Nearly 25% of women between the ages of 70-79 experience urinary incontinence at least once a week. Stress incontinence, which is associated with exertion (coughing, sneezing, or exercise), usually begins during the reproductive years, whereas urge incontinence more frequently affects postmenopausal women. Women may be sleep-deprived from waking up to use the bathroom, or unable to exercise, travel or attend events for fear of an “accident”. Diabetes, arthritis, weight, Caucasian race, and synthetic oral estrogen use are associated with increased risk for urge incontinence. Women with overactive bladder are also likely to experience sexual dysfunction. According to a study from the University of Pittsburgh, there is a link between urge incontinence and infrequent sexual activity. Additionally, the more distress or pain a woman experiences with her urge incontinence, the less enjoyable is her sexual activity. Women should not be embarrassed to confidentially discuss this medical problem, as effective treatments are available. Local estrogen therapy may improve urethral and bladder function when incontinence is associated with urogenital atrophy.