Urinary incontinence in women is no laughing matter. In fact, laughing can easily make you pee in your pants. One of my friends told me that one day when she was playing tennis, every time she lunged for the ball she’d leave a little puddle on the court. Her partner started laughing so hard that she, too, started leaving little puddles. Hysterical, doubled over with wet undies and puddles at their feet, they finally had to leave the tennis court. They didn’t want to have to explain themselves to the next players. Isn’t female bonding great?
Incontinence affects 1 out of 3 women
According to the American Urological Association, stress urinary incontinence (SUI), affects 1 out of 3 women. Yes, you read that right! That’s a whole lot of women. Discussing this subject seems to be taboo in our culture; I don’t hear a lot of women talking about urinary incontinence. Recipes, yes—their bladders, no. My friend was lucky to have such an open-minded friend for a tennis player.
What is Urinary Incontinence?
Urinary incontinence means that you can’t hold in your urine. When the urge comes, you can’t make it to the bathroom. You no longer have the muscle and bladder control to hold the contraction that keeps the urethra capped. Incontinence may occur suddenly or it can creep up on you. One day you’ll have control and the next day you won’t. Who knew those old sanitary pads would come in handy again, just when you were ready to donate them to a good cause (see The ‘Up Yours’ Campaign).
Causes of Urinary Incontinence in Women
On Dr. Amy Tuteur’s blog, The Skeptical OB, she discusses this issue of urinary incontinence in women. She explains that SUI is often associated with pregnancy, but usually, after the baby is born, the incontinence will stop. More commonly, it is associated with aging, particularly in women who have given birth in the past. The ligaments and muscles that support the pelvic organs stretch in response to pregnancy and childbirth. After menopause, when those ligaments and muscles weaken even further, the bladder and uterus may slip down (prolapse) into the vagina, distorting the normal relationships necessary to control bladder function.
Menopause and Incontinence
One condition of menopause, the loss of estrogen, is known to cause thinning of the walls of both the vagina and urethra. All of our muscles get flabbier due to the diminishing of estrogen. It stands to reason that those in our internal areas will weaken as well — add bladder leakage to the list of menopause symptoms.
Solutions for Incontinence in Women
Bladder training and pelvic floor exercises (and we don’t mean the laying-on-the-floor kind), also known as Kegels, are two natural treatments for an overactive bladder (OAB). Research suggests that these remedies can cut overactive bladder episodes by about half. This study compared different methods for management of an OAB. They compared the efficacy of pelvic floor muscle training (PFMT), biofeedback-assisted PFMT (BAPFMT), and electrical stimulation (ES) in the management of OAB. The subjective improvement/cure rate of OAB was 51.4% for ES, 50.0% for BAPFMT, and 38.2% for PFMT.
Do Your Kegels
Kegels are the first and easiest line of defense. This technique, named after Dr. Arnold Kegel, involves contracting and relaxing the muscles of the pelvic floor. You can do them at any time without any machinery or a doctor visit. UC San Francisco Medical Center gives a great “how to” lesson describing how to identify your pelvic muscle and know if you are using it in the right way. Basically, you draw in your vagina as if trying to hold your urine. Get tighter and tighter as you count to three. Then let out the tension in three counts. Never push out. Best idea ever: every time you get to a red light, do your Kegels!
Kegel Balls are an easy non-electrical tool to use to strengthen your pelvic muscles. These, from Good Vibrations, are inserted and held in the vagina. Just walk around and hold them in several times a day and in a short time, you will have more control. Could do your vacuuming at the same time? Multi-tasking…
The use of tampon-shaped vaginal weights are a simple biofeedback technique that can help a woman strengthen her pelvic floor muscles and achieve better bladder control. Vaginal weights are inserted in the vagina then held in while walking. They usually come in different weights, and you increase the weights over time as you gain more control. But what happens if they slip out while you are in the grocery store! Oh my!
I had a bad back and did Pilates-based rehabilitation. Not only am I now upright, but I no longer wet my pants. I believe that when using the ‘Pilates’ muscle, we are exercising our pelvic muscles. There are many different websites where you can learn about Pilates and find local Pilates studios. This is a great exercise system that may help with all kinds of aging muscle issues.
Here, UC San Francisco Medical Center talks about bladder training but with some extra tips not found on their pelvic floor muscle training page. Personally, I’d rather train my bladder to do the dishes but that’s another story.
Bio-feedback Helps Strengthen Muscles
One bio-feedback treatment for incontinence is to have a transvaginal sensor inserted into the vagina which is connected to a computer and monitor. This measures muscular activity, showing a woman just how effectively she is contracting her pelvic muscles. The monitor presents instant feedback as to which muscles need more training and strengthening. Any sports coaches out there?
Now, This Biofeedback Method Going A Little Too Far
Another biofeedback approach is to place two sensors near your anus. These sensors measure your pelvic floor contractions and teach you to use them correctly. There’s got to be a joke in here somewhere but if I start laughing, I’d start peeing.
Whatever the approach, you’ll need to talk to your health care provider to locate health centers offering these types of rehabilitation. As far as I can tell from my research, there are no home biofeedback machines for exercising your pelvic muscles. Please leave a post if you do know of any.
Sacral Nerve Stimulation
The sacral nerves control the bladder and muscles related to urinary incontinence. Electrical stimulation on the sacral nerves induces a contraction in these muscles, basically creating an electrically-induced Kegel. This is something that is done in a doctor’s office where they insert a probe in your vagina and create the electrical stimulation. There is an even more invasive procedure where they surgically implant the sensor under the skin of your buttocks. This approach is really the last resort and only for those who have totally lost control. Somehow I keep envisioning my Thanksgiving turkey…
When All Else Fails
OK, so you’ve tried all of these exercises but you still need to call the plumber. That would be your doc, in this case, who may suggest surgery. Meanwhile, there is a much less invasive solution – adult undergarments. Not your dream haute couture but they do solve the problem.
Some of the panties like these on the right are reusable and even pretty!
Cotton Incontinence Panties
These comfortable and natural cotton incontinence panties are the closest we could find to organic.
We’re looking for something organic and the only choice might be the type you used on your babies, but you would have to wash them yourself or send them out to a service. But they make such great dust rags that it would be worth purchasing them just for that.
I do hope you find something here to help you so that the next time someone tells you a joke you can laugh to your heart’s content without peeing your pants.
- Women’s Health.Gov – Urinary incontinence fact sheet