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Bartosh's problem is remarkably common but woefully underdiscussed. According to the American Urological Association, about 1 in 5 U.S. women over age 50 suffers from stress urinary incontinence (SUI), the tendency to leak urine when the bladder is stressed by running, jumping, sneezing, coughing or other activities. Urge incontinence, the sudden unbearable need to urinate, is far less common...

Author: /time Magazine | Title: Body & Mind: Taking Back Control | 4/12/2004 | See Source »

Childbearing is the biggest risk factor for SUI. Experts say approximately 1 of 3 women who have had a vaginal birth--even an uncomplicated one--will develop SUI at some point in their life. Giving birth to twins or bearing more than one child does not necessarily raise the risk because the damage has usually been done with the first child. "The big domino to fall is the first pregnancy," says Dr. Linda Brubaker, an expert in female pelvic medicine and reconstructive surgery at Loyola University in Chicago...

Author: /time Magazine | Title: Body & Mind: Taking Back Control | 4/12/2004 | See Source »

...also affect the urethral sphincter, the tiny knot at the base of the bladder that controls flow through the urethra. A woman who had labored but then had a caesarean section is at a slightly lower risk than if she had given birth vaginally. But preliminary studies suggest that SUI is rare in women who underwent scheduled Csections and never entered labor. That finding may be a factor in the rising rate of elective Csections...

Author: /time Magazine | Title: Body & Mind: Taking Back Control | 4/12/2004 | See Source »

Even young women can experience SUI after childbirth, but the problem rarely becomes chronic until much later, often around menopause. The loss of estrogen weakens muscle walls, but that only partly explains the timing. "There are a lot of injuries that happen during childbirth that women learn to compensate for," says Dr. Peggy Norton, chief of urogynecology and pelvic reconstructive surgery at the University of Utah. As a woman grows older, Norton explains, her body's means of compensating for the damage may give way. Her muscles may weaken, her reflexes may not be so sharp, or maybe...

Author: /time Magazine | Title: Body & Mind: Taking Back Control | 4/12/2004 | See Source »

Whatever the cause of SUI, shame is a common side effect, and it often stops women from seeking treatment. Brubaker guesses that 90% of her patients wait years before coming to see her. "They think this doesn't happen to anybody else but them," she says...

Author: /time Magazine | Title: Body & Mind: Taking Back Control | 4/12/2004 | See Source »

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