Incontinence, Women
Background
Urinary incontinence (UI) is any involuntary leakage of urine. It is a common and distressing problem, and often treatable.
Causes
Stress incontinence
Stress urinary incontinence (SUI), is caused by weakening of the pelvic floor muscles. It is the loss of small amounts of urine associated with coughing, laughing, sneezing, exercising or other movements that increase intra-abdominal pressure and thus increase pressure on the bladder. Described graciously by one woman as "I laughed so hard, tears ran down by legs!"
Low estrogen levels may lead to lower muscular pressure around the urethra (the tube draining urine from the bladder), as well as a shorter urethral length, increasing the risk of leakage.
Stress incontinence is treatable.
Urge incontinence
Urge incontinence is involuntary loss of urine occurring for no apparent reason while suddenly feeling the need or urge to urinate. The most common cause of urge incontinence is involuntary bladder spasm. This can occur from many causes including:
- Hidden bladder infections or vaginitis.
- Nerve problems such as stroke, MS, or Parkinson’s.
- Spasm of the muscle attached to the top of the pubic bone.
For incontinence, a urologist will do the best evaluation, but consider doing the treatments discussed under the "Treatments" section first to see if they work (allow 2-3 months) so you don’t get pushed into unnecessary surgery or medications.
Functional incontinence
This is when you can’t physically make it to the bathroom in time due to limited mobility.
Bladder spasm from tight pelvic muscles
If there is tenderness where the muscle going down the front of the abdomen attaches to the top of the pubic bone (the lowest bone in the middle of the abdomen/pelvis), this tight muscle attachment can trigger bladder spasm. A hot compress or other treatments to relax that tender area over the top of the pubic bone can help bladder spasm.
Also, have your urologist look for other more common and well known causes, and they can offer treatments that can also help. See Interstitial Cystitis if there is persistent urinary burning without infection being present.
Treatments
Therapies & Advice
Schedule frequent bathroom trips
Know how long you can hold it. If you leak after 90 minutes, go to urinate every 75 minutes while awake. Keep a chart till you naturally time train yourself.
Use pads
Attends Booster Pads™ and similar pads (or smaller menstrual pads) can offer relief from the anxiety of "What if there’s a leak?"
Kegel exercises
Kegel exercises to strengthen or retrain pelvic floor muscles and sphincter muscles can reduce stress leakage. Do at least 24 daily contractions for at least 6 weeks. Then simply doing the Kegel pelvic muscle tightening at the same time as you laugh or cough can keep the urine from squirting out.
Test for infection
Do a urine culture and sensitivity test for infection. If positive with E. coli bacteria (most are), use the supplement D-Mannose to suppress the infections safely.
Bioidentical estrogen
For stress incontinence, consider low dose bioidentical estrogen and progesterone (see Menopause) applied daily vaginally near where the urine comes out. Give it 3 months to work. This can be very helpful.
Recommended Supplements
Angelica
Angelica is very helpful for both males and females.
Magnesium
The nutrient magnesium (200-400 mg a day — less if diarrhea) helps decrease bladder spasm after 6 weeks of use.