Busting the Shame Around Incontinence for Men and Women

Urinary incontinence is defined as accidentally passing of urine. Laughter, cough, jogging, or sneezing can accidental release urine. It also occurs when you suddenly get the urge to use the bathroom, but aren’t able to access it on time. Older adults usually experience bladder control issues. Although incontinence isn’t a serious health problem, it’s often shameful and embarrassing.

Busting the Shame Around Incontinence for Men and Women
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Medicine, urinary tract infection or constipation can cause short-term incontinence. Treatment of the underlying problem can stop incontinence. However, long-term urinary incontinence is usually ongoing.

The two main types of urinary incontinence include stress and urge incontinences. Stress incontinence occurs when you cough, jog, sneeze, laugh, or engage in activities that exert pressure on your bladder. This is the most common of four types of urinary incontinence.

Urge incontinence is a result of a strong need to pass urine, but you are unable to get to the bathroom on time. This type of incontinence occurs even when your bladder doesn’t have much urine in storage.

Some people accidentally experience urine leaks even without warning. However, others only leak upon touching or hearing running water, or drinking water.

Although an overactive bladder is a form of urge incontinence, not everyone with the condition experience urine leaks.

Prevalence of urinary incontinence and interventions

Urinary incontinence is high prevalent in both men and women. According to the International Continence Society, UI is when an individual complains of involuntary or accidental urine leakage.

About a quarter of all women experience urine incontinence, a condition that’s highly prevalent among females. However, only half as many men experience UI.

The term UI is broad and covers mixed, urgency, stress, and other types of UI, including incontinence with a neurological diagnosis.

Various strategies to control urgency and frequency, voiding programs, and pelvic floor muscle training (PFMT) are used as part of interventions for UI. PFMT interventions enhance urinary incontinence, but most people with UI don’t seek help.

And, the minority of men and women who seek help reach out to primary health clinicians. Most of the people who seek help get referred to clinicians with training or specialize in management of incontinence.

The culture of secrecy, shame and stigma around UI

The culture of shame, secrecy and stigma that surrounds urinary incontinence prevents many people from seeking help. However, an environment with reduced stigma and shame of UI allows individuals to focus on techniques that can help enhance continence instead of keeping it secret. 

Significant shame and the culture of secrecy makes it difficult for persons with UI to talk about their condition and seek help.

Doctors proactively ask patients about incontinence to fight the taboo and stigma around it. It also makes help readily-available for those who need it. This also works for other embarrassing and anomalous medical conditions.

Differences in the ways that people can control UI directly affects clinical care. PFMT, according to research, can enhance incontinence. However, this isn’t the focus of most people using various strategies to overcome urinary incontinence.

A cultural environment without stigma and shame around UI can help persons with the condition to adopt interventions bound to improve continence such as PFMT.

Healthcare professionals must also recognize individuals’ need to keep UI secret. They must also collaborate with other professionals to offer a treatment approach that enhances incontinence and meets this need.

Is UI normal or an illness?

Although urination is normal, many people fail to understand whether UI is normal or an illness. They believe that it’s normal for older women and mothers to experience UI.

Urine incontinence is linked to incompetence and being decrepit, making it socially unacceptable. Therefore, people keep UI secret to appear normal. It’s also associated with extreme old age and infancy, making it an embarrassing anomaly for most people.

The fact that UI is an “amorphous problem” makes it difficult for people to determine whether they’re ill or not. Its insidious nature links it to no specific cause. Despite its underlying cause, men and women struggle to determine if it’s normal.

Despite being a real problem with an impact on daily life for many people, the start of UI is usually unclear. Medically, UI hasn’t been clearly defined as a legit and acceptable medical condition.

Therefore, many people consider UI a “personal matter” that doctors dealing with medical illnesses don’t handle. People with this kind of perception fail to seek help for the same reason.

UI is also considered a normal part of aging because it’s never serious, making people reluctant to seek help. People don’t see it as serious enough to seek treatment. Although it affects daily life, UI is seen as vague and difficult to understand.

The term “incontinence” is also seen as too strong to describe the condition. An “odd squirt” or “leaking” are more accurate terms for people who perceive this condition as minor. Others have more important things to prioritize and worry about: work, home and family.

UI affects individuals and their feelings

Urinary incontinence affects people’s lives and sense of self. The need to keep incontinence under control and hide it from others affects people with UI.

Adopting routine to take control of incontinence is the key to living a normal life. However, incontinence is unpredictable. Routine awareness and planning are key to keeping it under control. Leaks hamper self-esteem, hence the need to alter routines to improve security.

People also change their routines drastically to avoid accidental leaks and embarrassments. Sometimes, individuals are forced to limit social connections and stay at home.

UI also affects intimate relationships. People with incontinence cease to feel desirable and worry about urine leaks during sex. This makes it difficult to maintain existing and future relationships.

Men and women may often feel “disgusted,” “guilty” and “anxious” when pleasure should be the center stage of their intimate moments. Although some spouses consider continence during intimacy a strong sexual signal, it’s problematic for times not related to sex and when trying to make new relationships.

People with incontinence also fear reactions to their urine leaks. It affects personal hygiene and cleanliness. The shame, embarrassment, disgust, and humiliating feelings associated with incontinence make people prefer to hide it.

UI weighs down on people emotionally. They feel distressed, frustrated, hopeless, weepy, and sad, fed up, annoyed, and out of control. They lose confidence. Together with loneliness, shame, and depression, it affects people’s quality of life.

Fatigue from trying to keep UI under control and the experience of urgency affects sleep quality, further affecting quality of life.

Guilt, shame and stigma

UI is stigmatized and often kept a secret because it’s considered an embarrassing social anomaly. It lacks social etiquette, humiliates and causes shame, explaining why it’s considered a taboo topic.

People with UI hide it to avoid judgment and discrimination from others. They also avoid being labeled incontinent.

People avoid discussing the taboo subject to prevent embarrassment and gain protection from silence. After all, UI is vague and not worth discussing. Failure to control body and urine is linked to infancy, making people embarrassed and ashamed to discuss the subject.

Fear of the smell of urine due to UI worsens loss of control. Smell causes embarrassment, blame and stigma. Although UI is considered natural and normal, people struggle to align it with inevitability, responsibility and culpability (comes with a sense of control responsibility).

People with UI blame self for failing to follow advice, seek help or even do recommended exercises. Shame, stigma and self-blame affect individuals’ self-image. The feeling of being dirty can affect worship and prayers in some individuals.

Talking about UI is difficult, but helpful

People with UI keep it a secret and prefer not talk about it. However, talking about UI is beneficial to affected persons. Talking about incontinence makes people more understanding and supportive.

Shared experiences make individuals learn that they’re not alone in the situation. Discussing the topic reduce the taboo around it and helps people with UI build close relationships. This helps develop a bond or circle of trust that can help people experiencing incontinence to regain control.

People with UI expect doctors to initiate discussions about incontinence instead of waiting for them to enquire about it. They also expect doctors to be friendly, interested, compassionate, understanding, informative and knowledgeable, empathetic, and responsive.

The doctors must have good listening skills and tailor their services to individual needs apart offering treatment. Healthcare professionals should also be appropriate and accepting of people with UI, atop speaking the same language to promote understanding and communication.

Keeping UI under control

People with UI must constantly be vigilant to keep it under control. Advance planning helps them stay dry and retain their self-esteem and confidence.

Worry and a sense of vulnerability causes individuals to lose spontaneity and freedom. This is because everything has to be planned in advance and some places or situations avoided to stay in control. Staying at home leads to isolation. UI can lead to geographical restriction for fear of embarrassments.

People with UI feel inflexible and dependent. When at home, they may feel safe. However, public areas make them feel ashamed, vulnerable and abnormal.

Going to the loo often, restricting activities and planning itineraries to match toileting impact affected person’s way of life.

Most strategies for managing UI simply conceal bodily functions instead of treating or improving incontinence. Wearing incontinence pads, limiting drinks, and always getting to know the location of toilets, for example, only control incontinence. Buying pads can be costly in the long run whereas incontinence panties can offer a more sustainable and affordable alternative.

Pelvic floor muscle exercises use physical motion to control incontinence. The exercises give people with UI control over their bodies and improves confidence.

However, changes are small and slow. And, pelvic exercises can be time-consuming.

Do you need help?

When UI interferes with your work and life, the need to seek help far outweighs the shame and embarrassment that comes with discussing the topic or asking for help. The underlying cause of UI, if known, can also determine whether you should seek help or not.