Relieving the symptoms and stigma of female urinary incontinence

Urinary incontinence affects about a third of adult women in Canada, yet many never receive a diagnosis or treatment. On this episode, Dr. Blair Bigham and Dr. Mojola Omole discuss the CMAJ review “Diagnosis and management of urinary incontinence in females,” which outlines how physicians can identify common forms of incontinence and begin management in primary care.

The episode opens with Sharon Roman, who shares her experience living with bladder dysfunction related to multiple sclerosis. Her story highlights the embarrassment, health consequences and barriers to care that can come with urinary incontinence, as well as the frustration of being told to simply keep living with symptoms that profoundly affect quality of life.

Dr. Louise-Helene Gagnon, an author of the review, a urogynecologist at Sunnybrook Hospital and assistant professor at the University of Toronto, explains the distinction between stress urinary incontinence and urge incontinence. She reviews common risk factors, including childbirth, menopause and pelvic floor injury, and walks through treatment options including pelvic floor physiotherapy, pessaries, mirabegron, vaginal estrogen and specialist referral.

For physicians, the central message is simple: patients may not raise urinary incontinence on their own. Asking about it directly can open the door to practical treatments that reduce isolation, embarrassment and daily disruption.

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