example, every 2 hours).

  • Medication such as spasmolytic drugs may be needed to reduce bladder spasms and relax the bladder.

What are the most common types of urinary incontinence in women?

Stress incontinence and urge incontinence are the most common types of incontinence among women. This may be because of weakened pelvic floor muscles after pregnancy or childbirth, or an increased risk of incontinence due to hormonal changes after menopause. However, urine leakage isn’t a normal part of getting older as a woman, and symptoms can be prevented and improved.

What is the difference between stress incontinence and urge incontinence?

Stress incontinence happens when additional pressure is put on your bladder. Laughing, exercising, heavy lifting, or even sneezing can cause a small amount of urine to leak. Urge incontinence, on the other hand, is characterized by an uncontrollable loss of urine that’s caused by a sudden, intense urge to pee, often as the result of an overactive bladder. 

Can urinary incontinence be treated?

Urine leaks can be embarrassing and inconvenient, and are unlikely to go away on their own without the right treatment and lifestyle changes. Pelvic floor exercises, for example, are one of the simplest but most effective ways of improving bladder control and strengthening weak pelvic muscles, which can make a big difference in the frequency and severity of your urinary incontinence.

Treatments for urinary incontinence include:

  • Kegel exercises: pelvic floor exercises can help with all types of incontinence by strengthening the pelvic floor muscles and providing greater bladder control, enabling you to hold your urine and resist the urge to pee for longer.

  • Bladder training: depending on the type of incontinence you’re experiencing, retraining the bladder can reduce the chance of leakage; for example, try to go to the bathroom at timed intervals and resist the urge to go for as long as you can.

  • Dietary changes: cutting back on caffeinated drinks can lower bladder stimulation, decrease the kidney’s production of urine, and make urine leaks less frequent, while eating more fiber can help to prevent constipation, which can intensify incontinence symptoms. 

  • Quitting smoking: smoking leads to coughing, which can put unnecessary strain on your pelvic floor muscles and may lead to urinary incontinence. A weakened pelvic floor may not be able to support your bladder, making urine leaks more likely.

  • Losing weight: being overweight can place significant extra strain on the bladder and surrounding muscles, which can increase the risk of incontinence. If you’re overweight, switch to a healthy diet and increase your amount of exercise.

If you’re frequently leaking urine or making last-minute (often futile) dashes to the bathroom, you’re almost certainly suffering from incontinence. But what type of incontinence you have will impact how it affects your life and how you can deal with it. Understanding the symptoms and triggers involved is the first step to improving your symptoms and finding the right treatment for your needs.