Pelvic floor disorders, such as urinary incontinence, are among the most common reasons women refrain from leaving their homes and limit social activities. While the prevalence of pelvic floor disorders increases with age, it is not a normal part of aging. These are common medical conditions that have a variety of noninvasive, medical, and if necessary, surgical treatments.
More than 50 percent of women over the age of 55 suffer one or more problems caused by pelvic floor disorders. However, studies have shown that less than 46 percent discuss their condition with a clinician. Some women tend not to discuss incontinence due to embarrassment, while others are simply coping with the symptoms through the use of over-the-counter products. 
With the increase in life expectancy and a desire for older women to lead more active lifestyles, obstetricians and gynecologists have started to seek additional training in disorders that affect aging women. In fact, the American Board of Obstetrics and Gynecology has a special board certification in Female Pelvic Medicine and Reconstructive Surgery. Also known as Urogynecology, the additional specialty signifies expertise in the treatment of conditions that affect the female pelvic organs and the supporting muscles and tissues. 
Women’s healthcare providers, trained in pelvic medicine, are able to ask the right questions, offer solutions, and help women overcome obstacles and barriers that may otherwise impact their wellbeing. Common problems that they treat include urinary incontinence, overactive bladder syndrome, voiding dysfunction, prolapse, painful bladder syndrome, fecal incontinence, and other pelvic floor concerns.
Urogynecologists use several diagnostic tools to identify the type of incontinence that is occurring. Stress incontinence is the most common type. This occurs when there is an increase in abdominal pressure such as coughing, laughing or sneezing. Risk factors for stress incontinence include childbirth, constipation and work involving repetitive heavy lifting. Urge incontinence (often in association with overactive bladder) is described as an urgent need to go to the bathroom and not getting there in time. As women age, urgency becomes more bothersome. Many women struggle with both stress and urge incontinence, known as mixed incontinence. Lastly, overflow incontinence happens when the bladder is not fully emptied, causing leakage once the bladder is already full. 
Fortunately, there are steps women can take to promote pelvic floor health. A 5 percent weight loss can decrease incontinence by 50 percent and minimize prolapse symptoms. Avoiding artificial sweeteners, excess caffeine and other bladder irritants can significantly reduce urinary urgency and frequency. Regular voiding patterns and good bowel habits can also help.
Professional treatment of incontinence may include behavioral training (diet changes, timed voiding, biofeedback), pelvic floor physical therapy, prescribed medications, minimally invasive surgery, and a host of nonsurgical interventions such as Percutaneous Tibial Nerve Stimulation (PTNS). PTNS is a nondrug, nonsurgical treatment for overactive bladder that stimulates the nerves in the spinal cord that control pelvic floor function. 
Additionally, new research suggests successful outcomes with a variety of alternative interventions. For instance, recent small studies have shown mindfulness-based stress reduction, acupuncture and yoga to be as effective as drug treatment and bladder training in reducing urinary urgency, daytime accidents and incontinence-related quality of life. 
Urinary incontinence can be very distressing for women, but there are helpful solutions available. A specially trained healthcare provider can help diagnose the cause(s) of incontinence and provide effective treatment options so those suffering can return to living healthy and fulfilling lifestyles.