Specialist Advice — 6 minutes

Urinary leakage in women: Understanding the causes of a still too‑normalized issue

April 21, 2026

Urinary leakage affects many women and remains a taboo and often misunderstood topic. It is still frequently perceived as a “normal” consequence of pregnancy, childbirth, or aging. However, this is not the case. In most situations, urinary leakage, also known as urinary incontinence, is a sign of pelvic floor dysfunction. Treating it as inevitable can delay appropriate care and drastically impact the quality of life.

Better understanding the causes of urinary leakage helps dispel persistent myths, supports earlier screening, and guides women toward appropriate care and treatment options.

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A common women’s health issue

Scientific evidence is clear: urinary leakage is a common woman’s health concern at all stages of life [1]. Worldwide, more than 20% of adult women experience urinary leakage to varying degrees [2]. Among women over the age of 30, prevalence estimates range from 24% to 45%, depending on age and the type of urinary incontinence.

Despite how common this condition is, urinary leakage remains widely underdiagnosed and undertreated, largely due to the stigma surrounding the topic and limited access to clear, reliable information.

The key role of the pelvic floor

In most cases, urinary leakage is closely linked to pelvic floor dysfunction. The pelvic floor is a group of muscles and connective tissues that support the bladder, uterus, and rectum and play a critical role in bladder control and continence.

When these muscles are weakened, overstretched, or poorly coordinated, they may no longer effectively retain urine, particularly during activities that increase abdominal pressure, such as coughing, sneezing, laughing, lifting, or exercising. This presentation is known as stress urinary incontinence, the most common form of urinary incontinence in women [3].

Pregnancy and childbirth: Major risk factors

Pregnancy and childbirth are significant risk factors for urinary leakage. During pregnancy, hormonal changes and increased abdominal pressure progressively strain the pelvic floor. Childbirth can lead to excessive stretching of the pelvic muscles, nerve injury, and damage to the tissues supporting the urethra and bladder [3].

Research shows that approximately 26% of women experience urinary leakage during the postpartum period [4], with some studies reporting rates as high as 33% within the first three months after childbirth [5].

The risk of urinary leakage is significantly higher after a vaginal delivery compared to a cesarean section, with prevalence roughly twice as high among women who have delivered vaginally [5]. Other factors that may increase risk include assisted deliveries, higher birthweight infants, multiple pregnancies, and more advanced maternal age [4, 6].

Despite these findings, pelvic floor health is still not consistently integrated into postpartum follow‑up care, which may allow symptoms to persist for years in some women.

Menopause and hormonal changes

Menopause is another key period during which urinary leakage may appear or worsen. The decline in estrogen levels during the menopausal transition leads to significant changes in urogenital tissues, including reduced elasticity, decreased tissue quality, and altered bladder and urethral function [7].

The prevalence of urinary incontinence during menopause is estimated to range from 15% to 30% and may reach up to 50% [7]. With age, urgency urinary incontinence and mixed urinary incontinence also become more common [2].

A condition that is still too often normalized

Several studies show that urinary leakage is frequently normalized, not only by women themselves, but also by health care professionals [8]. This normalization can delay diagnosis, reduce quality of life, and have a significant psychological impact, including embarrassment, loss of self-confidence, and reduced participation in social, professional, and physical activities.

Yet urinary leakage is neither an inevitable consequence of motherhood nor an unavoidable part of aging.

In summary

Urinary leakage in women is:

  • common
  • multifactorial
  • closely linked to pelvic floor health
  • strongly influenced by pregnancy, childbirth, and menopause
  • still too often inadequately addressed

Understanding its causes is an essential step toward breaking the taboo, encouraging women to seek care, and guiding them toward appropriate, evidence‑based treatment options.

Sources8
  1. Villa, G., Marcomini, A., Trapani, D., et al. (2025). Prevalence, risk factors and costs of female urinary incontinence: A multicentre cross‑sectional study. International Journal of Urological Nursing.
  2. Abufaraj, M., Xu, T., Cao, C., Yang, L., Shariat, S. F., & Sutcliffe, S. (2021). Prevalence and trends in urinary incontinence among women in the United States, 2005–2018. American Journal of Obstetrics and Gynecology, 225(2), 166.e1–166.e12.
  3. Diez‑Itza, I. (2025). Urinary incontinence during pregnancy and in the postpartum period. Nature Reviews Urology, 23, 184–195.
  4. Dai, S., Chen, H., & Luo, T. (2023). Prevalence and factors of urinary incontinence among postpartum women: A systematic review and meta‑analysis. BMC Pregnancy and Childbirth, 23(1), 761.
  5. Thom, D. H., & Rortveit, G. (2010). Prevalence of postpartum urinary incontinence: A systematic review. Acta Obstetricia et Gynecologica Scandinavica, 89(12), 1511–1522.
  6. Tsinisizeli, N., Bothou, A., Gourounti, K., Deltsidou, A., Lykeridou, A., & Kyrkou, G. (2026). Analysis of the multifactorial risks of postpartum urinary incontinence: A systematic review. Healthcare, 14(3), 418.
  7. Șerbănescu, L., Mirea, S., Ionescu, P., Petrica, L. A., Iorga, I. C., Surdu, M., & Rotar, V. (2025). Involuntary urine loss in menopause: A narrative review. Journal of Clinical Medicine, 14(21), 7664.
  8. Lopes, F. D., Henriques, C., Lopes, M. S., & Mendes, I. M. (2025). Quality of life of women with urinary incontinence in the postpartum period: An integrative literature review. Frontiers in Global Women’s Health, 6, 1562572.