Weak muscles, nerve damage, medicine side effects, or other disease conditions can cause incontinence (Bladder control problem).

Causes of Incontinence

• Weak muscles, in particular, pelvic muscles cause the bladder control problems. Pregnancy and childbirth stretches and weakens this muscle. Weak muscles allow the bladder to go out of position, which may stretch the urethra opening.
• Nerve damage may send wrong signals to the bladder and results in bladder spasm, which may leak out urine without a warning. In some cases, damaged nerves do not sense or send no signals to the brain when the bladder is full. In this cause, both incontinence and incomplete emptying are possible.
• Prostate problems in men may cause bladder problems. Prostate is a male gland about the size of a walnut that surrounds the urethra (the tube that carries urine).
• o    An enlarged prostate, common among older men, may press the urethra. Results in a weak urine stream, an urgent need to urinate followed by leakage, and frequent urination at night.
• o    Surgery or radiation treatment for prostate cancer can cause temporary or permanent bladder control problems.

Diseases and conditions that can damage the nerves

• Diabetes
• Parkinson’s
• Multiple sclerosis
• Stroke

Trauma that can damage the nerves

• pelvic or back surgery
• herniated disc
• radiation

Other causes of Incontinence

• Medicines, alcohol, and caffeine can affect certain muscles or nerves. Medicine taken to calm the nerves may dull the nerves in the bladder and stop them from signaling the brain when the bladder is full. Without the message and urge, the bladder overflows. Drinking alcohol can also cause these nerves to fail. Water pills or diuretics medication removes water accumulated in the body and sends them to the bladder. This unexpected rapid filling may cause the bladder to leak. Caffeine drinks such as coffee and cola can cause the bladder to fill quickly.
• Infection such as a urinary tract infection can irritate bladder nerves and cause the bladder to squeeze without warning. Treat infection can help vanishes this type of incontinence.
• Over weight can put extra pressure on the bladder and contribute to stress incontinence.

Weak muscles or nerve damage can cause bladder control problems. Based on the cause and symptom bladder problems are of different types.

Each bladder control problem is different. Some of the common causes of bladder control problems are:

• weak muscles,
• damaged nerves,
• Medicine that dulls the nerves

Bladder control problem types

Bladder control problems of incontinence have different types. Six most common types of incontinence are:

Temporary incontinence - The name itself explains this incontinence does not last longer. It may be due to an illness, like a urinary tract infection, that causes frequent and sudden urination difficult to control or may be due to unexpected side effects of the medicine that increases the urination. As soon as you correct the cause then the temporary incontinence problem vanishes.

Stress incontinence - Produce urine leak when cough, laugh, sneeze, or exercise. This stress means physical pressure (pressure on the bladder) and not mental stress. When the pelvic and sphincter muscles are strong, they can handle the extra pressure from a cough, sneeze, exercise, or laugh. However, when those muscles are weak, then sudden pressure will expel urine out of the bladder.

Urge incontinence - It causes a urine leak after a strong, sudden urge to urinate. Nerve damage from diabetes, stroke, infection, or another medical condition may cause urge incontinence.

Mixed incontinence - It causes a urine leak due to mix of stress and urge incontinence. You may leak urine with a laugh or sneeze at one time and after a strong, sudden urge at another time.

Functional incontinence - Functional incontinence causes urine leakage because of functional problems such as cannot walk nor have other mobility problems.

Overactive bladder - Overactive bladder causes increase urination frequency. One who has overactive bladder needs to urinate eight or more times a day, and two or more times each night. Symptoms may be strong, sudden urges to urinate, and may or may not have urged incontinence.

Female sexual dysfunction causes

• Infections and irritation, chronic high blood sugars promote yeast infections and vaginal irritation.
• Low blood flow, vascular damage caused by poorly controlled diabetes restricts the blood flow to the vagina, which causes dryness and interferes with arousal.
• Nerve damage, women who have neuropathy to the genital area, the reproductive organs, or the vagina may have difficulty achieving orgasm.
• Neurogenic bladder, women with nerve damage to the bladder may have incontinence problems that make sex difficult and/or embarrassing. It can also make urinary tract infections (UTIs) more common, which may make sex uncomfortable.

Common female sexual dysfunctions

Numerous diabetes women are experiencing sexual problems that may include:

• vaginal dryness or decreased lubrication,
• sexual intercourse with discomfort or painful
• lack of desire for sexual activity
• low or absent sexual response

Low/absents from sexual response can be the inability to attain or remain to arouse, lack or absent of sensation in the genital, and always or occasional inability to attain orgasm.

Causes of sexual problems in women with diabetes may be due to nerve damage, lack of blood supply to genital and vaginal tissues, and hormonal changes. Other causes may be due to some medications, alcohol, smoking, psychological problems of anxiety or depression, gynecologic infections, other conditions relating to pregnancy or menopause.

Consult doctors for treatment, the treatment may be after diagnosing the cause. They will prescribe over the counter vaginal lubricant for dryness. In most of the cases, psychological counseling may provide useful solution.

Diagnose erectile dysfunction by assessing patient’s history, through physical examination and finally, some lab tests.

ED diagnosis

While a simple, recounting of sexual activity might distinguish among problems with sexual desire, erection, ejaculation, or orgasm.

ED diagnosis by Physical Exam

• If the penis is not sensitive to touch - then it is a nervous system problem.
• Problems of secondary sex (sexual maturity distinguishes one gender to other) hair growth, breast enlargement, etc. - hormonal problems (endocrine system)
• Circulatory problem - decreased pulses in the wrist or ankles.
• Physical (penis) - that bends or curves when erect (Peyronie's disease).
• If nocturnal erections (involuntary erections during sleep) do not occur, then ED is likely to have a physical rather than psychological cause.

Lab ED tests    

Blood counts, urinalysis, lipid profile, and measurements of creatinine and liver enzymes. Measuring the amount of free testosterone in the blood can yield information about problems with the endocrine system and is indicated especially in patients with decreased sexual desire.

• Blood tests measure hormone levels, cholesterol, blood sugar, liver and kidney function, thyroid function and levels of other sex hormones.
• CBC–Complete blood count (CBC) of red cells and white cells is useful to examine anemia; it causes fatigue and general malaise. The level of blood lipids (fats) may indicate arteriosclerosis, which can reduce blood flow to the penis causing erection problems.
• Liver and kidney function tests help to find any Liver or kidney disease can contribute to hormonal imbalances, which may results in ED.
• Thyroid function tests to find any thyroid hormonal abnormality, which regulate metabolism and sex hormone production; a deficiency may result in impotence.
• Urinalysis to measure levels of protein (albumin), glucose (sugar), and hormone testosterone. High levels of protein indicated kidney disease; high level of glucose indicates diabetes and low level of testosterone may cause ED.
• Erectile function tests to asses erectile by examining the blood vessels, nerves, muscles, and tissues of the penis.
• Duplex ultrasound is useful to diagnose blood flow, venous leak, atherosclerosis, and calcification of erectile tissue. This test is by inducing erection by injecting prostaglandin (hormone-like stimulator).
• Nocturnal penile tumescence (NPT), it is normal for a man to have five to sex erections each lost for 30 minutes with an in-between gap of 90 minutes during sleep, particularly during rapid eye movement (REM). Their absence may be due to nerve function or blood supply problems in the penis.
• Bulbocavernosus reflex test is to access nerve sensation in the penis. The physician presses the glans (head) of the penis, which immediately causes the anus to contract if nerve function is normal. If there is any abnormality suspected, then your doctor suggests specific nerve tests for further evaluation.