You may think leaking a bit of urine when you laugh, cough or sneeze or feeling like you have to pee all the time, is part of the aging process. Many women even believe it's just one of many unpleasant consequences of childbirth. And although urinary incontinence plagues many women, it isn't something you have to endure.
Regaining full bladder control is possible, and you can often do it without medication, says Therese Eutsler, a Franciscan Health physical therapist who specializes in pelvic floor issues at Franciscan Health Lafayette, Indiana. “There are multiple strategies we can use to help people address urinary incontinence. The first step though, is opening up to your doctor about it.”
Bladder Control is a Common Problem
You probably aren't the only person in your book club or gym class that worries about bladder leaks. That's because one in four women between 18 and 59 years of age have involuntary leakage.
"Urinary incontinence is not an inevitable result of childbearing or menopause," said Sarah Randolph-Kaminski, a physical therapist at Franciscan Health Indianapolis. "Even high school or college women athletes may have issues."
Experiencing leakage during activities that put pressure on your bladder is called stress incontinence, and it's the most common type of incontinence in young and middle-age women. Stress incontinence is often the result of scar tissue in the perineum from an episiotomy or prolonged pushing during childbirth. Other causes include pelvic radiation treatment, chronic constipation that leads to frequent straining and recurrent urinary tract infections.
Another type of incontinence is when you feel like you need to urinate all the time (like every 30 minutes). That's called urge incontinence or overactive bladder.
It Takes More Than a Few Kegels to Fix It
Instead of seeking treatment for incontinence, many women try to "deal with it" on their own by changing their exercise routines, trying Kegel exercises, even resorting to wearing sanitary napkins to absorb bladder leaks.
“Unfortunately, instead of getting medical treatment a lot of women try to deal with urinary incontinence on their own. They might stop running or doing other exercises that cause bladder leaks, or otherwise modify their lifestyle. Or, women might try doing Kegels at home or just resort to wearing pads," says Eutsler.
Half of women who have the condition never mention it to their doctors out of embarrassment, or because they think bladder leaks are a normal part of the aging process. Getting older does increase the likelihood of experiencing bladder leaks, or making it worse, in part because muscles – including those in the pelvic floor – lose tone as we age.
If you've experienced consistent bladder control issues for at least three months, you should seek medical treatment. Your primary care doctor, gynecologist (OBGYN) or urologist can guide your incontinence care.
Diet and Exercise Can Help Stop Bladder Leakage
After an initial evaluation with your healthcare provider, you’ll receive a treatment plan to follow at home. Recommended therapies may include dietary changes, pelvic floor exercises and/or medication.
For those with urge incontinence, tweaking your diet can help reduce urge incontinence. For example, you might need to scale back on caffeine since the stimulant can sensitize your bladder and increase your urge to urinate. Other foods like milk, tomatoes, avocados and certain fruits can stimulate your urinary tract in a similar way, too.
Often, you can also reduce incontinence with pelvic floor physical therapy. Your first session includes an internal and external assessment of the alignment, flexibility and muscle tone in your pelvic area. Based on that exam, your therapist creates an exercise program and goals for you to work on.
Pelvic exercises increase your range of motion and muscle strength. Your therapist may also use biofeedback, an electronic monitoring tool that shows how much pressure or contraction you can generate with your pelvic floor.
The best part about getting medical treatment for bladder leakage? You can see significant improvement in three to four months, says Eutsler.
Get the Treatment You Need
Don't let worry or embarrassment stop you from taking care of yourself. Ask your doctor if pelvic health rehabilitation or other treatments could get your bladder back on track.