Leaking and mental health

Is leaking urine linked to mental health?

Medically, leaking urine is a “quality-of-life” symptom and condition.  It isn’t cancer or heart disease.  We treat it when it bothers the patient and usually let the patient bring it up.  We don’t often screen for it or ask about it.  Even groups that are likely to be leaking (like women who just delivered) aren’t always asked about it. In lots of subtle ways, we minimize these symptoms. But leaking urine and worsening mental health are strongly linked.

Leaking urine is more than a small social problem.  Women can slowly give up activities they love like yoga, running, and long movies at the theater (when that was a thing).  It can impact self-esteem and confidence and feel like a personal weakness.  All of these little things add up and urinary incontinence can lead to anxiety and depression.

What does the data show?

There is a lot of research about incontinence and depression. Women who leak during their pregnancy or afterward are almost 4 times more likely to be depressed in the postpartum period.¹  Having a new baby is hard enough when your body is functioning predictably!  Throwing in leaking can make it all feel a little impossible.  And women who leak are more likely to develop anxiety and depression over their lifetime.²  There are data to suggest that the impact of incontinence and depression is additive, meaning that you feel much worse if you have both.  Women who have depression and develop incontinence can have “symptom amplification”- the same symptoms bother you more than someone else without depression.  Improving incontinence helps improve depression and all treatments for urinary incontinence improve quality of life.³ 

So, if you’re not feeling great about your leaking, you are not alone.  These feelings are real and raw.  This strong correlation between leaking and mental health is just one more reason why treating incontinence is important.  I’ve treated many women whose mental health improved as their incontinence improves.  Improving leaking can help so many things- confidence, self-esteem, mental health, sexuality.  It can be hard to start looking for treatment options but you’ll feel better if you improve your leaking.

1. Swenson CW et al. Postpartum depression screening and pelvic floor symptoms among women referred to a specialty postpartum perineal clinic. AJOG 2018;218(3):225e1-e6.
2. Felde G et al. Anxiety and depression associated with urinary incontinence. A 10 year follow-up study from the Norwegian HUNT study (EPINCONT) Neurourol Urogyn 2017;36(2) 32208.
3. Siff LN et al. The effect of major depression on quality of life after surgery for stress urinary incontinence: a secondary analysis of the Trial of Midurethral Slings.  AJOG 2016;215(4):455 e1-9.