Urinary Incontinence in Women

Urinary incontinence means involuntary leakage of urine. It may be a few drops when you cough, sneeze, laugh, jump or exercise, or a sudden urge so strong that you cannot reach the bathroom in time. The three main types in women are stress urinary incontinence, urgency urinary incontinence and mixed urinary incontinence. [5]

It may sound like a small physical problem, but it often does not feel small. Women may plan clothes around the possibility of a wet spot, map bathrooms before going out, avoid certain workouts or worry about odor. Bladder leakage can also affect body image, confidence, intimacy and sexual satisfaction.

For women already dealing with changes after pregnancy, weight fluctuations, perimenopause, menopause or aging, incontinence can feel like one more thing their body is doing to them instead of for them. Fear of leaking can make sex feel stressful instead of spontaneous and may lead some women to avoid intimacy or stay silent because of embarrassment.

At Bawa Medical, Dr. Kanwal Bawa does not treat urinary incontinence as a one-size-fits-all bladder problem. She looks at the pattern of leakage and the factors contributing to it, including pelvic-floor dysfunction, hormones, tissue changes and circulation, so treatment addresses the underlying problem rather than simply covering up the symptom.

There is no single cause of female urinary incontinence, and more than one factor can be present at the same time. Pregnancy and childbirth can affect pelvic-floor muscles and support structures. Aging, weight, chronic coughing or constipation, certain medications, urinary tract infections, neurologic conditions and changes in the muscles or tissues that support the bladder and urethra can also contribute. [5]

Vaginal birth is strongly associated with urinary incontinence in population data, but women who have never been pregnant can leak too. [1] Perimenopause, menopause and postmenopause can also bring genitourinary changes as estrogen declines, including urinary urgency and other bladder symptoms. [7]

That is why the symptom alone does not tell you the treatment. A woman who leaks when she jumps may not need the same plan as a woman who suddenly cannot hold her urine on the way to the bathroom. Dr. Bawa evaluates the whole picture—including pelvic-floor function, hormonal changes, tissue health, medical history and sexual symptoms—before deciding what should be treated and in what order.

The goal is not a Band-Aid for bladder leakage. It is to understand why it is happening and build the treatment plan around you.

Urinary incontinence can involve more than one problem, so Dr. Bawa often uses more than one treatment. Her combination approach is designed around what she finds rather than forcing every woman into the same protocol. The goal is to address the different contributors to leakage together when that is what the body needs.

Why Kegels Are Seldom Enough

Pelvic-floor muscle training can help urinary incontinence, but a Kegel is still a voluntary contraction. Even when a woman is doing Kegels correctly, there is a practical limit to how strongly and how often she can contract the pelvic floor on her own. In a 2026 randomized controlled trial, supervised pelvic-floor exercises improved stress urinary incontinence, but adding high-intensity focused electromagnetic pelvic-floor stimulation produced greater improvements in several objective muscle-function and urinary-symptom measures. [6]

That difference matters. BawaTone® allows Dr. Bawa to recruit the pelvic-floor muscles far more intensively than ordinary voluntary Kegels can in a treatment session. But stronger muscle stimulation is still only one part of the picture. If tissue quality, hormones, circulation or other factors are contributing, treating only the muscle may still leave part of the problem untouched.

Depending on your evaluation, Dr. Bawa may recommend one or more of the following:

• BawaTone®
• BawaRF®
• BawaWave®
• BawaShot®
• CO₂ Laser
• Hormone Optimization

Bladder leakage may be small in volume but enormous in effect. Women may avoid certain clothes or activities, carry pads everywhere, worry about odor or leakage, or constantly calculate where the nearest bathroom is. Over time, those changes can quietly take away confidence and freedom.

The impact can extend into body image, sexuality and relationships. Sex may feel especially stressful when a woman is worried about leaking or losing control. In a 2026 meta-analysis of 21,650 women, urine leakage during penetration was estimated at 50.5% among women with urinary incontinence. [2]

Unfortunately, only 28% of women with urinary incontinence seek treatment for it. [3] Just because it is common, it does not mean that you have to live with it.

At Bawa Medical in Boca Raton, Dr. Bawa addresses urinary symptoms alongside pelvic health, hormones, sexual wellness and rejuvenation. Women travel from across the United States and internationally, and a virtual consultation with Dr. Bawa can be a practical first step before coming to South Florida.

You don't have to wait until you're wearing adult diapers, avoiding even more activities or having less sex to ask for help.

1. Patel UJ, Godecker AL, Giles DL, Brown HW. Updated prevalence of urinary incontinence in women: 2015-2018 national population-based survey data. Female Pelvic Med Reconstr Surg. 2022;28(4):181-187. doi:10.1097/SPV.0000000000001127.

2. Karaçam Yılmaz ZD, Dinç Kaya H, Günaydın S. Prevalence of coital incontinence in women with urinary incontinence: a systematic review and meta-analysis. Int Urogynecol J. 2026;37(1):27-42. doi:10.1007/s00192-025-06358-w.

3. Liang S, Li J, Chen Z, et al. Prevalence and influencing factors of help-seeking behavior among women with urinary incontinence: a systematic review and meta-analysis. J Womens Health (Larchmt). 2023;32(12):1363-1379. doi:10.1089/jwh.2022.0482.

4. Bezerra LRPS, Britto DF, Frota IPR, et al. The impact of urinary incontinence on sexual function: a systematic review. Sex Med Rev. 2020;8(3):393-402. doi:10.1016/j.sxmr.2019.06.009.

5. American College of Obstetricians and Gynecologists; American Urogynecologic Society. ACOG Practice Bulletin No. 155: Urinary Incontinence in Women. Obstet Gynecol. 2015;126(5):e66-e81. doi:10.1097/AOG.0000000000001148. Reaffirmed 2025.

6. Kilicoz Bakar M, Ozkocak G, Algun ZC. Comparison of high-intensity electromagnetic therapy and pelvic floor muscle exercises in women with urinary incontinence: a randomized controlled trial. Int J Womens Health. 2026;18:612726. doi:10.2147/IJWH.S612726.

8. Cody JD, Jacobs ML, Richardson K, Moehrer B, Hextall A. Oestrogen therapy for urinary incontinence in post-menopausal women. Cochrane Database Syst Rev. 2012;(10):CD001405. doi:10.1002/14651858.CD001405.pub3.