Urinary urgency and bladder leakage is a common and frustrating problem that affects millions of women, most of them over the age of 50. Urinary urgency in women is frequently caused by an “overactive bladder” due to weakening of the pelvic muscles that support the bladder from aging and loss of estrogen as well as past pregnancies.
In other cases, an overactive bladder is due to abnormal contraction of the muscle that controls bladder emptying called the detrusor muscle. Sometimes this is caused by damage to the nerves that control the detrusor muscle, a problem that’s more common in diabetics, people with certain nervous system disorders like multiple sclerosis, and those who have had a stroke.
There are other causes of urinary urgency including infection in the bladder and urinary tract. That’s why it’s important to get a medical evaluation to make sure there isn’t an easily treatable cause for this problem.
As a physician, I’ve seen a number of women with bladder leakage and a frequent or “urgent” need to urinate. It’s a frustrating problem that keeps some women from enjoying their favorite activities for fear of not being close enough to a bathroom. Fortunately, there are ways to reduce this problem, many times without medications.
Watch What You Drink and How Often
You’ve probably been told to drink eight glasses of water a day. That’s good advice but can pose problems if you have an overactive bladder. Urologists that treat this problem often tell patients to keep a journal of how much they’re drinking during the day and advise them to cut back to five or six glasses a day unless they’re exercising or working in a hot environment. This simple step alone improves the problem for many women.
If you have an overactive bladder, stay away from caffeinated beverages and alcohol. They can both worsen the problem. It’s not just coffee and tea that contain caffeine, soft drinks have it too. Caffeine is a diuretic – and one that’s irritating to the bladder.
Make Sure Your Medications Aren’t a Problem
Some medications prescribed for high blood pressure and heart disease, especially diuretics, can aggravate bladder problems. Some medications used to treat anxiety and depression can also make an overactive bladder worse. Check with your doctor to see if your medications could be contributing to your symptoms.
Do Exercises to Strengthen Your Pelvic Floor
Pelvic muscles weakened by age and childbearing contribute to urinary urgency and bladder leakage. Exercises to strengthen the pelvic floor called Kegel exercises can have a big impact on this problem To do these exercises, empty your bladder and then squeeze the muscles in your pelvic region as if you’re trying to stop the flow of urine. Hold this contraction for three to five seconds before releasing. Do this exercise as many times as you can during the day, but a minimum of 12 times. You can do it while working at your computer or standing in line at the grocery, and you’ll gradually strengthen the pelvic muscles that support your bladder over time.
When you weigh more, it puts extra pressure on the pelvic floor and weakens the muscles. One study found that women with urinary incontinence who lost weight experienced significant improvement in their bladder symptoms. Losing weight if you’re overweight will not only improve your overall health, it helps with bladder problems too.
Retrain Your Bladder
Bladder retraining helps to increase bladder capacity, improve the symptoms of overactive bladder and reduce bladder leakage and urgency. The best way to retrain your bladder is to establish a set schedule for urination. For example, start by urinating every 30 minutes at a scheduled time. Once you’re able to hold your urine for 30 minutes, gradually increase the time between scheduled urination until you can go several hours without urinating. Research shows that bladder retraining helps three out of four women with bladder control issues.
Other Treatments
There are medications to treat an overactive bladder and bladder leakage but these medications have side effects – and a drug-free approach works well for many women. There’s some evidence that biofeedback and acupuncture are helpful for women with this problem but more research is needed. Bladder retraining, Kegel exercises, avoiding caffeine and maintaining a healthy weight can go far towards improving bladder urgency and leakage. The key is to be consistent.
References:
Medscape Reference “Overactive Bladder Treatment and Management”
Women’sHealth.gov “Urinary Incontinence Fact Sheet”
Personal experience as a physician
