Many women struggle with urinary incontinence. It’s uncomfortable
and embarrassing. And worse, it’s linked with other health problems.
Women can become dehydrated when they limit fluids to avoid leakage. They
can also become socially isolated and depressed.
“Women stay home due to fear of not being able to find a bathroom
close by, or fear having an accident in public,” says Salpi Salibian,
director of program development for
Hoag Hospital’s Pelvic Health Program in California.
It’s not a problem you should ignore. “Urinary incontinence
tends to get worse over time, not better. Waiting to see if it passes
will just lead to more years of discomfort and leakage,” says Heather
Jeffcoat, a physical therapist and owner of Femina Physical Therapyin
Los Angeles.
Fortunately, urinary incontinence (UI) is treatable.
A study published in the Annals of Internal Medicine in April found that
behavioral therapies beat medication for treatment.
“I want more people to know that there is help for UI that isn’t
surgery, drugs or diapers,” says
Sarah J. Haag, a specialist in women’s health physical therapy and author of Understanding
and Treating Incontinence.
Here’s what you can do
First, talk to your doctor about your symptoms—he or she can help
diagnose the type of incontinence you have and develop an effective treatment plan.
Your doctor might recommend these
DIY options:
Kegels
Women have been told for years to do Kegel exercises, multiple times a
day. And they can be helpful for a lot of women. But they aren’t
always done properly.
“Almost half of women do Kegels incorrectly, or in a way that is
actually making their problems worse,” Jeffcoat says. Many women
tend to squeeze their gluteal muscles, which makes it difficult to be
aware of the pelvic floor muscles.
Engage your lower abdomen instead, says Chitra Mittal, a women’s
health expert at Liberty Physical Therapy in Jersey City, NJ.
Physical therapist Katy Rush owns a specialized physical therapy clinic,
The Perfect Pelvis, in Missouri. Here’s her recommendation for a
proper Kegel technique: Imagine you are picking up a blueberry with your
vagina. It should feel like you are drawing your muscles up and in.
But Kegels aren’t always the solution. “Doing Kegels for muscles
that are already too tight will only make the problem worse. If you often
have pain, specifically lower abdominal pain, low back pain, or pain with
intercourse, it is likely that the pelvic floor muscles are too tight,”
Rush says.
For muscles that are too tight, you’ll need to focus on relaxation
before strengthening.
Maintain a healthy weight
Need another reason to
lose weight? Extra body weight can put pressure on the bladder and the pelvic organs.
“A healthy pelvic floor should be able to contract, relax, and lengthen
in a coordinated manner,” Mittal says.
Keep a bladder journal
Tracking your fluids and trips to the bathroom can help you identify triggers.
Carbonated, caffeinated, and alcoholic beverages are known bladder irritants,
says Salibian. If you wake up more than once a night to urinate, let your
doctor know.
How physical therapy can help
Your doctor might suggest that you see a
physical therapist who specializes in incontinence or pelvic floor problems.
“Studies have shown that working with a physical therapist who specializes
in pelvic physical therapy and biofeedback delivers the best results.
A pelvic physical therapist has specialty training in the pelvic muscles
and everything that is connected to them,” Salibian says.
Your physical therapist might try:
Biofeedback
This technique measures the electrical activity in a muscle—a contracted
muscle will have a higher number. Biofeedback can show you if you are
tightening and relaxing your muscles properly.
“Pelvic floor muscle biofeedback can be a great tool to help train
women to isolate these hard-to-find muscles by giving them real-time feedback,”
Jeffcoat says.
Electrical stimulation
Transcutaneous electrical nerve stimulation (TENS) uses electrodes to send
pulses of electricity that stimulate muscle contractions and strengthen
your bladder muscles.
Your physical therapist may also guide you in relaxation and strengthening
exercises.
And if you’re not getting results on your own or with physical therapy,
your doctor might recommend hormone replacement therapy, vaginal tablets,
Botox injections, or surgical options.
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