Scripted for Her: The Pharmacist’s Role in Urinary Incontinence

Urinary incontinence is often dismissed as a normal part of aging, but on the latest episode of Scripted for Her, pharmacist Brianne Porter, PharmD, MS, explains why that mindset leaves too many women suffering in silence. For many patients, urinary incontinence can mean sleepless nights, falls, social isolation, and depression, all of which create an opportunity for pharmacist-led counseling.

In this episode of Scripted for Her, host Natalie DiPietro Mager, PharmD, PhD, caught up with Porter, a colleague of hers from the Ohio Northern University-Raabe College of Pharmacy.

They discuss broader risk factors beyond typical reproductive changes, such as chronic constipation, neurological conditions, and uncontrolled diabetes, while outlining how pharmacists can sensitively initiate conversations during routine over-the-counter (OTC) consultations or prescription fills. They also walk through tailored management strategies for stress, urgency, and mixed incontinence, contrasting pelvic floor muscle training as first-line therapy against bladder retraining and targeted medications based on individual patient goals.

READ MORE: Menopause Status, Symptoms Remain Inconsistently Documented

Expanding Beyond Traditional Risk Factors

Epidemiological estimates indicate that involuntary urine loss impacts roughly a quarter of reproductive-age women, nearly half of middle-aged women, and up to 75% of older adult women. Although clinical discussions frequently center on reproductive causes such as pregnancy, childbirth, or menopausal estrogen depletion, wider physical and systemic drivers warrant equal clinical attention.^1-3

Increased intra-abdominal pressure stemming from chronic constipation, abdominal obesity, or poor core muscular strength significantly undermines bladder retention capacity regardless of patient age. Furthermore, functional barriers and systemic medical conditions like stroke, Parkinson disease, multiple sclerosis, and poorly managed diabetes disrupt neural signaling or elevate urinary frequency.^1,3

Urinary leakage affects over 25 million adult Americans across diverse life stages. Unmanaged symptoms trigger far-reaching health complications, ranging from recurrent urinary tract infections and severe perineal skin breakdown to increased fall risks during nighttime voiding episodes.^1-4

Additionally, many women suffer psychological distress, including social isolation, anxiety, and depression, as fear of public leakage leads them to restrict routine daily activities.^1,4

Initiating Sensitive Conversations in Pharmacy Practice

Community pharmacists occupy a uniquely accessible vantage point to bridge the treatment gap for the estimated 66% of affected women who currently suffer in silence due to social embarrassment. Rather than relying solely on formal screening questionnaires, practitioners can utilize routine daily encounters to open supportive, nonjudgmental dialogue.¹

For instance, perusing OTC aisles for continence pads, protective underwear, or constipation remedies provides a natural opportunity for a pharmacist to offer practical product guidance or explore underlying bladder concerns. Similarly, reviewing prescription fill histories for chronic conditions like diabetes, hypertension, or hormone replacement therapy allows pharmacists to gently inquire about broader systemic symptoms.

Maintaining a confident, professional tone reassures patients that urinary incontinence is a highly manageable health condition rather than an inevitable consequence of aging. Through proactive counseling and stigma reduction, pharmacy teams empower individuals to transition from passive coping to active clinical care.¹

Tailored Interventions and Patient-Centered Care

Optimal therapeutic management depends heavily on accurately distinguishing between the specific classifications of urinary incontinence. Stress incontinence involves small-volume leakage during activities that elevate abdominal pressure, such as coughing, laughing, or exercising. Because stress leakage stems from mechanical sphincter or pelvic-floor weakness, conservative nonpharmacologic measures like pelvic-floor muscle training remain the primary first-line therapy.^1,2,4

Conversely, urge incontinence features sudden, large-volume losses driven by involuntary detrusor muscle contractions. Bladder retraining with progressive voiding intervals helps retrain bladder signaling over time. When behavioral modifications require augmentation, targeted medications such as antimuscarinic agents or beta 3 adrenergic agonists like mirabegron work to relax bladder muscle.

Pharmacists play a vital role in performing comprehensive medication reviews, evaluating cumulative anticholinergic burden, managing side effects like dry mouth or constipation, and ensuring treatment choices align directly with individual patient goals and quality of life priorities.^1,4

Explore these additional resources to learn more:

• National Association for Continence Patient Site
• National Association for Continence Health Care Provider Site

Scripted for Her, a podcast from Drug Topics hosted by Natalie DiPietro Mager, PharmD, PhD, MPH, professor of pharmacy practice at Ohio Northern University, aims to help pharmacists provide comprehensive care and continuity of care within the women’s health space. All episodes of Scripted for Her are available in video format via DrugTopics.com on the third Wednesday of each month. Check out our most recent episode: The Pharmacist's Role in HPV Prevention.

REFERENCES

1. Urinary incontinence: recognition, assessment and the pharmacist’s role in patient care. Irish Pharmacy News. June 1, 2026. Accessed October 20, 2026. https://irishpharmacynews.ie/urinary-incontinence-pharmacists-role-patient-care/

2. Urinary incontinence in women. Johns Hopkins Medicine. Accessed October 20, 2026. https://www.hopkinsmedicine.org/health/conditions-and-diseases/urinary-incontinence/urinary-incontinence-in-women

3. Urinary incontinence: symptoms and causes. Mayo Clinic. February 9, 2023. Accessed October 20, 2026. https://www.mayoclinic.org/diseases-conditions/urinary-incontinence/symptoms-causes/syc-20352808

4. Wilson JA, Waghel RC. The management of urinary incontinence. U.S. Pharmacist. 2016; 41(9):22-26. https://www.uspharmacist.com/article/the-management-of-urinary-incontinence