What is urinary incontinence — UroWoman Kazakhstan

How common is it

Many women experience leakage: according to European guidelines, between a quarter and almost half of adult women report some degree of incontinence. It most often starts after childbirth, around menopause and with age, but it also affects young women who have never given birth — athletes, for example.

Yet many women wait years before seeing a doctor: they feel embarrassed, think it's normal or don't know that help exists. In the study of women in Kazakhstan, quality of life was most affected among those with urgency incontinence — symptoms clearly affect work, sleep, relationships and self-esteem.

How the bladder works

The bladder is a muscular reservoir that gradually fills with urine from the kidneys. While it fills, its wall stays relaxed and the outlet is kept closed by the urethral sphincter and the pelvic floor muscles. When the bladder is about half full, you feel the first urge, but you can put it off. When the time is right, the brain gives the signal: the bladder wall contracts, the sphincter relaxes and you pass urine.

The pelvic floor muscles form a "hammock" that supports the bladder, uterus and rectum. When you cough or jump, they tighten reflexively and stop urine escaping. When any part of this system fails, leakage occurs.

Why leakage happens

When support weakens

Pregnancy, childbirth (especially of a large baby or twins), excess weight, chronic cough, constipation and heavy lifting stretch and weaken the pelvic floor. Urine then leaks during effort — this is stress incontinence.

When the bladder "rushes"

Sometimes the bladder muscle contracts too early, before the bladder is full. This causes a sudden strong urge — urgency incontinence, often part of overactive bladder syndrome.

Other contributors include menopause (lower oestrogen makes tissues thinner), some medicines (such as diuretics), diabetes, neurological conditions and previous pelvic surgery. See Types of incontinence and Risk factors for more.

Symptoms you may notice

leakage when coughing, sneezing, laughing, running, jumping or lifting;
a sudden strong urge when it's hard to reach the toilet in time;
passing urine often during the day (usually more than 8 times a day is considered frequent);
getting up more than once at night to pass urine;
leakage at the sound of running water or when putting your key in the door at home;
a feeling of incomplete emptying or a weak stream;
changing habits: planning routes around toilets, avoiding sport, travel or intimacy.

If you recognise yourself in even one of these, take the short ICIQ-SF test and discuss the result with a doctor.

Why you shouldn't wait

Incontinence itself isn't life-threatening, but without help it often gradually gets worse. Women start drinking less, going out less and giving up exercise — which in turn harms overall health. Similar symptoms can also be caused by urinary tract infections, pelvic organ prolapse and other conditions that need to be ruled out.

The good news is that first-line treatment — pelvic floor exercises, bladder training and changing habits — is safe, accessible and helps many women without medicines or surgery.

Where to start

Take the ICIQ-SF test — it takes 2 minutes.
For 3 days, note how much you drink, when you pass urine and when leaks happen.
Book an appointment with a family doctor or gynaecologist and bring your notes. See How assessment works.
Start pelvic floor muscle training now and review your daily habits.

Sources

EAU Guidelines on Non-neurogenic Female LUTS. European Association of Urology. uroweb.org
NICE guideline NG123. Urinary incontinence and pelvic organ prolapse in women: management. 2019. nice.org.uk
Haylen BT, et al. An IUGA/ICS joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010;29(1):4–20.
Ryspayeva Zh, et al. Risk Factors and Quality of Life in Women with Urinary Incontinence in Kazakhstan. IJERPH. 2026;23(7):893. mdpi.com