That “got-to-go” feeling — so intense and sudden that you know you’re not going to make it to the bathroom — is a common one in the U.S.

An estimated 13 million women nationwide deal with urinary incontinence, or the involuntary leakage of urine, on a daily basis.

Though it’s common among older women, incontinence can affect men and women of all ages. But it doesn’t have to slow anyone down, says Dr. Annaceci Peacher, a urogynecologist at Tidelands Health OB/GYN.

“People try to normalize it. They say it’s a normal part of getting older,” Dr. Peacher says. “It’s common, but it’s not normal.”

There are two types of urinary incontinence: urge and stress. Each has its own causes and treatments.

Urge incontinence is not associated with doing an activity. It’s the feeling of having to go to the bathroom that seemingly comes out of nowhere. 

Your bladder is supposed to sense the need to contract when you’re sitting on the toilet. But with urge incontinence, the muscles contract prematurely. That’s what causes a leak or makes you feel like you have to go.

“People often complain that they’re not emptying their bladder completely,” Dr. Peacher says. “That’s not actually happening. The bladder is hypersensitive and feels full, or can’t stop contracting.”

The first line of treatment is a medication that helps relax the bladder. If that’s not a good fit, your doctor may suggest bladder Botox, which is injected into the muscle every six to nine months. If neither of those provide relief, the most effective treatment is a procedure called mackerel neural modulation. It involves inserting a battery-operated device into your pelvic area to correct the over-firing of nerves near your bladder and control the urge to go to the bathroom.

People who have diabetes, hypertension or any illness that affects the small vessels or arteries, chronic back pain or a chronic neurological condition such as Parkinson’s or Alzheimer’s are at a greater risk for urge incontinence. Tobacco, alcohol and caffeine also can make bladder sensitivity worse.

Stress incontinence can be triggered by coughing, sneezing, laughing, bending, lifting — some type of activity that uses your abdominal muscles.

The leakage happens because of weakness around the urethra. Some people are genetically predisposed. But a number of factors can weaken that tissue over time, including childbirth, having large babies, chronic cough or constipation or a lifetime of heavy lifting.

“With both types of incontinence, risk increases as you age,” Dr. Peacher says. “If this is something you’ve been compensating for, your ability to do that will worsen over time.”

The first line of treatment for stress incontinence is an attempt to strengthen those muscles with Kegel exercises. These can be done at home or with the help of a pelvic floor therapist who can help make sure you do them correctly. After that, your doctor may suggest a procedure that can help reinforce the muscles in that area by putting a small piece of mesh that functions like a hammock.

In some cases, patients have both stress and urge incontinence. In those cases, doctors will treat whatever causes the most frequent leaks or leaks of the largest volume.

People with incontinence are encouraged to work with their doctor to find the best treatment for their symptoms to improve their quality of life.

“Sometimes it’s a process to get to the end goal,” she says.