Ever laughed so hard you wet your pants? Or leaked a little when you sneezed or coughed? Though that warm, wet sensation in your underwear might feel far from normal, rest assured that urinary incontinence (the term for uncontrollable leaking of urine) is something many people deal with on an everyday basis. In fact, The Cleveland Clinic estimates that between 13 and 17 million adult Americans and close to half of all women in the United States experience some degree of incontinence.

But, as you might expect, urinary incontinence is on a long list of health topics that a lot of people don’t feel comfortable chatting about at the dinner table or around the water cooler at work. As a result, urinary incontinence is often only discussed in regards to the elderly or women who have recently given birth. However, those two groups certainly aren’t the only people affected. Here’s everything you should know about urinary incontinence.

What is urinary incontinence?
Urinary incontinence is defined as the loss of bladder control. “The severity ranges from leaking urine when you cough or sneeze to having an urge to urinate that’s so sudden and strong you don’t get to a toilet in time.” This can make incontinence a particularly uncomfortable and distressing condition.

There are five types of urinary incontinence: stress, urge, overflow, functional, and mixed. While stress incontinence occurs when force is exerted on the bladder (by sneezing, coughing, laughing, or exercising), urge incontinence is when you have that sudden, intense need to urinate followed by a loss of pee. The latter can sometimes happen due to urinary tract infections (UTIs).

Overflow incontinence is when urine frequently or constantly dribbles out of the bladder because it never fully empties, and functional incontinence is due to an physical or mental impairment that prevents you from making it to the bathroom — like back pain or arthritis, which can make it tough to unbutton and pull down your pants (let alone make it to the toilet). Lastly, mixed incontinence is some combination of the other four types.

Why does it happen?
Urinary incontinence can either be persistent or temporary, and the underlying causes for each are different. For example, pregnancy and childbirth can cause leaking that lasts for long periods of time due to the weight of the fetus, hormone changes, and weakened pelvic floor muscles which support the bladder. Hormonal changes during menopause can also trigger incontinence.

Neurological disorders, like Parkinson’s and strokes, may interfere with nerve signals involved in bladder control, thus leading to persistent incontinence. (After all, both the brain and bladder have to work together in order to properly urinate.)

And just like any muscle, the bladder loses strength and ages over time. This is why older people often experience persistent incontinence.

Temporary incontinence, on the other hand, can be caused for a short period of time due to diuretics (substances that make you pee more frequently) like alcohol, coffee, spicy foods, chocolate, or vitamin C. Constipation, UTIs, and medications you’re taking — like muscle relaxants or sedatives — are also known to cause temporary problems.

Keep in mind, there are some risk factors that can make you more likely to struggle with incontinence. Compared to their male counterparts, women are unfortunately more likely to find themselves leaking. Obesity can put extra weight on your bladder, thus increasing your likelihood of experiencing it. Studies show that urinary incontinence is also related to tobacco use. And since urinary incontinence can be a symptom of genetic neurological disorders like Parkinson’s, multiple sclerosis, and strokes, you may have an increased likelihood of one day being diagnosed with both the disease and bladder trouble if these disorders run in your family.

What you can do about it
Experts at the Cleveland Clinic assure us that incontinence can almost always be treated. Exercises that strengthen your pelvic floor like kegels are useful, while weight management and not smoking are also strategies to prevent and improve incontinence.

If incontinence is currently impacting your quality of life or daily activities, it’s important to seek professional help. Pelvic physical therapists have training in evaluating and treating pelvic floor dysfunction as it relates to sexual, bowel, and — you guessed it — bladder function.

English Taylor is a San Francisco-based women’s health and wellness writer and birth doula. Her work has been featured in The Atlantic, Healthline, Refinery29, NYLON, and Modern Fertility. Follow English and her work at https://medium.com/@englishtaylor or on Instagram at @englishtaylor.