Bladder health may be far from the most riveting of conversations, but trust me, a bladder that behaves itself will make your life a whole lot more enjoyable, and that includes your sex life, as well.
As we discussed in the last post, bladder misbehavior in the form of incontinence and urinary tract infections (UTIs) is a common female complaint, and it tends to become more common and more troublesome as we age. This is because decreasing estrogen affects genital tissue and muscles in unhelpful ways.
You don’t need to check out adult diapers just yet, however. Not only are treatment options available, depending on the type of incontinence you have, but you can develop some common-sense bladder health habits that will tune up that tired organ and may even roll back some of the age-related changes.
- Do Kegels. This critical exercise for strengthening and toning your pelvic floor is your first line of defense for any weakening, sagging, or leakage. In several studies, Kegels were the one non-surgical treatment for incontinence that actually seemed to make a difference. “Overall, there is strong evidence that pelvic muscle training can significantly improve sexual health in women with stress and urgency UI respectively,” conclude the authors of one study.
- One way to challenge yourself and to ensure you’re exercising the right muscles is with Kegel weights or balls. Firm up those pelvic floor muscles, and you’ll help all those downtown organs stay where they belong. Kegels may not completely end all your incontinence issues, but they are the place to start.
- Stay hydrated. It sounds counterintuitive, but drinking plenty of plain water will keep your system moisturized and it will help prevent UTIs. The only caveats are not to go overboard with the hydration and perhaps not to drink liquids close to bedtime if nighttime urges wake you up.
- Avoid caffeine in all its forms. Caffeine isn’t hydrating, and as you know, it just makes you pee more. If you’ve got a Diet Coke habit, be aware that carbonated drinks combine caffeine and carbonation as bladder irritants, adding to the urgency and frequency of urination.
- Drink cranberry juice. While overly acidic foods and beverages may not sit well with your system, cranberry juice, while not a definitive cure, proves beneficial for some women. Tablet forms may also be effective.
- Lose weight. Excess avoirdupois puts extra pressure on the pelvic floor, bladder included. Losing weight and staying active can help prevent episodes of both incontinence and UTIs.
- Pee before and after sex. If you tend to tinkle during sex (coital incontinence), remember to pee right before and right after having sex. This will help with both involuntary leaking and to prevent a UTI.
- Keep your bottom extra clean. Wash regularly with a mild, moisturizing soap to keep UTI-causing bacteria in check.
- Have sex. It’s like a workout for your pelvic floor, and it keeps tissues moist and supple.
Despite your attention to good bladder health, you may still experience bothersome levels of incontinence and UTIs. The next step is to talk with your doctor. Studies show that most women avoid this conversation because, well, it’s embarrassing. Let me assure you that we’ve heard it all, and incontinence is an incredibly common female issue. This isn’t something you should endure. Treatments are available, and they do work.
Depending on the type of incontinence you have, (urge and stress incontinence are the two major sub-types), treatment options could be very simple. With bladder training, for example, you set a timer and wait for increasingly longer periods before urinating to “retrain” the bladder (and yourself). This method coupled with Kegel exercises can cut urge incontinence problems in half, according to the National Institutes of Health.
There are a number of medications, including some new ones, that are very effective in treating urge incontinence. Your health care provider can help you weigh the options.
Since stress incontinence is more commonly caused by wear and tear on the pelvic floor (by childbirth, for example) as well as by normal aging and hormonal loss, medications are less effective in treating it. Topical estrogen, however, is a good option for rejuvenating tissue in the entire genital area, urethra included. It isn’t absorbed systemically, so it’s a good option for those who want to avoid extra hormonal exposure
A common and minimally invasive surgical procedure involves inserting a tiny mesh sling to support the urethra. This procedure is effective in over 85 percent of cases.
For most of us, some level of incontinence is an annoying fact of life. But it shouldn’t compromise our quality of life or cause undue embarrassment or anxiety. If you find this to be the case, it’s time for a talk with your doctor.
Use the promotion code SQUEEZE for a 10% discount on Kegel exercise tools, and increase your pelvic muscle tone. Offer expires December 17.
Dr. Barb DePree, M.D., has been a gynecologist and women’s health provider for almost 30 years and a menopause care specialist for the past ten.
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