How Incontinence Affects Men And Women Differently

How Incontinence Affects Men And Women Differently

How Incontinence Affects Men And Women Differently

Did you know that incontinence affects around 300 million people worldwide – which equates to 5% of the population? To put that into perspective, that makes incontinence more common than asthma and diabetes combined. 

And, while in the UK it is estimated that around 7 million people suffer from incontinence, figures could be much higher since many people are not comfortable enough to seek professional help. 

What’s more, around 24% of the UK’s older population (60 and above) struggle with incontinence. 

But how does it affect men and women differently?

Below, we discuss which types of incontinence are more common for women versus for men, and why. 

Urinary incontinence in men and women: the figures

While urinary incontinence affects both men and women of any age, it tends to be more common in women overall. In fact, women are twice more likely to suffer from incontinence than men, and 50% of the female population experience some form of incontinence at some point in their lives. 

And, while the prevalence of severe incontinence in young women is low, it rapidly increases between the ages of 70 to 80 years.  As noted above, however, these figures could be higher, since on average, only 1 in 5 women seek medical help for incontinence issues.

In men, the prevalence of incontinence is much lower at all ages than it is for women. 

Looking at men alone, it is also more predominant in older age - over 10% of men over 65 suffer from urinary incontinence to some degree. And while the risk of severe incontinence in men also increases with age, particularly in their 70s and 80s, it is still only about half of that in women.

Stress incontinence

In both men and women, stress incontinence is the most prevalent form of incontinence. 

For both sexes, individuals are at higher risk of stress incontinence from factors such as:

  • Obesity and related conditions such as diabetes
  • Seniority
  • Mental impairments such as dementia
  • Comorbidities

Stress incontinence in women

In women, stress incontinence is the most common form of urinary incontinence.

This is because natural deterioration of the pelvic floor muscles is likely to occur in women who have given birth or are experiencing the menopause.

And while women of childbearing age are often only mildly impacted by stress incontinence, the risk increases for women over 50, which is most likely a result of the menopause.  

Other factors which implicate stress incontinence in women include surgeries and treatments, such as hysterectomy and hormone replacement therapy. 

Stress incontinence in men

While Isolated stress incontinence is the most predominant form of incontinence for men, it still only accounts for less than 10% of incontinence symptoms in male patients. 

Prostate-related problems are the leading cause of incontinence in men. Removal of the prostate for cancer treatment (prostatectomy) is the most common cause of stress incontinence in men. That is because the procedure can weaken the sphincter, which is a muscle encircling the urethra below the prostate gland, in charge of controlling urine release. 

Urge incontinence

The causes of urge incontinence are very similar to those discussed above. However, one other leading cause is an obstruction of or in the urinary tract.

While constipation is a common obstruction for both men and women, other causes can be quite different for men and women.

Urge incontinence in women

In women, obstructions such as cysts, urinary tract infections, or even obstructive menstrual tissue and pressure resulting from endometriosis can cause a regular urge to use the toilet. 

Urge incontinence affects roughly 34% of women in the UK. 

Urge incontinence in men

Urge incontinence is more prevalent in men than women, being the most prominent symptom for 40-80% of male patients. 

This is because, as noted above, the prostate is a factor incontinence for men. The primary problems of the prostate include:

  • Prostatitis - an infection of the prostate gland that may relate to a urinary tract infection.
  • Benign prostatic hyperplasia (BPH) – also known as an enlarged prostate, this problem usually starts around middle age. Around 25% of men with BPH will require surgery or medical treatment. However, it is important to note the condition does not lead to cancer.

Bowel (faecal) incontinence 

In the UK, severe faecal incontinence affects 1.4% of people over 40. Further, 25% of the UK’s older (85 and above) population in care homes are affected by bowel incontinence. One of the leading causes of faecal incontinence is constipation, which affects between 3% and 15% of the population.

At present, studies suggest that faecal incontinence does not show preponderance in one sex over another. Rather, it is very much an age-related issue for both men and women. There are a multitude of causes for faecal incontinence, which may explain why prevalence is similar for both men and women. 

Mixed incontinence 

Mixed incontinence usually refers to a mix of stress and urge incontinence, but may also refer to a mixture of urinary and faecal incontinence. Regarding the latter, combined faecal incontinence and urinary incontinence affects roughly 5-6% of men, and 10% of women respectively. What’s more, this figure increases to almost 50% for nursing home residents (both male and female).

On average, about 14% of women have mixed urinary incontinence, while it is more prevalent in men, averaging between 15-30%.

People with mixed incontinence will usually find that the symptoms of one incontinence is worse than the other. Causes for mixed incontinence include those discussed above, as both symptoms for urge and stress incontinence generally apply. 

What to do if you think you have incontinence

The NHS website has a useful tool which you can use to assess bladder function (though sadly will not help with assessing faecal incontinence).  

However, while this tool is useful, we would still advise you to seek medical advice. Regardless of how mild or severe your symptoms are, if incontinence is beginning to affect your life or your personal wellbeing, it is essential to find a resolution. 

6 August 2020