ALBANY, N.Y. (NEWS10) — Urinary incontinence affects more than 25 million people in the U.S.—and affects women at twice the rate as it does men. However, it is not a normal part of aging and can be treated.

“I have women that will start working with me and come back for follow up appointments and say, ‘I started to speak with my friends about this, and it’s—I never knew how many people had this problem,'” said Dr. Gillian Wolff, a urologist at Albany Medical Center.

Pregnancy, childbirth, and menopause make it more likely among women, and it’s important to raise awareness in November, which is Bladder Health Month. “It is something that people tend not to speak about even with their primary care physicians,” Wolff said.

“Women can be suffering and dealing with these problems in silence and not knowing the different options that are available.”

Dr. Gillian Wolff

Wolff said that common bladder conditions include stress incontinence—leakage due to physical activity, like coughing or jumping—and urge incontinence—the need to urinate right away and often. Physical therapy, behavioral and dietary changes can help. “There are very small things that you can do, such as pelvic floor exercises, to doing more invasive things,” she said.

Medications can relax the bladder muscle, helping to empty your bladder more completely. Pelvic sling procedures can help with stress incontinence. “You can imagine when you’re coughing or sneezing, the bladder moves a little bit? It acts as a hammock to stop that leakage,” Wolff said.

There’s also nerve stimulation, “which we do with an acupuncture needle, as well as one where we actually implant a device underneath the skin in a small outpatient procedure,” Wolff said.

And Botox injections aren’t just for wrinkles. “We can place the Botox directly into the muscle of the bladder,” she said. “It selectively does relax many of the muscles in the bladder so that the person had less urgency, fewer accidents.”

The Botox does fade, so a repeat procedure is needed within three to 12 months. “There are a lot of really good responses to it and most women who have had it who have waiting on it will tell me afterward, ‘I wish I had done this sooner.’”

Even if you’re embarrassed, talk to your doctor if you’re going to the bathroom eight or more times a day, wake up twice or more to use the bathroom at night, if you have difficulty with daily tasks, or you’re avoiding social situations.