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 getting older. But, although UI is common, it’s not normal, and new research suggests urinary incontinence (UI) could also be a clue about your heart health.

A University of Iowa study of more than 20,000 women found that current UI was linked to cardiovascular risk factors, including Type 2 diabetes and dyslipidemia (an unhealthy mix of cholesterol or other fats in the blood), stroke and a history of coronary bypass surgery. The connection held even after researchers adjusted for age, body weight, race and smoking.

The study doesn't prove one causes the other, but rather just a connection between the two. The findings give women and their healthcare providers (HCPs) a reason to look at 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 working nerves to fill, hold and empty. When circulation or nerve signaling is disrupted, bladder function suffers.

"The bladder is highly vascularized and highly innervated by nerves, so anytime there's a disruption of that process, the bladder is going to be impacted," said Aleece Fosnight, PA-C, a physician assistant specializing in urology and sexual medicine.

Fosnight explained that conditions like Type 2 diabetes, high blood pressure and stroke can damage the 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 make leaks worse, she said.

2. New or worsening symptoms are the bigger clue

The Iowa study found the cardiovascular link only with current UI.

Symptoms that come on or get worse over time seem to matter most.

"If somebody had urinary incontinence issues in their 30s or 40s, and now in their 40s and 50s they're seeing worsening of that urinary incontinence, it's that change that we need to be aware of," Fosnight said.

She added that this kind of shift can 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 one woman in her early 40s who turned out to have blockages in her coronary arteries.

3. Women in midlife should pay closer attention

Estrogen supports tissue health in the heart, brain and pelvis. When levels drop in perimenopause and menopause, the risk of both cardiovascular disease and urinary incontinence climbs, Fosnight explained.

Women over 40 with new urinary symptoms, especially alongside changes like higher blood pressure, disrupted sleep 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, urine volume and timing.

4. UI can keep women from caring for their hearts

There's another side to the connection. Nieca Goldberg, M.D., a cardiologist and member of HealthyWomen's Women's Health Advisory Council said UI can stop women from doing the very things that protect heart health, like exercising regularly, staying hydrated and staying socially active.

"Women who have incontinence limit their water intake and, if they exercise, can put themselves at risk for fainting as they exercise while being dehydrated," Goldberg said. Another danger is that women may avoid exercising to avoid bladder leakage. "A sedentary lifestyle may lead to elevated blood pressure, cholesterol and glucose, all risk factors for heart disease," said Goldberg.

According to Fosnight, UI may cause women to skip 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 ramps up bladder urgency and frequency, making the cycle harder to break.

5. Ask about heart screening when you talk about your bladder

The new research is a reason to bring heart screening into the conversation when women report bladder problems.

"We should always look at studies like this and say it is another opportunity to screen women for heart disease risk," said Goldberg.

Sometimes, women feel uncomfortable discussing UI, so it would be ideal if HCPs bring the topic up during regular visits. However, if they don’t, it’s important to move past the embarrassment and bring up any bladder symptoms you have so you can get the care you need.

Goldberg recommended that women with UI get evaluated for cardiovascular risk factors, including blood pressure, cholesterol, blood sugar, and lifestyle factors like activity level and smoking.

Talk to your HCP about bladder health and heart health

Bladder leaks aren't just an embarrassing inconvenience. Treating UI as a window into cardiovascular health gives women a chance to catch heart problems earlier and feel better in 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 check too.

Your bladder and your heart work together, and your care should too.

Related Articles Around the Web