Urinary incontinence affects up to 55% of women at some point in their lives, and this figure can exceed 70% in older women. It is defined as the involuntary loss of urine, and is generally classified, according to the International Continence Society (ISC), as: Stress incontinence, Urge urinary incontinence, and Mixed urinary incontinence. Urge incontinence is related to the consumption of non-caloric sweeteners.
The main mechanism is related to alterations of the detrusor muscle of the bladder (the specialized muscle of its wall), such as hyperactivity, poor distensibility or bladder hypersensitivity.
The possible link between artificial sweeteners and urinary incontinence is that, when eliminated through urine, some sweeteners, such as acesulfame K, aspartame, and sodium saccharin, come into direct contact with the bladder. Research suggests that these substances can increase detrusor muscle contraction, even at low concentrations.
A UK study by Jaydipi Dasgupta and colleagues proposed that the pathophysiological mechanism involves increased calcium influx into bladder smooth muscle cells. Since calcium is a key mediator of muscle contraction, its intracellular increase promotes stronger and/or more frequent detrusor muscle contractions, which could contribute to the development of urinary urgency symptoms.

Research hypothesis: Higher consumption of artificially sweetened beverages is associated with a higher prevalence (or likelihood) of urinary incontinence symptoms in women.

A cross-sectional study was conducted at a hospital in Northwest Mexico (n = 88). UI subtypes (urge, stress, and mixed) were assessed using instruments adapted from the ICIQ-UI Short Form. ASB exposure was categorized as use of table sweeteners, consumption of diet soft drinks, and combined consumption. Statistical analysis included chi-square tests with Haldane-Anscombe odds ratios (ORs), Spearman correlation, and multivariable binary logistic regression with Welch-corrected t-tests.

The overall prevalence of UI was 50.0%. The use of artificial sweeteners was significantly associated with any type of urinary incontinence (OR = 3.85, 95% CI: 1.57–9.43; p = 0.005). Multivariable logistic regression identified sweetener consumption as the only significant independent predictor of any type of urinary incontinence (adjusted OR = 4.74, 95% CI: 1.80–12.47; p = 0.002), independent of age, BMI, and parity. Age was the only significant predictor of exertional urinary incontinence (OR = 1.12/year, 95% CI: 1.05–1.21; p = 0.001), while artificial sweetener consumption showed a limited statistical trend (OR = 2.94; p = 0.055).

Consumption of artificial sweeteners increases the likelihood of urinary incontinence almost fivefold in Mexican women, regardless of BMI or obstetric history.

These findings support dietary counseling aimed at reducing artificial sweetener consumption as a potential modifiable strategy for the treatment of urinary incontinence in this population.