Fellowship-Trained Urogynecologist
Urogynecology & Reconstructive Pelvic Surgery
Green Bay, Wisconsin
✓ Medically reviewed March 2026
Can urinary incontinence get worse over time?
Yes, it often does. Without treatment, urinary incontinence tends to progress gradually. What starts as an occasional leak during a hard sneeze can slowly become more frequent leaking during lighter activities like walking, standing up, or bending over. This progression isn’t inevitable, but it’s common when the underlying causes aren’t addressed.
Why it progresses
The factors that cause incontinence don’t usually stop on their own:
- Pelvic floor muscles continue to weaken without targeted exercise
- Hormonal changes during and after menopause thin the tissues that support the urethra
- Weight gain adds more chronic pressure to the pelvic floor
- Chronic coughing from allergies or asthma adds ongoing strain
- Natural aging reduces muscle mass and connective tissue strength
“I think of pelvic floor health like any other aspect of fitness. Without attention, things tend to decline over time. The good news is that with the right interventions, we can not only stop the decline but actually reverse it in many cases.”
The cost of waiting
On average, women wait 6-8 years before seeking treatment for incontinence. During that time, symptoms typically worsen, treatment options may become more involved, and coping strategies like limiting fluids, avoiding activities, and wearing pads become ingrained habits.
What you can do now
- Start pelvic floor exercises, ideally with guidance from a physical therapist
- Maintain a healthy weight; even modest weight loss can improve symptoms
- Address chronic cough or constipation to reduce repeated strain on the pelvic floor
- See a specialist. A urogynecologist can establish a baseline and create a plan.
“Early treatment almost always means simpler treatment. I’d rather see a patient when their symptoms are mild and we can make a big impact with physical therapy, than years later when we’re discussing surgical options.”
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