Incontinence– the loss of bladder control – affects about 25 million Americans, but you don't hear much about it. While 55% of women in their 80s have the problem, nearly 30% of women in their 30s experience some loss of bladder control at least once a month. Believe it or not, about 50% of American women have experienced incontinence.

Why is incontinence so common in women? Part of the reason is the construction of the bladder itself. The bladder must be able to contract in order to efficiently empty when it’s supposed to, as well as be able to relax enough to serve as an adequate reservoir for urine collection.  All of this relaxing and contracting must be in conjunction with the voluntarily controlled sphincter muscle that surrounds the urethra, the tube that empties the bladder. As it contracts and relaxes, the sphincter muscle alternately squeezes the urethral tube. In her lifetime, a woman’s bladder will be asked to relax and contract with perfection 300,000 to 400,000 times.

Basically, women are more susceptible to incontinence because of their anatomy. A woman’s urethra is much shorter than a man’s, so it offers less resistance to outflow when the bladder muscle contracts. There are other reasons – including effects on the bladder from childbearing as well as weight gain, which can have a similar effect on the urinary system as childbirth. In one study, women with a body mass index (BMI) of greater than 30 were 139% more likely to be incontinent than those within a normal weight range. Also, metabolic conditions and neurological degenerative diseases can injure the nerves of the bladder and urethra and increase the risk of incontinence.

As you might expect, problems with incontinence increase as women age. In the late years, it can become a serious enough management problem that it can trip a woman from independence to dependence. In fact, half of all nursing home patients are incontinent.

Is there anything women can do? First, as a woman, understand that bladder care is essential. If you have pain, frequency, or leakage, don’t suffer in silence. Be evaluated thoroughly. Second, for caregivers, routine questioning and screening for incontinence in women is crucial – especially among those who have had children or hysterectomies, are depressed or overweight, or are diabetic or have neurological problems.

The majority of incontinence conditions can be improved or cured with treatment. But in order to get treatment, you have to take that first step – talk openly and honestly with your health care professional. As always, to learn more, either watch this week's video or read the full transcript below, then leave a comment on this topic.