Female Incontinence – Embarrassed About Wetting Yourself?
It’s an embarrassing problem – one that many women, and for that matter, many men, neglect to bring up during their visit to the doctors. Urinary incontinence might not be life threatening but it can be a confidence busting inconvenience. There’s no need to suffer in silence though, because it’s often treatable and preventable.
Urinary incontinence is the accidental or involuntary leakage of urine. There are two primary types of incontinence: stress related incontinence and urge incontinence.
Stress Incontinence occurs when the pelvic muscles don’t support the bladder well enough. This can happen during pregnancy, during menopause or when you do anything that puts pressure on the abdomen such as laughing, sneezing, coughing, lifting something heavy, exercising or even walking.
Urge Incontinence is a urine leak that is preceded by a sudden desire to urinate, and may result in the loss of large amounts of urine. Many women experience urge incontinence because of infections that irritate the urethra or bladder, or because of muscle spasms, which force the urine out of the bladder. In urge incontinence, the bladder is said to be ‘overactive’ – it’s contracting even when your bladder isn’t full. In fact, urge continence is sometimes called overactive bladder or irritable bladder.
Those who have weak bladder muscles might suffer from overflow incontinence as they cannot completely empty their bladders, causing either a constantly full bladder requiring frequent urination or a consult dribbling of urine, or both. It can also result from the urethra being blocked due to kidney or urinary stones, tumors, an enlarged prostate in men, or a birth defect.
Other types include functional incontinence, common among elderly patients with arthritis, Parkinson’s disease or Alzheimer’s disease. Often, these patients are unable to control their bladder before reaching the bathroom due to limitations in moving, thinking or communicating.
Spinal cord lesion such as quadriplegia may cause reflex incontinence, when the bladder empties due to reflex activity with no control of urination.
Who Usually Suffer From Incontinence?
Doctors say that as many as half of all women younger than 45 know what it’s like to accidentally wet themselves. There are, however, certain factors that raise the risk of suffering from incontinence, and they include:
- Age. Incontinence occurs more often in older adults, but it is not necessarily a part of aging and in many cases can be cured.
- Gender. Women experience incontinence twice as often as men, often as a result of pregnancy or childbirth weakening the pelvic floor muscles that support the bladder. After menopause, the lack of estrogen can also weaken the pelvic floor muscles.
- Diet. Some foods can irritate the bladder, especially those with caffeine content (coffee, tea, colas and chocolate) as well as, acidic fruit juices and alcoholic beverages. Simply drinking a lot of fluid in a short time can lead to temporary urinary frequency and even the occasional accident. On the other hand, not drinking enough water can cause urine to become concentrated. This can irritate the bladder, again possibly leading to an accident.
- Side effects of medication. Diuretics (water pills), as well as some sedatives, muscle relaxants and antidepressants, high blood pressure and heart medicines, cold relief and diet pills can all affect bladder control.
- Neurological disease or injury. Damage to the nerves or nerve pathways (strokes, multiple sclerosis etc) can cause incontinence.
- Neurological birth defect. These may also lead to neurogenic bladder.
- Physical birth defect. Abnormalities in the urinary tract can cause various types of incontinence.
Strategies To Cope With Incontinence
There are some basic steps that can be taken to minimize some of the affects of urinary incontinence.
Kegel exercises. This is one simple thing you can do to strengthen the pelvic muscles, which hold the bladder in place. Some women learn to squeeze the bladder before coughing or sneezing, as this also holds the bladder and helps to eliminate urine leakage.
Bladder training. There are many different techniques, such as emptying your bladder at fixed intervals (part of what’s known as ‘bladder drill’) which may show improvements in as little as a week.
Estrogen. Hormone replacement therapy can be taken as tablets, patches or creams, and has been shown to significantly improve symptoms, especially in stress and urge incontinence.
Herbal remedies. There are natural herbal remedies available to stimulate the nerves that control urine flow, or which tone up the bladder muscles, may be as effective as pelvic floor exercises.
Surgery. In extreme cases, surgery may be recommended. The options include pulling a drooping bladder up into a more normal position, or inserting an artificial sphincter (a doughnut shaped sac that circles the urethra) to help deal with the problem.