The adult incontinence products market is booming. Because old age is a main cause of incontinence, rapidly aging populations in the U.S. and many other high-income countries are a key growth driver for the market. Additionally, other common ailments including childbirth, obesity, diabetes and other health factors can increase the chances of incontinence.

With rising awareness of various incontinence conditions, normalization of incontinence and better access to products contributing to growth, manufacturers are working diligently to improve absorbency levels, odor control, skin friendliness, discretion and breathability when developing new products that cater to a range of consumers.

According to Euromonitor International, in the U.S., the retail adult incontinence market witnessed a healthy roughly mid-single-digit growth rate in volume and a much more elevated 11% growth in value due to inflation in 2022. In the forecast period of 2022-2027, the category is expected to grow at 6% CAGR in retail volume and value terms (USD, fixed exchange, without inflation).

“While aging remained the fundamental driver for adult incontinence, growing awareness, lessened taboo, healthy and active living trends and income improvements are also supporting the category’s performance,” says Liying Qian, head of Tissue and Hygiene, Euromonitor International.

According to Euromonitor, the moderate/heavy incontinence segment, including products marketed for moderate to severe incontinence symptoms, slightly outgrew the light incontinence segment in 2022 in both volume and value terms, partially benefitting from inflation-led consumer spending redistribution to focus on higher mileage products, or products with higher cost-benefit ratio. “Moderate/heavy format’s growth was also supported by a slew of targeted innovations bringing enhanced performance, comfort and variety to consumers with heavier incontinence, who tend to be underserved compared to those with light symptoms given stigma,” Qian explains.

From a product format perspective, she says performance-related product properties, ranging from speed of leak absorption to dryness, odor control and breathability, remained top priorities for incontinence consumers.

First Quality prioritized enhanced leak absorption with its latest launch in the incontinence category. The new technology, MaxSorb+ Zone, helps keep skin dry all day and supports skin health. MaxSorb+ Zone for bladder control pads absorbs up to 50% faster compared to previous Prevail bladder control pads.

“Keeping skin dry is extremely important when managing incontinence, because excess moisture can lead to skin irritation, discomfort and other issues,” says Sima Delafraz, chief commercial officer, First Quality. “Our Prevail Plus Ultimate Long Daily Pads for women are one of the first pads on the market to utilize this technology. Skin health is a key focus for us, so we will continue to explore opportunities to expand the technology within the Prevail brand and beyond.”

Prevail Plus Ultimate Long Daily Pads have a soft topsheet and are 100% breathable, designed to let air circulate and heat escape for supreme comfort and skin protection. As with all Prevail products, they feature Omni-Odor Guard to instantly neutralize odors throughout the day.

Based on demographic trends, First Quality expects to see the incontinence category to continue to grow organically. “We also see more people open to private label products in this category,” Delafraz says. “In the current economy, more consumers are reconsidering private label options and that includes seniors who may be on a fixed income. This is an opportunity for retailers to invest in their own incontinence brands and take a holistic approach to building consumer loyalty. Doing so means understanding consumers’ lifestyles and preferences and delivering personalized products and experiences that meet those needs.”

Principle Business Enterprises (PBE) is also in product development mode. The incontinence products manufacturer recently launched its Tranquility Essential line, which provides two protection levels that support comfort and confidence for those with moderate to heavy incontinence.

“Many of these products are designed to meet the strictest state Medicaid performance requirements, making them a great option for wearers and product suppliers through reimbursement programs,” says Ann Hertzfeld, vice president of Research and Development, PBE.

Available in briefs, pull-on underwear, booster pads and underpads, Essential products offer Tranquility’s Real Life Protection, guaranteeing they will absorb and contain their stated fluid capacity no matter how much pressure is applied during everyday activities.

Key demands from consumers with heavy to severe incontinence continue to include overall protection against leakage and odor, and they also desire discretion, as well as assurance that the product they are using is reliable, according to Hertzfeld.

“We have a continued focus on compassion-driven innovation through rigorous research and testing,” she says. “Unique to the industry, our C.U.P. (Capacity Under Pressure) test methodology allows us to ensure that Tranquility products will retain their stated fluid capacity so that people may go about their daily activities with confidence. We continually look for ways to improve our products to provide security from leakage.”

Meanwhile, Drylock U.S.’s latest innovations within its bladder control line include pads and male guards. The new products are focused on improving the consumer experience by delivering the most discreet and thinnest product line available today. “They are simply thinner and more discreet while maintaining performance,” says Matt Koloseike, vice president, sales & marketing, Drylock Technologies. “This work also reduced the packaging size, so the bag takes up less space on the shelf, as well as uses fewer plastic materials.”

For those who live active lifestyles, and prefer a more discreet, flexible product, disposable incontinence underwear is becoming a popular choice.

“Increased adoption of an active lifestyle has reinforced the appeal of mobility-assuring, comfort-enhancing features, such as adjustable fastenable tape, quick-to-dry, flexible move, cloth-like and form-fitting,” says Qian. “Pull-on incontinence underwear, typically discreet and form-fitting like normal underwear, has been gaining attraction despite their relatively higher price, which many consider a fair trade for convenience and security.”

Drylock plans to roll out new patented anti-leak channel underwear this year in the U.S. market. Drylock US says it will be the first private label manufacturer to offer this. “This technology provides an incredible level of enhanced protection while providing the most discreet and comfortable product available to consumers today,” Koloseike says.

Attindas Hygiene Partners, the hygiene business formerly owned by Domtar, recently launched a new adult disposable incontinence underwear product in North America. Invisible under clothing while providing up to 100% leak-free protection, the new product leverages Maxi Comfort ultrasonic bonding technology for more elastic material that conforms to a range of body shapes. This creates a comfortable and sleek fit that doesn’t bunch, roll, ride up or dig at the waist. The company says the product fits and feels like regular underwear, invisibly providing protection day and night. The thin, contoured center contains channels that dry so quickly, users forget that they are wearing the product. The product is available for men and women in three colors that are cottony-soft and skin-friendly.

“There’s no reason why incontinence should hold you back or prevent you from doing the things you love with confidence,” says Jacqueline Trauring, senior marketing manager, Global Adult Incontinence for Attindas. “It’s all about security – protection that feels so comfortable, you’ll forget it’s there.”

The updated product design is an extension of Attindas’ ultrasonic bonding technology that launched across Europe, where the absence glue adhesive was shown to measurably reduce greenhouse gas emissions, including carbon dioxide, to provide less environmental impact.

Direct-to-consumer brand Nexwear also offers protective underwear as well as disposable bladder control pads.

“Our protective underwear has evolved overtime and is now one of the thinnest products on the market today, but it can still absorb as much as the leading brands, making our protective underwear one of a kind,” says Matt Anderson, founder and CEO of Nexwear.

Nexwear was founded in 2018 with a profound sense of empathy and a focus on serving an increasingly older tech savvy generation, according to Anderson. “Once we learned how widespread incontinence was, we wanted to create something that if you saw it, you wouldn’t think this is a ‘diaper’ and it’s definitely not something to be embarrassed about,” he says. “Through advancements in technology, we designed absorbent modern products both discreet and comfortable to wear. Providing subscription orders direct to consumer, customers can now receive scheduled deliveries hassle and stress free.”

In August, Nexwear expanded its range in the incontinence market with the acquisition of Lily Bird, a national direct-to-consumer brand for women in midlife and beyond, focusing on products for bladder leaks.

“Lily Bird fits very well into our overall shared sense of purpose, securing continued access to high-end innovative incontinence care products. This alliance, combining our strengths, allows us to better serve the needs of our customers and business partners bringing even more product innovation to market, faster,” says Anderson.

With an exclusive focus on women, and a high caliber team in place to support its mission, Lily Bird maintains deep connections to its diverse and highly engaged customer base. The two product portfolios of Nexwear and Lily Bird are highly complementary and together will offer a more comprehensive range of products and services to better serve the fast-growing customer base.

Going Green

Like in other hygiene categories, sustainability has become more important in the adult incontinence products market, and manufacturers have been working on innovations that aim to lessen the impact of these products on the planet. This has resulted in new products that are reusable, thinner, made of plant-based fibers, or all of the above.

According to Qian, alternative formats such as washables, sanitary protection products and devices pre-empting leakage are blowing headwinds given cost efficiency and sustainable advantages. “These disruptive forces urge disposable players to reflect on pricing and sustainability strategy,” she says.

“Washable incontinence underwear’s rise, which was stoked by pandemic-induced price sensitivity and eco awareness as well as the desire for aesthetic discreetness and regular underwear-like comfort and fit, is placing pressure on disposable adult incontinence goods,” Qian continues. “Though still far from the mainstream, it is gaining traction among especially millennial and generation Z consumers. Key recent M&A activities such as Kimberly-Clark’s majority acquisition of Thinx and Essity’s buys of Modibodi and Knix further illustrated the headways this format possesses.”

Essity finalized the acquisitions of the Canadian company Knix Wear Inc. and the Australian company Modibodi, both leading providers of leakproof apparel for periods and incontinence, in September.

Knix offers a broad assortment of intimate apparel in the growing leakproof apparel category. The company has a strong presence in the U.S. and Canada and sells mainly direct-to-consumer through online channels. Essity acquired 80% of the shares in Knix. Founder and CEO, Joanna Griffiths, holds the remaining 20% share and is remaining president of Knix. 

Modibodi provides leakproof apparel for periods and incontinence and has a strong presence in Australia, New Zealand and the U.K. The company operates an online, direct-to-consumer business model, with growing sales in retail and through e-tailers. 

“Knix and Modibodi are a good complement to our global leading incontinence care brand Tena as they offer a wide range of products that deliver comfort and protection for a variety of leaks covering period, urine, sweat and daily fluids,” says Helena Hansen, media relations manager, Corporate Communications, Essity. “Joined with Essity expertise in Intimate Hygiene, these two brands will keep delivering superior innovations to improve people well-being.”

Hansen says the market share of leakproof apparel its still minor, but is an increasing part of the incontinence market, mainly catering to the lightest needs. However, Essity estimates that leakproof apparel has an expected annual growth rate of more than 20% for the next five years (estimate based on market data compiled by Essity, excluding Asia).

Meanwhile, Kimberly-Clark’s majority acquisition of Thinx, known for its line of reusable period underwear, was finalized early last year and includes Speax by Thinx, a brand of incontinence underwear.

“Kimberly-Clark is committed to providing innovative solutions that meet the needs of our consumers, and our partnership with Thinx is a strategic fit as we both build our portfolio of period and light bladder leakage offerings,” says Kubica Guevara, senior global brand director for Adult Care, Kimberly-Clark. “We have tremendous respect for what Thinx has been able to accomplish as an industry disruptor and a leader in the reusable underwear category.”

The Speax by Thinx brand incontinence underwear continues to bring breakthrough products and additional solutions to more people, according to Guevara. “This is an important collaboration for our future, and we continue to learn from each other and build on our mutual strengths.”

Kimberly-Clark has also launched reusable underwear under its Poise brand in Australia last year. Poise 2-in-1 Washable Underwear has received a very positive response from consumers, Guevara says. This uniquely designed two-in-one reusable underwear with absorption and odor control offers protection for both periods and bladder leakage. 

Other ways companies are making their products more sustainable is by replacing petroleum-based materials with plant-based materials.

Direct-to-consumer brand Attn: Grace offers a line of incontinence pads, liners and briefs that feature plant-based backsheets as well as 100% plant-based topsheets that protect sensitive skin and wick moisture 10 times better than organic cotton topsheets, according to the company.

Since the brand launched in 2020, it has added two new products to its incontinence line—Ultimate Pads that offer maximum protection for day and night, and its All Natural Barrier Cream that soothes, protects and restores skin that’s at-risk due to excessive dryness or prolonged wetness. “Both were developed in response to feedback from our community and have been hugely successful,” says Alexandra Fennell, co-founder and co-CEO, Attn: Grace.

When it comes to consumer demands in this space, Fennell says, like any other consumer category, women want incontinence products that don’t force them to compromise on product performance or their larger values. “They want products that are designed using clean, traceable ingredients from a brand they can trust, but those products have to perform. Women also want to see themselves and their values represented in the brands they support. For our team, those two things are table stakes.”

Last year Attn: Grace became the first brand in its category to earn a B Corp Certification. B Corp Certification is a designation that a business is meeting high standards of verified performance, accountability and transparency on factors from employee benefits and charitable giving to supply chain practices and input materials.

“As a mission-driven, Certified B Corp, our social and environmental impact is core to everything we do,” says Fennell. “We’re working to destigmatize incontinence while providing women with an all-around better, more sustainable solution for their bladder leaks. Incorporating cutting edge technology into our designs, we’re able to replace meaningful amounts of plastic, petroleum and other chemicals with powerful, plant-based alternatives. Our B Corp status also presents a huge opportunity to harness the power of more conscious decision-making across every aspect of our business and serves as a rigorous framework within which we measure our progress towards our larger, longer-term goals.”

Meanwhile, Essity’s incontinence brand Tena launched Tena lights Sensitive last year in Western Europe. Tena lights Sensitive is specially designed for sensitive skin and is breaking new ground on sustainability, according to Hansen.

Tena’s new Ultra Pads come with a super soft topsheet, a skin care emulsion and 0% fragrances and dyes – dermatologically approved by Skin Health Alliance. Tena lights Sensitive Ultra pads are available in two different absorption levels for light bladder weakness and offer secure protection against leaks, odor and moisture.

Additionally, this new launch comes with the first paper packaging in incontinence and for Tena ever. “We contribute to reduce plastic waste and our carbon footprint thanks to at least 50% plant-based materials used in product and pack. Our paper packaging is made of 100% renewable fibers, recyclable and FSC labeled in most markets,” says Hansen.

In other news, Essity fully relaunched its Tena Men brand last year with product innovation, new pack design, new communication, and a distinctive new visual identity. The current shields, protectors and pants are now connected into one premium range named Tena Men ActiveFit. Additionally, a completely new protectors’ range called Tena Men was launched at a lower price point. “Both ranges have strong Tena Triple protection claim to strengthen the positioning on performance and discreet security,” Hansen explains. “The range was launched with a new 360 campaign under the ‘Keep Control’ platform that talks to modern men in a taboo-breaking and straightforward way.”

Incontinence Care Goes Digital

In addition to improving the absorbent products they are making, brands and manufacturers are also expanding their capabilities by developing digital solutions to improve incontinence care for consumers.

“The acceleration of digitalization is a key enabler in the development of the next generation of products and solutions to meet the needs of our customers and consumers,” says Hansen. “The hygiene and health landscape is changing with aging populations, health care systems under pressure and rising expectations on sustainable use. This requires new ways of thinking and using digital tools to reach its full potential. It might sound challenging, but the digital infrastructure and the digital maturity among the population have increased significantly during the last years.”

With Essity’s Tena SmartCare range, it has developed a suite of digital solutions for continence management. The Identifi solution is a digital assessment solution for long term care to generate individualized care, use of products changing and toileting routines. “The outcome is amazing with up to 30% reduced waste, 15% CO2 reduction, 40% of users optimized absorption and 44% reduction of leakages,” she says.

Essity has also launched the Tena SmartCare change indicator which is a reusable sensor-based solution for care giving relatives at home and professional caregivers in long term care. It gives the caregiver insights on a smartphone when to change the absorbent product which results in less time checking and changing and more optimal use of products. “This enables greater wellbeing, comfort, improved night sleep and a more dignified relationship with the carer,” Hansen explains. “It also gives the caregiving relative peace of mind knowing that their loved one is taken care of in the best way; and the professional caregivers increased efficiency, improved care outcomes and reduced workload to a lower cost.”

In a recent clinical study with caregiving relatives, Tena SmartCare change indicator managed to reduce the number of manual checks between changes with 16% and reduce leakages with 40%. Generally, the solution was seen as very useful with 89% agreeing with the response “very good, would recommend to others,” according to Essity.

Meanwhile, absorbent hygiene manufacturer Ontex’s smart incontinence solution Orizon is an example of how it can meet unmet needs in hospitals and care homes that traditional products cannot address. The Orizon solution contains a printed sensor, a transmitter clipped onto the diaper, as well as a mobile and web application. This combination accurately determines the saturation level of the diaper and alerts caregivers when it is possibly necessary to change the diaper.

“Inflation and staff shortages are putting institutional healthcare under pressure,” says Maarten Verbanck, global external communications manager, Ontex. “A smart incontinence solution can help to increase the well-being of residents of care homes by giving them more comfort and discretion, better leakage protection and dignity and sleeping through the night. The Orizon smart solution can also help to increase the time for human interaction between staff and residents and makes costs of incontinence care more transparent.”

Finding the Right Product

With so many options available today, incontinence product brands and manufacturers are doing their best to educate consumers on choosing the best product for their particular situations.

“Some consumers put bladder control pads inside their underwear to add absorbency, but that just makes it more expensive and not as effective,” says Koloseike of Drylock. “Instead, consumers should use heavy incontinence products, such as adult briefs or overnight underwear.  We also see consumers using feminine hygiene products for light incontinence, instead of bladder control pads, which are designed for incontinence and have better leakage and odor control.”

To help consumers choose the correct product(s) to use based on their absorbency need and lifestyle, Drylock has created a product guide. It also shares this information on its social media pages.

According to Fennell of Attn: Grace, many women are turning to period products to absorb their bladder leaks, perhaps because they are more accessible to them, or less embarrassing to purchase, but this is problematic as their liner or pad of choice is most likely letting them down. “And compounding all of this is the fact that this condition is still so highly stigmatized, to the point that it takes an average of six years of living with bladder leaks before she’ll speak to her doctor about them,” she adds.

For Attn: Grace, education and awareness is key to tackling all of these challenges. “As with so many other aspects of our health and well-being, the ingredients in and composition of the products women use to manage bladder leaks matter, but we’ve been socialized for decades to trust what we see on the shelf and/or to assume that it’s as good as it gets, and that a high-performance, cleaner alternative isn’t feasible or doesn’t yet exist,” says Fennell. “Raising awareness and empowering women around these issues is core to our larger mission. Equally critical is getting the word out that for many women, bladder leaks can be treated or mitigated. We want women to feel confident enough to talk to their doctors and seek out the best possible options for their care.”

Kimberly-Clark conducted an online survey of a nationally representative sample of 500 U.S. moms 18+ with children between the ages of 5-15 that found that most moms with bladder leakage still use menstrual pads, “which don’t adequately protect them from bladder leakage since they are designed for slow-moving menstrual flows – bladder leakage pads are built for dribbles, bursts, and gushes of urine,” says Guevara. “We found that nearly half of all moms sometimes feel forced to miss out on fun with family and friends because of bladder leakage. They are more likely to avoid certain forms of exercise, jumping, amusement park and carnival rides, and skipping, and they’ll often leave an event due to concerns about bladder leakage.” 

To help moms and women worry less and have more fun, Kimberly-Clark launched Poise Ultra Thin Pads with Wings in the U.S. last year. The new pads wick away moisture and odor for all-day protection, helping keep women 10 times drier from bladder leaks than the leading period pad.

Dedicated to shattering damaging stigmas surrounding women’s health, Poise is also partnering with mom influencers to ignite honest conversations with all women about experiencing and addressing bladder leakage.

For First Quality, innovation goes beyond products and technology to include services that support retailers’ private label brands, Delafraz says. For example, the company recently made its clinical support services available to its retail partners. “This gives retailers access to our clinical team, who bring a combined 380+ years of experience as licensed nurses, case managers and geriatric nurses,” she says. “They staff a 24/7 nurse line, providing free, 100% confidential support to consumers online and over the phone. This level of individualized service is important because of the personal nature of incontinence care.”

First Quality started out over 30 years ago providing incontinence products to nursing homes and senior living facilities. Its clinical team would visit the facilities to educate residents and professional staff on how to use the products, and that’s where it saw the need for personalized support. “As more people age at home and family members take on caregiver roles, they also need support to make educated decisions about incontinence care,” Delafraz says. “First Quality is committed to providing the same level of care and support to consumers as we have always provided our healthcare partners.”

According to PBE, several challenges prevent consumers from using the correct product to manage incontinence. These include lack of knowledge and education about the many different types of absorbent products available, how to choose the right one, or how to use them properly. Stigma and embarrassment, cost and availability are also barriers to accessing the right products.

Tranquility is working to address these challenges by providing education and resources to help people understand incontinence and the different products available to manage this condition. Examples include providing direct access to a knowledgeable customer service team and sharing new blog articles and email newsletters every month. Tranquility also manufactures a wide range of incontinence products, including high-quality products available through Medicaid, waivers and other reimbursement programs to make them more accessible to everyone.

In addition, Tranquility has a generous sampling program allowing its consumers to try most products before they buy, helping them find the right solution. “We have a dedicated, U.S.-based customer care staff that offers individualized care to help people along their journey with incontinence. We also offer a variety of product training options for our suppliers, helping them to better educate their customers,” says Hertzfeld. “By addressing these challenges, Tranquility aims to make it easier for people with incontinence to find the right products and manage their condition with confidence and dignity.”