What To Know About Underwear for Incontinence

If bladder leakage is affecting your quality of life, you might feel like you’re all alone. But it’s more common than you might realize.

An estimated 33 million Americans experience some type of incontinence. And if it’s happening to you, here’s something else important to know: You have options.

Special types of underwear for incontinence can help you take back control, though there are a few important factors to consider — and there are other options to look into first.

What kind of incontinence issues are you having?

To figure out the best course of action, you need to first determine what kind of incontinence issues you’re dealing with. There are two main types: stress incontinence and urge incontinence.

Stress incontinence happens when there’s extra pressure on your bladder and your weakened or damaged muscles can’t adapt. Stress incontinence is more common in women and people assigned female at birth (AFAB) and can be made worse by childbirth. In men and people assigned male at birth (AMAB), it’s typically only seen after having prostate surgery or gender-affirming surgery.

“This leakage can happen when you cough, sneeze, exercise or during other types of movements,” says certified nurse practitioner Natalie Weigand, CNP, who specializes in urogynecology and pelvic reconstructive surgery. “It’s essentially the inability of the urethral channel to provide enough resistance when the pressure in your belly goes up.”

Then, there’s urge incontinence, which is a symptom of an overactive bladder. As you’ve aged, you may have developed a general inability to control the release of urine. With urge incontinence, it’s common to have sudden urges to go to the bathroom but not get there in time to avoid leakage.

“It’s sometimes seen in people who have blockage from their prostate,” Weigand says, “but it can happen to anyone, for any reason.”

Are incontinence underwear right for you?

Many people seek help when they begin to frequently feel wet or can smell urine — when it affects their quality of life. But what’s considered minimal and what should be treated? That’s up to you.

“It’s up to each individual,” Weigand affirms. “If it bothers you, it’s not normal. And if it bothers you, seek treatment.”

To find the best solution, it’s important to discuss the causes of your incontinence and the severity of the problem with a healthcare provider.

How to avoid leakage in the first place

But don’t buy incontinence underwear just yet. There are so many ways to treat and even cure urinary incontinence that disposable undergarments are usually recommended only for people who have exhausted these options.

First, there are steps you can take to either avoid using incontinence underwear entirely or lessen the time you’ll need them. You can:

• Empty your bladder. Be sure to empty your bladder regularly and fully. “It can be especially helpful to do so before physical activity,” Weigand advises.
• Try bladder training. Going to the bathroom on a schedule (called bladder training or timed voiding) can prevent you from having to run to the restroom whenever the urge hits.
• Cut back on caffeine and alcohol. “They can irritate the bladder and make you have to run to the bathroom more often,” Weigand says.
• Try Kegels. Performing regular pelvic floor exercises can help strengthen your muscles and reduce stress incontinence (though it won’t help with urge incontinence).

Your healthcare provider might talk to you about other treatment options that can further help prevent urinary leakage:

• Medication. A prescription can relieve overactive bladder symptoms.
• Pelvic floor physical therapy. A physical therapist can teach you exercises to stretch and strengthen your muscles to reduce leakage.
• Vaginal inserts. “These are small devices that can obstruct the urethra, help support it and prevent leakage in some people who have stress incontinence,” Weigand explains.
• Outpatient procedures. Depending on what kind of incontinence issues you’re having, your healthcare provider may recommend treatments like Botox®, bulking injections or electrical stimulation.
• Surgical options. There are different types of procedures, including minimally invasive options, that can help support or close your urethra to avoid leakage.

It’s also important to know that weight loss has been shown to help both stress and urge incontinence. This is, of course, not a simple solution, but if you’re already pursuing weight loss, you should know that it might help with this issue.

Types of incontinence underwear

If other treatments don’t work for you, or if you’re dealing with leaks while you wait for those treatments to “kick in,” it may be time to try incontinence underwear. Depending on your needs, you may choose single-use undergarments that absorb leaks or pads and shields that fit inside your regular underwear.

Here are some of the most common options:

• Briefs with tabs can be put on and taken off without having to remove your pants. They’re a good option for people with mobility issues, as well as for people who don’t want to have to take off their other clothing to change underwear when a leak hits.
• Pull-on style briefs are put on the same way you’d put on cotton underwear: Just step into them and pull them up around your waist.
• Incontinence pads or liners are similar to menstrual pads, with a sticky backing that attaches to regular underwear and absorbs light leakage.
• Incontinence shields are guards that have a cup-shaped design that fits around your penis. They’re often recommended after prostate surgery.

It’s understandable if you’re a little nervous or uncomfortable about buying incontinence underwear — but gone are the days of bulky (not to mention rudely named) “adult diapers” for dealing with leaks. These days, disposable undergarments are unassuming and unnoticeable to other people, fitting nicely beneath your clothing.

How to wear incontinence underwear

Follow these tips to boost your confidence and comfort when you’re wearing incontinence underwear:

• Change them regularly, especially after leaks. This will help keep you comfortable and avoid any odors.
• Practice good hygiene. “Cleanse your skin with a baby wipe or a gentle soap and warm water,” Weigand advises. “This will also help you avoid irritation to the skin from leaking.”
• Use a barrier ointment or lotion. This helps avoid irritation and other issues that can happen when your skin is regularly exposed to urine.
• Wear comfortable clothes. Much of today’s incontinence underwear is designed to be discreet, but in the beginning, wearing loose-fitting clothing can reduce any worries about others noticing what you’re wearing underneath.

When is incontinence a sign of serious problems?

Age-related incontinence is gradual and worsens slowly over time. Sudden incontinence with heavy leakage may mean something else is going on, like an infection or a neurological issue. Make an appointment with a healthcare provider to have these symptoms checked.