Five Things You Have Been Told About Leaking That Are Simply Not True

Myth 1: "It is just part of getting older"

Leaking becomes more common with age. That is not the same as being caused by age, and it is certainly not the same as being untreatable. Tissue changes after menopause, activity levels drop, and old pregnancies catch up with people — but the pelvic floor is skeletal muscle, and skeletal muscle responds to training at seventy just as it does at thirty. Supervised pelvic floor muscle training cures or significantly improves stress incontinence in the majority of women, across age groups. Age is a reason to start, not a reason to stop.

Myth 2: "Drink less water and you will leak less"

This is the most common self-treatment and one of the most counterproductive. Concentrated urine irritates the bladder lining, which increases urgency and frequency. Restricting fluid also trains the bladder to hold less, so it starts complaining at smaller and smaller volumes, and it causes constipation, which loads the pelvic floor further. Steady fluid through the day and fewer bladder irritants works. Dehydration does not.

Myth 3: "Just do more Kegels"

Kegels are genuinely effective for the right person doing them correctly. The problem is that a large share of people performing them unsupervised are doing them wrong — bearing down instead of lifting, holding their breath, or gripping glutes and inner thighs. And a significant group leaks because their pelvic floor is too tight and cannot relax to let the bladder fill, in which case more squeezing makes everything worse. That is why I assess before I prescribe, and why I use real-time ultrasound so you can see on screen whether you are lifting or pushing.

A Kegel done incorrectly is not a weaker version of the exercise. It is often the opposite of it.

Myth 4: "Pads are the solution"

Pads manage the laundry. They do nothing for the cause, and they quietly cost several hundred dollars a year while the underlying problem carries on. There is nothing wrong with using them while you work on this — but they should be a bridge, not a destination.

Myth 5: "Surgery is the only real fix"

Conservative treatment is the recommended first step for both stress and urge incontinence, before surgery is considered. Many people never need an operation. For those who do, doing this work beforehand improves outcomes, and returning to it afterwards protects the repair — because the habits and muscle patterns that contributed do not change because a surgeon operated.

And one thing that is true

Leaking is common — roughly one in three women and a substantial number of men, particularly after prostate surgery, experience it. Common, treatable, and nothing to be embarrassed about in a room where it is discussed all day long.

Getting assessed in North Jersey

Our clinic is in Upper Montclair, minutes from Montclair, Glen Ridge, Bloomfield, Verona, Cedar Grove and the rest of Essex County. Every visit is a full hour, one-on-one with me. If you are not sure whether your symptoms warrant an appointment, the screening tool on this site takes two minutes.