Background
Urinary incontinence (UI) is any involuntary leakage of urine. It is a common and distressing problem, and often treatable.
Causes
Stress incontinence
Stress urinary incontinence (SUI), is caused by weakening of the pelvic floor muscles. It is the loss of small amounts of urine associated with coughing, laughing, sneezing, exercising or other movements that increase intra-abdominal pressure and thus increase pressure on the bladder.
Low estrogen levels may lead to lower muscular pressure around the urethra (the tube draining urine from the bladder), as well as a shorter urethral length, increasing the risk of leakage.
Stress incontinence is treatable.
Urge incontinence
Urge incontinence is involuntary loss of urine occurring for no apparent reason while suddenly feeling the need or urge to urinate. The most common cause of urge incontinence is involuntary bladder spasm. This can occur from many causes including:
- Hidden bladder infections or vaginitis
- Nerve problems such as stroke, MS, or Parkinson's
- Spasm of the muscle attached to the top of the pubic bone
For incontinence, a urologist will do the best evaluation, but consider doing the treatments discussed under the "Treatments" section first to see if they work (allow 2-3 months) so you don't get pushed into unnecessary surgery or medications.
Functional incontinence
This is when you can't physically make it to the bathroom in time due to limited mobility.
Treatment
Therapies & Advice
Schedule frequent bathroom trips
Know how long you can hold it. If you leak after 90 minutes, go to urinate every 75 minutes while awake. Keep a chart till you naturally time train yourself.
Use pads
Attends Booster Pads™ and similar pads (or smaller menstrual pads) can offer relief from the anxiety of "What if there's a leak?"
Kegel exercises
Kegel exercises to strengthen or retrain pelvic floor muscles and sphincter muscles can reduce stress leakage. Do at least 24 daily contractions for at least 6 weeks.
Test for infection
Do a urine culture and sensitivity test for infection. If positive with E. coli bacteria (most are), use the supplement D-Mannose to suppress the infections safely.
Bioidentical estrogen
For stress incontinence, consider low dose bioidentical estrogen and progesterone (see Menopause) applied daily vaginally near where the urine comes out. Give it 3 months to work. This can be very helpful.
Recommended Supplements
Magnesium
The nutrient magnesium (200-400 mg a day — less if diarrhea) helps decrease bladder spasm after 6 weeks of use.
