Urinary Incontinence: Natural Treatments Women Can Use
Urinary incontinence is one of those oh no moments when your body disobeys your mind. Sometimes the urgency comes up without warning. Other times, you just can’t stop it.
It affects some 30 million Americans, mostly women, and ranges from occasionally annoying to truly disruptive.
Urinary incontinence—the basics
When 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
OAB is very often manageable—you can hold off until it’s convenient to go. More serious are two other types of incontinence:
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?
Stress incontinence affects the greatest number of people. It results when the muscles of the pelvic floor and bladder weaken. This weakening is typically caused by pregnancy/childbirth, weight gain, or hormonal changes—hence the reason more women than men are affected.
Urge incontinence (also called overactive bladder) is caused by involuntary contractions of the bladder muscles. Those who suffer from this condition report they can’t “hold it” long enough to get to the bathroom and constantly feel like they need to go immediately. Overactive bladder is linked to a lot of potential underlying causes, including neurological diseases (multiple sclerosis, Parkinson’s, etc.), stroke, nerve damage, and even side effects of drugs.
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
Various tests can find what might be behind incontinence:
- 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
Conventional Treatment of Incontinence
Treatment of incontinence is a multimillion-dollar industry. Many different therapies and potential solutions exist—but what works for some may not work for others. Furthermore, many of the conventional treatment options carry the risk of significant side effects, some of which outweigh the benefits. Here’s a rundown of the most common treatments available.
The main class of pharmaceutical drugs used treat incontinence (mainly urge incontinence) is anticholinergics (Detrol, Ditropan, Enablex, etc.). These drugs work by blocking the nerve transmitter acetylcholine, which stops involuntary bladder contractions.
Though effective, studies show adherence to these drugs is low, most likely because their side effects can be bothersome at best, debilitating at worse. They include blurred vision, dry mouth, constipation, rapid heartbeat, confusion, memory loss, and in some cases, problems urinating.
If anticholinergics don’t work or if the side effects are intolerable, Botox is another option. That’s right—Americans’ favorite wrinkle reducer is an approved treatment for urge incontinence! It is injected directly into the bladder, causing temporary paralysis. This allows the bladder to relax and gives it the ability to store more urine.
For postmenopausal women, supplemental estrogen therapy can help as well. Topical bioidentical estrogen helps keep tissues healthy and can reduce symptoms of both stress and urge incontinence.
Sometimes, doctors will recommend devices that get inserted into the vagina or urethra to treat stress incontinence.
Vaginal inserts are called pessaries. Safe and effective, pessaries prevent leakage by holding up the bladder, which lies near the vagina. If you want to try this option, an FDA-approved pessary called Impressa is available over the counter. Otherwise, you need to work with your doctor to get fitted for one.
Vaginal cones are small plastic cones of different weights that you hold in your vagina for about 15 minutes, twice a day. When you can hold the lightest weight comfortably, you move up to the next weight.
Other options in this category include urethral inserts (these can be painful to insert, increase risk of urinary tract infection, and aren’t a popular choice); urine seals (adhesive pads placed over the urethral opening); and bladder neck support devices (another rather unpopular option due to discomfort and higher risk of infection).
With electrical stimulation, electrodes are temporarily inserted in the vagina or rectum, or implanted under the skin near the buttock, to stimulate and strengthen the muscles that control urine flow. This can be used for both stress and urge incontinence, but usually multiple treatments are needed.
Stem Cell Therapy
Stem cell therapy is an up-and-coming therapy that shows promise. It involves transplanting a woman’s own stem cells into the urinary tract to restore muscle mass and function.
According to a published study, “Current gold standard therapies often provide symptomatic relief without targeting the underlying [causes of incontinence].” But stem cells have been shown to not only halt disease progression but also reverse the underlying causes.
In severe cases, surgery is an option. It can improve or even cure incontinence in many cases, but as with all surgeries, serious complications can result.
A common surgery for stress incontinence involves pulling the bladder up and securing it using a sling made from synthetic mesh or strips or your body’s own tissue. This sling supports the neck of the bladder and keeps the urethra closed, especially when pressure is exerted, such as during coughing or sneezing. But complications include tissue erosion and organ perforation, so these potential drawbacks need to be strongly considered before going through with this surgery.
Bladder neck suspension surgery improves support of the urethra and bladder neck via an incision in the abdomen. And prolapse surgery, another surgical technique often used to treat incontinence, lifts up organs, such as the bladder, that have slipped out of place.
Lifestyle Changes That Can Help
Making certain changes to your lifestyle and personal habits can also make a big difference in symptoms of incontinence.
- Lose weight. Excess pounds place a lot of stress on the bladder.
- Avoid bladder irritants. Foods and other substances that can irritate the bladder include black pepper and acidic or spicy foods.
- Try bladder training, which involves going to the bathroom on a regular schedule. Start by going every 30 minutes or so, whether you feel the need to or not. The goal is to lengthen the time between bathroom breaks to, ultimately, every two to four hours.
- Examine the drugs you’re taking. Diuretics, muscle relaxants, antidepressants/psychiatric drugs, alpha blockers, and many other medications have incontinence as a possible side effect. Talk to your doctor about switching to a different med or discontinuing use altogether.
- Try acupuncture. This ancient therapy has been used for centuries to treat countless diseases and conditions, including incontinence.
- Take bladder-supportive supplements. While there’s not a lot of slam-dunks when it comes to effective supplements for incontinence, you can nonetheless find many such products on the market. If you opt to try one, make sure it contains ingredients that are supported by research. Some of these include pumpkin seed extract, soy isoflavones, horsetail extract (Equisetum arvense), and the herbal blend gosha-jinki-gan.
Practical solutions to prevent incontinence
Here 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
“Sexual healing” for incontinence
Vaginal 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.
Exercises to prevent or reverse incontinence
All our muscles shrink with age, at about 1 percent per year after we’re 40. Much like your biceps or quadricep muscles, pelvic floor muscles need to be exercised in order to stay strong and functional—especially as we age. Kegels “work out” the muscles of the pelvic floor, strengthening and toning them so that they can better control bladder function.
To do a Kegel correctly, tighten the muscles you would use to stop urinating, and hold for 10 seconds, then release for 10 seconds. (If this is too hard, start with 2-3 seconds and build your way up to 10 seconds.) Repeat 10 times, three to four times a day.
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