Research has found that at least half of people with urinary incontinence don’t discuss the condition with a health care provider. But there’s no need to feel embarrassed. If you have a leaky bladder, you’re definitely not alone. Bladder leakage, or urinary incontinence, affects women and men of all ages, though it becomes more common later in life.

And it’s definitely worth discussing, because of the many ways it can interfere with enjoying daily life—from exercise and travel to social outings and romance, says E. James Wright, M.D., director of urology at Johns Hopkins Bayview Medical Center.

What Causes Bladder Leaks?

There are two main types of urinary incontinence:

Stress incontinence 

If you have this type, activities that raise the pressure inside your abdomen cause urine to leak through the ring of muscle in your bladder that normally holds it in. Coughing, sneezing, jumping and lifting heavy objects could lead to a leak.

Going through childbirth, smoking or being overweight can raise the risk of stress incontinence for women, Wright says. Stress incontinence in men is rare, and when it arises, it’s often due to prostate cancer treatment, such as radiation or surgery.

Urge incontinence 

With this type, your brain, spinal cord and bladder don’t work together properly to allow you to hold and release urine at the right time. Your bladder may suddenly empty itself without warning. Or you may feel like you need to urinate frequently, a problem called overactive bladder.

Some diseases that affect the nervous system, such as multiple sclerosis or stroke, can cause this kind of incontinence, says Wright. In men, an enlarged prostate may be the culprit. But in many cases, doctors don’t know what causes urge incontinence.

It is possible to have both types of incontinence at the same time.

Regaining Bladder Control

No matter what’s causing your bladder leakage, Wright offers good news: “The vast majority of cases can either be cured or significantly improved.” Some strategies that can help:

Watch your diet 

You may be able to cut down on bladder leaks by avoiding certain foods, drinks and ingredients, including:

• Alcohol
• Artificial sweeteners
• Caffeine
• Carbonated beverages
• Chocolate
• Citrus fruits and tomatoes
• Corn syrup
• Honey
• Spicy foods

Shed extra pounds 

Research has found that overweight and obese women who lose weight report fewer episodes of bladder leakage.

Train your bladder 

Certain exercises can help you keep your bladder under better control:

• Kegel exercises. During Kegels, you regularly tighten certain muscles in your pelvis to strengthen them, which helps you become more leak-proof.
• The Knack. With this method, you do a Kegel just as you cough, sneeze or do another activity that tends to trigger a leak.

These require practice, Wright says. You may need a professional—your doctor or a physical therapist—to show you how to do them properly.

Know your options 

Depending on the type of incontinence you have, your doctor may recommend one of the following treatments, Wright says:

• Medications that can help your bladder hold more, reduce urgency and improve your ability to empty your bladder. (There is even a recently approved over-the-counter patch for women with overactive bladder that helps relax the bladder muscle; the patch is available for men by prescription.)
• An injection of Botox into the lining of your bladder to block the release of a chemical that prompts muscle contractions.
• An injection of a thick substance around your urethra (the tube that carries urine out of your body) to help it hold back urine.
• Surgery to insert a strip of mesh to press against your urethra and prevent leaks.

“Many solutions are available, but you can only get help for what you’re willing to talk about and explain,” Wright says.