While we may be getting slightly more comfortable as a society discussing women’s health topics like periods and reproductive rights, there’s one demographic that continues to be overlooked: women over 50. For most women in that age group, getting their period is no longer an issue, but a significant portion experiences another problem — urinary incontinence. Despite affecting 35 million women in America, it’s not something most people want to talk about.
That is, with the exception of Dr. Toni Harris, a urogynecologist who has been focusing on treating incontinence in older women since the 1980s when she participated in one of the first fellowships for training in that specialty in the United States. Since then, Harris has devoted her career to caring for women with urinary incontinence and pelvic organ prolapse.
More: Understanding Urinary Incontinence in Women
In addition to working in the area for three decades, Harris — who originally trained as a biochemist — helped to develop Finess, the first FDA-approved over-the-counter product designed to stop leakage in the most common type of urinary incontinence. More on that in a minute, but first, let’s look at the different types of urinary incontinence and how they can be treated.
In a nutshell, urinary incontinence is an involuntary leakage of urine, and there are two main types: stress urinary incontinence and urge urinary incontinence. SUI refers to leaking urine when pressures are put on your bladder, like when you cough, lift something, jump or bend over. It is common during pregnancy and as you age. It happens when the urethra itself fails to remain closed when the bladder is under pressure from activities.
According to Harris, 1 in 4 women in the U.S. experience SUI, although the degree of the problem varies depending on the person.
“Your pelvic floor muscle group and related connective tissue hold your bladder and urethra up in place and prevent urine from leaking out when you cough or sneeze,” she told SheKnows. “Childbirth can and often does damage those pelvic floor muscles so they’re not as effective at protecting you from urine leakage with pressure on the bladder. Child bearing, weight gain, chronic cough, aging- and hormone-related changes can increase our risk of having SUI.”
The second type — UUI — happens when the bladder involuntarily contracts and pushes the urine out through the urethra and is more common among older women. Many women have both types, which is called mixed incontinence.
For those with SUI, Harris breaks the options down into two categories: management, which had previously been restricted largely to absorbent products, like pads, and treatment, which includes everything from Kegel exercises and physical therapy to surgical procedures. While Kegel exercises are beneficial for women regardless of age or bladder condition, they require persistence and perseverance for sustained benefit and still don’t help everyone. More invasive treatment options, like surgeries involving pelvic mesh, can be highly successful, but carry risks and failure rates. Harris was on the lookout for a better option to help women cope with this incredibly common condition.
More: Overactive Bladder: Treatment for OAB
Starting in the 1990s, Harris encountered a new product now called Finess, a simple foam barrier that is applied over the opening to the urethra to stop urine before it leaks out during SUI. The product has an adhesive gel backing that allows you to stick it onto your skin right over the urethral opening, so when you cough or jump or laugh, urine cannot escape. The components of the product are used in many medical applications, like wound care, contraceptives and contact lenses and have been demonstrated to be safe.
According to Harris, who served as the principal investigator on a large multicenter study of Finess, less than 1 percent of the women in the study stopped using the product because they found it irritating, and most said that it fit comfortably. The product was very successful in reducing leakage episodes and improving quality of life for women with mild to moderate SUI.
“I know it’s safe, I know it’s effective and it’s a tremendous alternative to absorbent pads that leave you with wetness against your skin, fear of smelling like urine and risk of overflow onto your clothes,” Harris said. “Women have few options for managing this lousy problem of having pee run down your leg when you cough.”
As Finess is available direct to consumers through their website, you do not need to visit your doctor before trying the product.
“It’s a very common problem and a safe, effective, direct-to-consumer product that actually prevents leakage is a great step forward,” she added. “Getting this product through the system and into consumers’ hands has been a long road and I’m so happy to see Finess out there.”