Urinary incontinence—the basicsWhen your bladder is full, it sends the message we all know well—gotta go! Ordinarily, we can hold it until it's convenient, then we allow the muscles around the bladder to relax, and your urethra opens so urine exits. But sometimes, signals tell your bladder it's time to go, even when it isn't full. That's known as overactive bladder (OAB). OAB presents itself via:
- Frequency: Having to pee more than 7 times a day (normal is 4–7 times) and more than once at night, known as nocturia
- Residual urine: Incompletely emptied bladder
- Urge Urinary Incontinence (UUI) is when you have a powerful need to pee that you can't hold back, even when your bladder isn't full.
- Stress Urinary Incontinence (SUI) is involuntary leakage of urine when you:
What causes urinary incontinence?
- Your urethral muscle needs estrogen for normal health. Estrogen levels decline during or after menopause, often with a noticeable (and reversible) effect on muscle strength
- Testosterone also declines in post-menopausal women, which has been linked to urinary incontinence
- Infection, bladder stones, and abnormal cells (including cancer) can also set off symptoms, as can drinking too much liquid, especially alcoholic or caffeinated, which often contribute to the symptoms
- Ultrasound imagery shows how your bladder and urethra change when you pee or cough
- A pad test shows how much urine you pass throughout the day
- A bladder stress test checks for SUI
- Cystometry measures bladder pressure
- An MRI scan can find problems not detected by other tests
Practical solutions to prevent incontinenceHere are some practical solutions for all types of urinary incontinence:
- Limit yourself to 6–8 glasses of liquid per day
- Cut back liquids after 4 p.m. if you leak overnight
- Cut down your alcohol, soda, and caffeine intake. Start with half as much as usual, and cut down more if no results
- Other beverages? Fill your cup or glass halfway, but don't cut down on water
- Pee every 2–4 hours, even when you don't need to, to keep the pressure off.
Exercises to prevent or reverse incontinenceAll our muscles shrink with age, at about 1 percent per year after we're 40. That includes your bladder-regulating muscles, which become more leak-prone over time. Fortunately, there are simple, home-grown ways to prevent and even reverse urinary incontinence by working on your pelvic floor or Kegel muscles. How simple? Just clench the muscles you would use to squeeze a tampon in your vagina, or during sex. Hold the squeeze for 10 seconds, then relax. Do three or four sets every day.
Devices that help prevent or reverse incontinence
Hormone replacement therapy (HRT) for incontinenceLoss of estrogen and testosterone after menopause can be corrected with HRT. Innovative ways to create and administer treatments mean they can be "customized" to work best with your heath profile and history. If you explore this option with your doctor(s), insist on bio-identical hormones, not synthetic ones.
"Sexual healing" for incontinenceVaginal intercourse, with a trusted, intimate partner, at least once a week can also work wonders. I can't prescribe it, but wow, do I strongly recommend it to strengthen your Kegel and other muscles. I know sex as we age can be a challenge, and our natural lubricants are less plentiful. But we can do something about it. Simply use a lubricant—virgin coconut oil is great if you and your partner don’t use condoms. If you do use latex condoms to protect your health, use a water-based lubricant, not oil. There are scores of options. You'll surely find the ones that work best for you and your partner.
With that happy thought, take good care.
- Wakamatsu, May. 'What is a pad test for urinary incontinence?" Sharecare. Published NA. Last accessed December 27, 2017.
- "5 Best Exercises for Women with an Overactive Bladder" Healthline. Published November 8, 2016. Last accessed December 27, 2017.
- Duvall, Sarah Ellis. "The Best Pelvic Floor Exercises" Published NA. Last accessed December 27, 2017.
- Osterweil, Neil. "Incontinence Tied to Low Testosterone in Women" MedScape. Published May 18, 2017. Last accessed December 27, 2017.
- Charnow, Jody. “Low Testosterone Increases Women's Urinary Incontinence Risk” Renal & Urology News. Published May 14, 2017. Last accessed December 27, 2017.
- Payne, Jacqueline. "Pelvic Floor Exercises" Published NA. Last accessed December 27, 2017.
- Fields, Lisa. "Tips to Help You Manage Urinary Incontinence" WebMD. Published NA. Last accessed December 27, 2017.
- White, Melissa. "Wetter is Better—How to Choose the Best Lube" Huffington Post. Updated Mar 23, 2014. Last accessed December 27, 2017.