Though loss of bladder control becomes more likely as the years accumulate, there's plenty you can do to lessen the likelihood of being affected, or at least to decrease the condition's impact on your quality of life. More than half of adults will experience incontinence at some point in their lifetime, sometimes as an effect of medications or a urinary tract infection and sometimes because of weakened pelvic floor muscles. Many will live in constant dread of embarrassment, fearful of revealing their plight even to a doctor. But "it's a big myth" that urinary incontinence goes hand-in-hand with aging, says Tomas Griebling, vice chair of urology and faculty associate at the Landon Center on Aging at the University of Kansas.
Among people 40 and older, women are three times more likely to suffer leaky plumbing than men. This may be because of childbearing or the fact that women have shorter urethras, making it harder for muscles to clamp down on urine flow, says Debuene Chang, a urology program director at the National Institutes of Health. Men typically have troubles with urination related to an enlarged prostate or with loss of control after treatment for prostate cancer. But both genders may head off trouble (or minimize it) by doing regular pelvic floor exercises before giving birth or having a prostatectomy, then continuing in the years that follow. The simple exercise entails squeezing the muscles used to stop the flow of urine, making sure not to strain the abdomen, which can cause symptoms to worsen. Doing periodic reps throughout the day for a total of 10 minutes—and stopping if they become uncomfortable—is probably plenty. It's possible that exercise in general may play a role. Certain studies have found that physically active women were less likely to experience incontinence, though other research leaves doubt. But dropping pounds might help: A 2005 study in the Journal of Urology found that overweight and obese women who lost 5 to 10 percent of their weight halved their weekly episodes of incontinence, possibly by reducing pressure on the abdomen and bladder.
Bathroom habits and diet can matter, too. Some people—with diabetes, for example—lose the sensation of the bladder filling, says Griebling; a regular schedule of bathroom breaks can avert awkward waterworks. In others, the bladder's lining becomes irritated, boosting the sense of urgency to urinate, by anything from caffeine to alcohol to spicy or acidic foods. The bottom line, experts say, is that you needn't—and shouldn't—chalk a bladder problem up to the march of time.