Like a lot of persistent health conditions, female urinary incontinence (UI) rarely resolves on its own, and managing it can take a real toll — socially, financially, emotionally. The upside is that effective treatments exist. Which is why it matters to actually ask women three things: Do you have UI? Does it bother you? Do you want to do something about it?

That question is at the center of the Women’s Preventive Services Initiative (WPSI), a federally supported program led by the American College of Obstetricians and Gynecologists (ACOG). Care-seeking rates among women with UI can be as low as 25%, which is part of why WPSI recommends screening as a routine part of every woman’s annual wellness exam: asking whether she has UI, how much it affects her life, and whether she wants treatment. A few validated tools support this, including the 3-Incontinence Questions (3IQ) and the Michigan Incontinence Symptom Index (MISI).

Turning that recommendation into everyday practice is hard even under normal conditions. It gets harder still whenever access to non-urgent care is disrupted, whether by a public health emergency, provider shortages, or symptoms that simply go unspoken for years. One way to read that is as a backlog problem for the health system to eventually work through. A more useful way to read it: the burden of UI grows the longer it goes unaddressed, and screening isn’t a one-time box to check. It’s an ongoing conversation.

Telehealth has become a genuinely useful tool here, for screening, early evaluation, and first-line care like pelvic floor muscle training and behavioral changes. It particularly helps women who face barriers to in-person visits, whether that’s distance, mobility, scheduling, or simply not wanting to bring it up face to face.

Here’s a striking number: more than half of women with UI who never mentioned it to their provider say it’s because the provider never asked. So — is it time to change that?