Insight
Understanding incontinence: beyond leaks, a guide to a common condition
By Gloria Kolb, co-founder and CEO of Elitone

Incontinence — often whispered about or ignored due to embarrassment — is a prevalent and significant health concern affecting millions worldwide.
Defined as the involuntary loss of bladder or bowel control, it manifests in various forms, from occasional leaks to frequent urges that disrupt daily life. Despite its widespread impact, incontinence remains under-discussed and misunderstood, leading many affected individuals to suffer in silence.
By shedding light on this common condition, I want to empower individuals to seek help, improve their quality of life, and break the stigma surrounding incontinence. Whether you’re navigating occasional leaks or more persistent symptoms, knowledge and support are crucial steps toward managing and overcoming the challenges of incontinence effectively.
What is incontinence?
Incontinence encompasses a spectrum of conditions characterised by the involuntary loss of bladder or bowel control, affecting people of all ages and genders. The most common types include stress incontinence, which involves leakage during activities such as coughing, sneezing, or exercising due to weakened pelvic floor muscles.
Urge incontinence is marked by a sudden and intense urge to urinate, often leading to leakage before reaching a restroom. Overflow incontinence occurs when the bladder is overly full, but there is no signal to urinate, causing frequent dribbling or leakage.
For many individuals, incontinence represents more than just a physical inconvenience; it can profoundly impact daily routines, social interactions, and emotional wellbeing. The condition may stem from various factors, including age-related changes, childbirth, pelvic floor disorders, neurological conditions, or certain medications.
Understanding the type of incontinence one experiences is crucial for determining appropriate management strategies, which range from lifestyle modifications and pelvic floor exercises to medical interventions and, in severe cases, surgical procedures.
Causes and risk factors
Incontinence can arise from a combination of factors related to bladder function, pelvic floor muscle strength, and overall health.
Common causes include:
- Age: As people age, bladder muscles may weaken, leading to increased susceptibility to incontinence.
- Childbirth: The strain and trauma of pregnancy and childbirth can weaken pelvic floor muscles, contributing to urinary leakage.
- Menopause: Hormonal changes during menopause can lead to changes in muscle strength and wall lining, leading to an increased incidence of incontinence.
- Chronic conditions: Conditions such as diabetes, obesity, and neurological disorders can affect bladder control.
- Medications: Certain medications, including diuretics and sedatives, can contribute to bladder control problems.
- Smoking: Tobacco use is associated with a higher risk of bladder control issues.
Understanding these factors helps individuals and healthcare providers identify potential contributors to incontinence and tailor treatment plans accordingly. Addressing underlying causes through lifestyle modifications, pelvic floor exercises, and medical interventions can significantly improve bladder control and quality of life.
Symptoms and impact
Incontinence manifests in various ways that can significantly affect daily life. One of the most common symptoms is urinary leakage, which occurs during activities like coughing, sneezing, laughing, or physical exertion, known as stress incontinence.
Another key symptom is urgency, characterised by sudden and intense urges to urinate that often result in involuntary leakage before reaching a restroom, known as urge incontinence.
Individuals may also experience increased frequency of urination, waking up multiple times at night to urinate (nocturia), and continuous or frequent dribbling of urine due to an overfull bladder (overflow). These symptoms can lead to substantial disruptions, impacting social interactions, emotional wellbeing, and overall quality of life.
Many people with incontinence face embarrassment, anxiety, and limitations in daily activities due to concerns about leakage and the need for frequent access to restroom facilities. Early recognition of these symptoms and timely intervention are crucial to managing incontinence effectively and improving one’s ability to lead a fulfilling life.
Treatment options
Treating incontinence involves a range of approaches tailored to the type and severity of symptoms experienced. For stress incontinence, which is often caused by weakened pelvic floor muscles, pelvic floor exercises (Kegel exercises) are commonly recommended to strengthen these muscles and improve bladder control.
Lifestyle changes such as maintaining a healthy weight, avoiding caffeine and alcohol, and quitting smoking can also help alleviate symptoms.
External solutions, such as wearable devices that tone the pelvic floor and calm overactive bladder symptoms, offer innovative alternatives. These devices provide electrical stimulation to improve muscle function and bladder control. They can be used alongside other treatments to enhance effectiveness.
For more severe or persistent cases of incontinence, medical interventions may be necessary. These can include minimally invasive procedures, such as injections of bulking agents around the urethra to help close the bladder opening and prevent leakage.
Nerve stimulation techniques, like sacral neuromodulation, can also help regulate bladder function by sending electrical pulses to the nerves that control an overactive bladder.
Consulting with a healthcare provider can help determine the most appropriate treatment plan to enhance bladder control and restore quality of life, but typically start with the most conservative and least invasive (and costly) treatments.
Future directions and innovations
Looking ahead, ongoing research and innovation in the field of incontinence offer promising avenues for improving treatment outcomes and quality of life for affected individuals.
Advances in wearable technology continue to refine devices that provide biofeedback and electrical stimulation, enhancing their effectiveness in strengthening pelvic floor muscles and managing bladder function.
Additionally, there is growing interest in personalised medicine approaches tailored to individual genetic profiles and specific types of incontinence. This could lead to more targeted treatments that address underlying causes and optimise therapeutic outcomes.
Furthermore, collaborative efforts between healthcare providers, researchers, and technology developers are driving the development of novel therapies and interventions. From advanced surgical techniques to non-invasive treatment options, the future holds promise for more effective, minimally disruptive solutions for managing and potentially curing incontinence.
By staying informed about these advancements and engaging in discussions with healthcare providers, individuals can look forward to a future where managing incontinence is more accessible, effective, and empowering.
Gloria Kolb is the CEO and co-founder of Elitone, the first non-invasive, FDA-cleared, wearable treatment for women with urinary incontinence. Elitone’s accolades include winning Best New Product by My Face My Body, Sling Shot 2020, finalist in Women Startup Challenge, and many startup pitch competitions. As an inventor with 30+ patents, Gloria has been featured in Forbes as a Top Scientist Driving Innovation in Women’s Health. Her designs and problem-solving abilities have earned her recognition, such as Boston’s “40 Under 40” and MIT Review’s “World’s Top Innovators under 35.” She has engineering degrees from MIT and Stanford and an entrepreneurship MBA from Babson College.

Insight
Women urged to be wary of menopause misinformation on social media

Women are being urged to seek evidence-based advice and avoid menopause misinformation shared on social media.
A seminar co-hosted by the World Health Organization (WHO) mainly examined what is known about the cognitive effects of menopause and current research in the field worldwide.
Dr Nicole Jaff, a South African academic and certified menopause practitioner, said research into menopause and its effects was now at a peak.
She said: “There’s a lot of information out there.
“But I would say please look for the evidence-based information, not for the influencers and the misinformation, but those who are giving guidelines, who are giving information.”
Jaff highlighted research into cognitive changes during menopause and how some women experience brain fog, a term for difficulties with memory, concentration and clear thinking.
She said: “I’m very excited about the non-hormonal treatments that are now available, especially for women who could never take hormone therapy because of breast cancers and various cancers, who can now take it.
“I’m extremely excited about people who are standing up for evidence-based medicine, for science, who are actually fighting back against a lot of the social media and influencers who are not giving evidence-based information and making life very difficult for women because they think they should be forever young or buying this or buying that.”
Jaff advised women and healthcare workers to read new guidelines recently issued by the International Menopause Society. They are available free to download from its website.
The seminar also heard from Professor Aimee Spector, professor of clinical psychology of ageing at University College London.
She raised similar concerns about misinformation, particularly claims linking hormone replacement therapy, known as HRT, to dementia. Some claims suggest HRT reduces dementia risk, while others suggest it increases the risk.
Spector said: “I think there’s also lots of misinformation.
“And I think that there’s huge variations in how even professionals and doctors interpret this information.”
She was part of an international research team commissioned by the WHO last year to assess published studies on the issue.
The institutions involved also included the Global Brain Health Institute at Trinity College Dublin.
Spector said: “The first thing to say is that the quality of evidence was very low.
“Nine out of the 10 studies we looked at were observational, which means that you’re observing patterns over time. But you don’t necessarily know whether that’s due to the hormone therapy or not.
“Our overall recommendation was that there’s insufficient evidence for menopause hormone therapy in terms of either increasing or reducing the risk of dementia. In other words, we don’t know either way.”
Spector said women should therefore decide whether to use HRT to treat menopause symptoms rather than based on concerns about dementia.
She said: “It’s recommended for menopause symptoms, but it’s not recommended to reduce dementia. And I think a lot of people are saying that.”
The Menopause on the Brain webinar was part of an ongoing series hosted by the WHO and other global health agencies.
Insight
Endometriosis musical set for Edinburgh Fringe stage

An endometriosis musical by two US writers will debut at the Edinburgh Festival Fringe in August.
“Endometriosis: The Musical” follows Jane, a woman trying to discover why she is living with chronic pain.
Maria Bartholdi and Kristin Stowell first developed the production for the 2022 Minnesota Fringe Festival.
The full show premiered at Theater in the Round in Minneapolis in 2025.
Stowell said the play drew on personal experience, although neither writer realised it at the time.
“So it’s like my goal to let women see themselves in this who are dealing with this and have a question they can bring back to their doctor,” she said.
“Like, could it be endometriosis?”
Bartholdi said she did not realise she might have the condition herself until after the play premiered.
“This show helped diagnose me, which I think is just one of the miraculous things that we hope this the show does for other people as well,” Bartholdi said.
Dr Wendy VanBuren, a radiologist at Mayo Clinic in Rochester, said she was a fan of the musical and its role in raising awareness of a common but underdiagnosed disease.
“Cells that are similar to but not identical to the cells that comprise the lining of the uterus, the inside of the uterus, are located outside the uterus,” said VanBuren.
“When they’re outside the uterus, there isn’t the right environment to deal with that. So basically, what you get is bleeding, and then you get inflammation.”
Roughly one in seven women live with the disease, and receiving a diagnosis can take nearly a decade.
Insight
Johnson & Johnson offers to pay US$5.5bn to settle talc cancer lawsuits

Johnson & Johnson has offered an estimated US$5.5bn settlement covering about 76,000 claims that its talc products caused ovarian cancer.
The proposed agreement could end a contentious legal dispute over the company’s baby powder and other talc-based products that has lasted around a decade.
Johnson & Johnson said the settlement covers claims consolidated in a federal court in New Jersey and related cases in state court.
The claims represent nearly all the remaining talc cases against the US multinational, according to the company.
Johnson & Johnson has previously settled most claims alleging that its talc contained asbestos and caused mesothelioma.
Mesothelioma is a rare cancer affecting the lining of organs, most commonly the lungs, and is usually linked to asbestos exposure.
Law firms representing claimants confirmed the proposed deal, describing it as a good resolution after around 10 years of litigation.
The agreement must be accepted by 95 per cent of ovarian cancer claimants in state or federal court before it becomes final.
Erik Haas, vice-president of litigation at Johnson & Johnson, said the claims were “meritless” and that the company was willing to settle to bring the litigation to a close.
“While we are confident the company would have ultimately prevailed with further litigation, as it has in the vast majority of cases tried to date, this resolution allows the company to put this matter behind it and remain focused on its mission to develop medicines and devices that save lives,” Haas said.
The company expects to pay US$3bn in 2027, with further payments due in 2028.
The deal could be worth more, depending on how many people take part in the settlement.
Chris Seeger, a lawyer representing around 2,500 clients with talc claims who helped negotiate the agreement, said Johnson & Johnson could ultimately pay US$7bn or more.
The settlement assigns specific values to qualifying ovarian cancer claims but does not cap the company’s total payout.
“We got a fair settlement, and our clients are going to be happy with it,” Seeger said.
Johnson & Johnson reached the agreement after a series of court victories, including wins in individual trials and successful efforts to disqualify claimants’ lawyers from the litigation.
The company also secured court rulings against experts used by claimants to support their cases.
A federal judge last week questioned whether individual claimants could prove that talc had specifically caused their ovarian cancer.
Johnson & Johnson has consistently denied that its talc products caused cancer, maintaining that the products were safe and did not contain asbestos.
The company stopped selling talc-based baby powder in the US in 2020 and switched to a cornstarch-based product.
Litigation resumed in March 2025 after being paused for more than three years while Johnson & Johnson pursued a bankruptcy strategy known as the “Texas two step”.
The company filed three bankruptcies through a shell-company subsidiary in an attempt to settle the cases. Each bankruptcy was dismissed.
Before the bankruptcy attempts, Johnson & Johnson had a mixed record in talc trials.
These included a multibillion-dollar verdict for 22 women who said baby powder caused their ovarian cancer, alongside trials won by Johnson & Johnson and other verdicts later reduced on appeal.
Unlike the proposed bankruptcy settlements, the latest agreement applies only to existing claims and does not cover future lawsuits.
Seeger said excluding future claims made more money available for current claimants than the bankruptcy proposal and would allow all claims to be paid within 18 months rather than over more than a decade.
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