If you've ever had an accidental bladder leak when you laugh, sneeze, or cough, you're not alone. In fact, research says 60% of women and 35% of men over the age of 65 experience bladder leaks, also called urinary incontinence.

Bladder leaks are more common as we age. If they start to affect your daily life, it’s important to talk with your healthcare provider. There are many ways to manage bladder leaks, including lifestyle changes, medications, and other helpful options.

Keep reading to learn more about what causes bladder leaks in seniors, and ways to improve your symptoms.

Types of bladder leaks in seniors

There are many different types of bladder leaks that can affect seniors. They can be caused by a range of things, including physical effort, certain foods and drinks, and mobility challenges. It’s helpful to figure out the type of bladder leaks you’re dealing with so that you and your care team can make a plan. Here are some common types of urinary incontinence in seniors:

• Stress incontinence is when you have bladder leaks caused by physical effort like coughing, sneezing, or lifting something heavy. This can happen because of pelvic floor problems, which are common in seniors. Pelvic floor exercises for seniors can help improve stress incontinence.
• Urge incontinence is when you have a sudden, strong need to urinate, even when your bladder isn’t full. This is often triggered by bladder irritation from caffeinated drinks or bubbly drinks. 
• Functional incontinence is when you just can’t get to the bathroom in time. This can happen when you have mobility challenges or brain health conditions. 
• Overflow incontinence is when you can’t fully empty your bladder and have leaks or dribbles after going to the bathroom. 
• Nocturnal enuresis, or wetting the bed.
• Postural incontinence is when you have a bladder leak when you change positions (e.g., when you stand up from sitting in a chair).
• Coital incontinence, or peeing during sex.

When should I talk to my doctor about bladder leaks?

You should talk to your doctor any time you notice bladder leaks that you weren’t having before. Reach out for medical advice if you notice any of the following problems: 

• New or suddenly worse bladder leaks
• Feeling a strong or sudden need to urinate, or needing to go much more often than usual
• Confusion or memory loss linked to changes in bladder control
• Wetting the bed 
• Trouble feeling when your bladder is full
• Any bladder problems after a surgery, like prostate surgery or a hysterectomy
• Getting a urinary tract infection (UTI) two or more times within 6 months

Your healthcare provider can help create a treatment plan to improve bladder leaks. They might recommend:

• Bladder retraining programs, like keeping a bladder diary or using the bathroom on a schedule
• Pelvic floor physical therapy
• Medication
• Procedures like Botox or nerve stimulation

Not sure where to start? Check out Bold’s guide on how to talk to your doctor about pelvic health.

Why are bladder leaks more common with age?

Bladder leaks are more common with age for several reasons, including muscle weakness, nerve damage, and underlying medical conditions. There are lots of medical problems and habits that can cause bladder leaks. 

Causes of bladder leaks that can’t be changed (non-modifiable risk factors):

• Losing muscle mass with age. As we age, we lose muscle (around 3–5% of our muscle mass every 10 years). This includes the muscles that support your bladder and control urination. Weak muscles can make it harder to hold in urine, causing bladder leaks. 
• Hormone changes after menopause. After menopause, a woman’s body makes less estrogen. Lower estrogen levels can cause the muscles and tissues in the pelvic area to become thinner and weaker. This can increase the risk of pelvic floor problems, such as bladder leaks or pelvic organ prolapse.
• Lower bladder capacity. With age, the bladder holds less urine, and you can feel urgency much sooner.  This means you may feel the need to go more often, even if there isn’t much urine in your bladder.
• Brain health conditions. Health conditions like Alzheimer’s and Parkinson’s affect how the brain connects with the bladder. This can make it harder to know when to go or to get to the bathroom in time.
• Prostate issues. You can have bladder leaks and other problems after prostate surgery, or if you have an enlarged prostate. 

Causes of bladder leaks that can be changed (modifiable risk factors):

• Foods and drinks that irritate the bladder. Certain foods and fluids can increase symptoms of urinary urgency and leakage. Coffee, tea, alcohol, and fizzy drinks like soda or sparkling water can make symptoms worse. Acidic foods and drinks, such as lemon water and tomato sauce, can do the same.
• Urinary tract infections (UTIs) can increase the urge to urinate, which can sometimes lead to uncontrolled leakage.
• Weight gain and obesity. Weight gain can put more stress on the bladder, which can contribute to bladder leaks in seniors. 
• Low activity levels. A sedentary lifestyle can weaken your pelvic floor muscles. This makes it harder to control bladder movements. Get moving with Bold’s online exercise classes for seniors.

What lifestyle changes can help support bladder health?

If you're dealing with urinary incontinence, you can adjust certain factors to help manage it. Try practicing these healthy habits: 

• Avoid bladder irritants such as caffeine, alcohol, and spicy and acidic foods.
• Try bladder retraining. If you find yourself going to the bathroom too often, you can try following a set bathroom schedule, called a voiding schedule. Gradually, you work on going longer between bathroom breaks until your bladder gets back to a more normal routine. 
• • Use the Bold Bladder Diary to keep track of your urinary habits
• Drink plenty of water. Staying well hydrated is important for a healthy bladder. Many people with bladder leaks drink less liquid to try to prevent urinary incontinence. But smaller amounts of urine can actually become more concentrated, causing more urgency and leakage. This can also encourage more bacteria, which may lead to infections.
• Check your medications. Certain types of blood pressure medications can increase the urge to urinate. If you have urinary incontinence, talk to your doctor. If they think medication is causing bladder leaks, they can talk to you about switching medications or finding other ways to help. 
• Make sure you can get to the bathroom easily at home. It can be helpful to make sure your home is free of clutter and has clear paths for walking. Remove any tripping hazards, such as loose rugs or electrical cords, that may slow you down on your way to the bathroom. 
• Consider bladder protection items. Stay comfortable and confident with absorbent products that help manage bladder leaks. You can use items like urinary pads, or bed pads when needed, but remember they shouldn’t be your only solution. It’s also a good idea to talk with your doctor to see if you are appropriate for other options, such as a pessary, which can help support the bladder and reduce leaks.Exercises to prevent bladder leakage

What exercises can help prevent bladder leaks in seniors?

Exercises that keep our pelvic muscles strong and flexible can help prevent bladder leaks. If you experience urinary incontinence, your healthcare provider may recommend some key movements and routines:

1. Kegel exercises, also known as pelvic floor contractions, involve tightening and relaxing the muscles that support the bladder. These are the same muscles you use to hold back urine, stool, and gas. When they work properly, these muscles contract to prevent bladder leaks and relax to allow you to use the bathroom. Regular kegels can help improve strength, coordination, and control—supporting better bladder function over time.
2. • Practice guided Kegels in Bold’s pelvic floor classes
2. Diaphragmatic breathing. Try slow breathing to calm the urgency to urinate. This also builds awareness for better bladder control.
3. • Try Bold’s breathing classes to hone breathing techniques.
3. Combination moves. Combine strength training with pelvic engagement. This can help improve motor control and strength in the pelvic floor when you’re doing movements like walking, lifting, or using stairs.
4. • Explore combination moves like Kegel squats in Bold classes.
4. Strength training. Strengthen the muscles around the pelvic area, like the core, hips, and legs. This can help with stability and bladder control.
5. • Try Bold’s strength training classes featuring moves like bridges, heel slides, and leg lifts.
5. Walking supports circulation, core strength, and posture. These help with urinary control.
6. • Check out Bold’s walking classes to get your steps.
6. Exercises called urge control techniques. These can be helpful when you experience a strong urge to urinate. Here’s how to try:
7. • Step 1: Stop activity, stand quietly, or sit down. Put some pressure on the pelvic area using your hands or leaning forward while sitting. Try to stay very still to maintain control. Avoid rushing to the toilet.
   • Step 2: Contract your pelvic floor muscles by squeezing and letting go 5-10 times to keep from leaking or maintain a holding contraction if you feel as though leakage will occur if you relax the muscles. Pelvic floor contractions send a message to the bladder to relax and hold urine. You can also try raising your heels off the floor 10 times while sitting or standing. Try to distract yourself by thinking of something other than going to the bathroom.
   • Step 3: Relax. Do not rush to the toilet. Take a deep belly or diaphragmatic breath and let it out slowly. Let the urge to urinate pass by using distraction techniques and positive thoughts.
   • Final step: If the urge returns, repeat the above steps to regain control. When you feel the urge decrease, walk calmly to the bathroom.

Explore hundreds of online exercise classes, including Bold’s pelvic floor exercise program, today. Start any time from the comfort of your home. Not yet a Bold member? Check if you’re eligible for Bold at no cost through your health plan or provider. See you in class!