Stress, pregnancy, menopause, old age, diabetes and a host of other health ailments have one condition in common as a side effect – urinary incontinence, or involuntary loss of bladder, ranging from occasional leakage to more severe issues. According to a joint study by Redseer Strategy Consultants and Nobel Hygiene, a leading producer of adult diapers in India, about 20 million Indians suffer from incontinence, but only about 5% know to seek medical help for the same. Doctors hold that in a majority of cases, individuals suffering from incontinence consider it a part of ageing, postpartum symptoms, or even normal, which is why the number of people getting diagnosed, seeking help or purchasing adult diapers is abysmally low.
Lack of awareness
“Urinary incontinence is an under-recognised yet widespread health concern in India,” says Dr Roopali Sehgal, Benzer Maternity and Hospital, Member of the Royal College of Obstetrician and Gynaecology UK, and also associated as a consultant with Nobel Hygiene. “However, what is truly concerning is that less than half of these people are aware that their symptoms constitute a medical issue since many simply accept bladder leaks as a normal part of ageing or a consequence of childbirth,” she adds.
“When people do not recognise early signs of bladder issues or misinterpret them as inevitable, they are far less likely to seek medical help or even discuss the matter with family or friends. This silence delays diagnosis and effective management,” explains Dr Sehgal, adding that not only does this result in physical challenges such as increased risk of urinary tract infections (UTIs) and skin problems but also psychological distress and loss of confidence.
Incontinence is usually not an isolated problem — rather, it is a symptom of other underlying health issues. Dr Sehgal enumerates, “For women, menopause, pelvic organ prolapse, or childbirth-related trauma are common contributors. In men, prostate enlargement or surgery
can lead to post-void leakage or overflow incontinence. Neurological disorders like Parkinson’s, multiple sclerosis and stroke can also impair bladder control.”
More recently, other conditions have also been linked to incontinence, such as uncontrolled diabetes, obesity, urinary tract infections and even certain medications have started to affect the younger ages as well. Additionally, lifestyle triggers like high caffeine/ tea intake, or limited mobility in the elderly, can lead to functional incontinence, Dr Sehgal adds.
Dr Shyam Varma, robotic urologist and transplant surgeon, Kokilaben Dhirubhai Ambani Hospitals, Mumbai, breaks it down further. He shares, “Statistics mention 15-20% of women and 10-15% of men over 40 in India have this issue. But here’s the kicker – fewer than 20% of them actually go to a doctor.” Apart from being a symptom to many health conditions, incontinence itself can also lead to higher risk of depression, anxiety, and feeling cut off from friends and family, he explains, adding: “All this adds up to less independence and a pretty lonely life.”
Kartik Johari, vice president and promoter at Nobel Hygiene, says that the journey from first experiencing symptoms to finally seeking effective management or using a solution like adult diapers is painfully long in India. “On an average, adoption takes over 1.5 years for most individuals. This emotional arc spans denial, shame, consultation with doctors, and finally acceptance,” he adds.
Women most affected
As revealed by the Redseer study on the use of adult diapers in India, only about 35% of adult diaper users in India are elderly. The majority, a significant 65%, are younger adults aged 35 to 60, grappling with incontinence due to factors such as diabetes, menopause, prostate conditions and obesity. At least 20 million individuals suffer, “but only half are aware of their condition, and a mere 5% currently use adult diapers, a category penetration that points to deep issues of access, acceptability, and education”, according to the report. Functional concerns such as fear of leaks, discomfort, or skin irritation deter 82% of potential users, while 18% cite social stigma rooted in cultural values linking bladder control with dignity and manhood, or feelings of insecurity for women, as per the survey.
Dr Sehgal says that women are overwhelmingly more affected by incontinence, and that three out of every four sufferers are female. “This is largely due to the different phases of life that women go through over the years, from hormonal shifts in adolescence to pregnancy, childbirth, and menopause, all of which weaken the pelvic floor thereby increasing the probability of incontinence troubles between the ages of 45 and 60 years,” she says, stressing that it is simply a myth that incontinence affects only the elderly.
As for men, she says the numbers increase mainly with advancing age, particularly due to prostate-related health issues or neurological conditions. “Cultural barriers and masculine stigma may make men even more reluctant to seek help or discuss their symptoms,” she adds.
Social stigma
“The reluctance to address incontinence is multi-layered. It’s a combination of shame, lack of basic knowledge, and absence of role models openly discussing the issue,” Dr Sehgal opines. “Incontinence is one of India’s most misunderstood and underestimated health issues, primarily because, culturally, any loss of bodily control is associated with shame and loss of dignity,” echoes Johari. “Honest conversations and awareness between the family is most important. We have noted in our primary research that individuals who suffer from incontinence first approach their spouses for an open conversation,” he says.
He adds that the data from their study with Redseer strongly highlights that incontinence and bladder health are not issues confined to old age, but rather span a much broader segment of the population. “It brings to light the urgent need for mainstream healthcare awareness, early intervention, and stigma reduction among middle-aged Indians who often suffer in silence,” he adds.
In Dr Varma’s experience, there is a striking aversion to talking about this subject. “People just don’t want to talk about this,” he says, adding: “If you’re a woman, you might get told, ‘That’s just what happens after kids’. If you’re older, it’s ‘Well, you’re not young anymore’. All this shame and silence? It keeps people from getting real help-even though there are treatments that actually work.”
“In my practice, I feel that social stigma and lack of awareness prevent many from seeking help. Understanding that incontinence is often the symptom, not the disease is critical,” adds Dr Sehgal. “With the right diagnosis and support tools, including products that prioritise skin safety and leak protection, people can manage the condition with dignity and normalcy.”
If left undiagnosed
“It can turn from a little annoyance to a life-ruining mess-physically and mentally,” says Dr Varma. “You end up relying on others, staying home, missing out. Plus, sometimes incontinence is a red flag for something much more serious. Getting things checked early can really change the game,” he adds.
Dr Sehgal also elaborates on the same, saying that leaving incontinence undiagnosed can lead to repeated urinary tract infections, skin breakdown, and chronic discomfort. “However, as a doctor, I am also deeply concerned about the emotional toll. My patients often describe a sense of lost control, reduced confidence, sleep disturbances, and withdrawal from social interactions,” she says. “The drastic impact on the quality of life is unimaginable. Early intervention, whether through pelvic floor therapy, medical management, or high-quality hygiene products, can have a transformative impact on both health and quality of life,” advises Dr Sehgal.
“In my practice, I witness how this gap in awareness leads to years of unnecessary suffering, often robbing men and women of their dignity, autonomy, and quality of life. Many endure sleep disturbances, reduce social activities, and in extreme cases, face anxiety and depression, all because of a condition that remains in the shadows,” she adds.