Stress incontinence is a common condition where urine leaks during activities that increase abdominal pressure, such as coughing, sneezing, laughing, or exercising. It occurs when the muscles and tissues supporting the bladder weaken, leading to involuntary leakage. While it can be embarrassing and disruptive, you don’t have to live with it—effective treatments are available to restore control and confidence.
At MD Total Wellness in Brea, CA, we specialize in non-invasive and personalized solutions to address stress incontinence, helping women regain their quality of life. Led by Allison Mollet, PA-C, a certified menopause provider, and David Oliak, MD, a board-certified surgeon, our team is here to support you. Schedule a free consultation today to explore how we can help.
Stress urinary incontinence (SUI) affects millions of women worldwide and can significantly impact daily activities, emotional well-being, and social interactions. Studies show that the prevalence of SUI ranges from 20% to 54.5% among women, increasing with age. This condition often leads to distress, with many women reporting adverse effects on mental health, social life, and overall quality of life, including avoidance of physical activities or intimacy.
The primary causes of SUI include hormonal changes and physical trauma. During menopause, declining estrogen levels weaken the urethral sphincter and pelvic floor tissues, reducing their ability to prevent leakage. Pregnancy and childbirth further exacerbate this, as the weight of the uterus pressures the bladder, and vaginal deliveries can cause muscle tears, nerve damage, or stretching of the pelvic floor. Factors like obesity, chronic coughing, and previous pelvic surgeries also contribute. Recognizing these causes is key to effective treatment, as addressing root issues like hormone imbalance or muscle weakness can lead to lasting improvements.
Several evidence-based treatments exist for SUI, ranging from conservative to advanced therapies. While no single approach works for everyone, combining options often yields the best results.
Medications can play a role in managing SUI, though none are universally approved specifically for this condition in the U.S. Duloxetine, a serotonin-norepinephrine reuptake inhibitor, has shown some efficacy in reducing incontinence episodes by strengthening the urethral sphincter, with meta-analyses indicating improvements in symptoms for many women. However, side effects like nausea and fatigue limit its use.
Bioidentical hormone therapy (BHR) uses hormones that are chemically identical to those produced by the body to restore balance and alleviate SUI symptoms, particularly in postmenopausal women. Vaginal estrogen, a local form of therapy applied as creams, rings, or tablets, directly targets the urethral and vaginal tissues, improving elasticity, thickness, and lubrication to reduce leakage associated with genitourinary syndrome of menopause (GSM). Studies show it effectively decreases incontinence episodes with minimal systemic absorption and low risk. Systemic bioidentical hormone therapy addresses broader hormone deficiencies like estrogen and progesterone, supporting overall pelvic tissue health and potentially reducing SUI severity. Research supports BHR’s efficacy and safety when tailored appropriately (Files et al., 2011).
Kegel exercises, or pelvic floor muscle training (PFMT), are a first-line, non-invasive treatment that involves contracting and relaxing the pelvic floor muscles to build strength and endurance. When performed correctly—typically 10-15 repetitions several times a day—they can reduce SUI symptoms, with studies showing significant improvements in leakage frequency and quality of life. Supervised programs, often with biofeedback, are more effective than unsupervised ones, achieving better adherence and results. However, consistency is key, and many women struggle with proper technique or long-term commitment, leading to variable success rates. Kegels are safe, cost-free, and can prevent worsening of symptoms, making them an excellent starting point.
At MD Total Wellness, we focus on personalized care to treat the root causes of SUI.
BHR restores estrogen and progesterone balance to strengthen urethral and vaginal tissues, reducing SUI symptoms linked to GSM. Local applications like vaginal estrogen show reduced leakage and improved tissue health, while systemic options provide broader benefits. Customized via creams, pellets, or patches, it targets incontinence and enhances vitality (Files et al., 2011).
Emsella® provides an efficient, convenient, non-invasive, and medication-free solution for strengthening the pelvic floor to reduce incontinence. We’ve had two recent patients who were able to cancel planned bladder lift surgery due to the improvements achieved with Emsella®! Combined treatment with BHR, when appropriate, is a comprehensive approach targeting the root causes of SUI, hormone deficiency and weakened pelvic floor muscles.
At MD Total Wellness in Brea, CA, we are committed to empowering women through expert, compassionate care. We offer:
we’ll identify the hormonal, muscular, and lifestyle factors that contribute to your symptoms.
Don’t let stress incontinence control your life—proven treatments can help you thrive. Book a consultation with Allison Mollet, PA-C, MSCP, at MD Total Wellness in Brea, CA, to start your path to better bladder health and confidence.
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Symptoms of perimenopause can start in your 30s or 40s, and can significantly impact quality of life.
Learn what why menopause symptoms happen and how hormone therapy can help you feel like yourself again.
Discover the causes of stress incontinence and explore non-surgical treatment options to regain confidence and control.
Restore hormone balance to improve health and quality of life.
Noninvasive pelvic floor strengthening to treat incontinence and improve sexual function.
Radiofrequency treatment to improve tone, lubrication, and sensitivity.
