If you’ve ever leaked a little when you sneezed or laughed, you’ve probably been told it’s just one of those things that comes with having babies or growing up. But while UI is common, it’s not normal, and new research suggests that urinary incontinence (UI) could also be an indicator of your heart health.
A University of Iowa study of more than 20,000 women found that current UI was associated with cardiovascular risk factors, including type 2 diabetes and dyslipidemia (unhealthy mix of cholesterol or other fats in the blood), stroke and history of coronary artery bypass surgery. The link held even after the researchers adjusted for age, body weight, race and smoking.
The study does not prove that one causes the other, but simply a connection between the two. The findings give women and healthcare providers (HCPs) a reason to consider bladder symptoms as part of the bigger picture of women’s health.
1. Your bladder and heart share the same plumbing
The bladder relies on a healthy blood supply and properly functioning nerves to fill, hold and empty. When circulation or nerve signaling is disrupted, bladder function suffers.
“The bladder is very vascular and heavily innervated by nerves, so any time there’s a disruption in that process, the bladder will be affected,” he said. Aleece Fosnight, PA-Cphysician assistant specializing in urology and sexual medicine.
Fosnight explained that conditions such as type 2 diabetes, high blood pressure and stroke can damage small blood vessels and nerves throughout the body, including those that control the bladder. Diabetes also pushes extra glucose through the kidneys, which can increase urine volume and worsen leaks, he said.
2. New or worsening symptoms are the biggest clue
The Iowa study found the cardiovascular link only with the current user interface. Symptoms that appear or worsen over time seem to matter more.
“If someone had urinary incontinence problems in their 30s or 40s and now in their 40s and 50s they’re seeing a worsening of that urinary incontinence, that’s the change we need to be aware of,” Fosnight said.
He added that this kind of shift could signal an underlying vascular, metabolic or neurological problem. Fosnight has had patients whose new bladder symptoms led her to refer them to a cardiologist, including a woman in her 40s who was found to have blockages in her coronary arteries.
3. Middle-aged women should pay more attention
Estrogen supports tissue health in the heart, brain and pelvis. When levels drop in perimenopause and menopause, the risk for both cardiovascular disease and urinary incontinence increases, Fosnight explained.
Women over 40 with new urinary symptoms, especially alongside changes such as higher blood pressure, sleep disturbances, or a family history of heart disease, should bring them up with their HCP. Fosnight recommended keeping a simple bladder diary for a few days to track patterns in frequency, volume and time.
4. UI can prevent women from caring about their hearts
There is another side to the connection. Nieca Goldberg, MD, a cardiologist and member of HealthyWomen’s Women’s Health Advisory Council, said UI can prevent women from doing the same things that protect heart health, such as regular exercise, hydration and social activity.
“Women who are incontinent limit their water intake, and if they exercise, they may be at risk of fainting as they exercise while dehydrated,” Goldberg said. Another risk is that women may avoid exercise to avoid bladder leakage. “A sedentary lifestyle can lead to increased blood pressure, cholesterol and glucose, all risk factors for heart disease,” Goldberg said.
According to Fosnight, UI can cause women to avoid social events, leading to isolation. Fosnight has seen this cycle play out in her patients. Stress and isolation can also activate the sympathetic nervous system, which increases bladder urgency and frequency, making the cycle harder to break.
5. Ask about heart control when talking about your bladder
The new research is one reason to bring heart screening into the conversation when women report bladder problems.
“We should always look at studies like this and say it’s another opportunity to screen women for heart disease risk,” Goldberg said.
Sometimes, women feel uncomfortable discussing UI, so it would be ideal if HCPs bring up the topic during regular visits. However, if they don’t, it’s important to get over the embarrassment and report any bladder symptoms you have so you can get the care you need.
Goldberg recommended that women with UI be evaluated for cardiovascular risk factors, including blood pressure, cholesterol, blood sugar, and lifestyle factors such as activity level and smoking.
Talk to your HC about bladder health and heart health
Bladder leaks aren’t just an annoying nuisance. Treating UI as a window into cardiovascular health gives women the opportunity to treat heart problems earlier and feel better about their daily lives.
If your bladder symptoms are new, getting worse, or affecting your quality of life, mention them at your next appointment and ask about a cardiovascular screening as well. Your bladder and heart work together and your care should too.
Related articles around the web
