Regain bladder control
Few people want to talk about incontinence, but according to the National Association for Continence, nearly 25 million Americans struggle with bladder control. Of those, 75 to 80% are women.
There are drugs and surgeries that may help incontinence, depending on the cause of the problem, but there are other options. Exercises, lifestyle changes, and possibly even some supplements may help. Here are 12 to consider.
Kegel exercises—which involve flexing the same muscles you use to stop the urinary flow—are top on the list of remedies.
“Kegels are very useful for early stages of incontinence, and after a surgical repair to maintain pelvic floor tone over time,” says Philippe Zimmern, MD, a professor of urology at UT Southwestern Medical Center in Dallas.
A physical therapist can tell you how to do them and how often; You may see an improvement after six to 12 weeks of continued practice. And you’ll have to keep doing the exercises to maintain the benefit, Dr. Zimmern points out.
“Losing weight if you are overweight is an important step toward reducing the severity of your incontinence,” says Dr. Zimmern.
Excess belly fat puts pressure on the bladder and the pelvic muscles. Shedding a few pounds if you are overweight can help restore your bladder control.
Train your bladder
Think of it as a bladder boot camp. While it may sound simple, training your bladder takes patience.
The key is to to learn how to put off the need to rush to the nearest bathroom. In the beginning, try to delay urinating by 10 minutes and build up to 20 minutes. Eventually you increase the time so that you can comfortably use the restroom every four hours.
Keeping a diary of trips to the bathroom can help youand your doctorkeep track of your bladder training.
Magnesium, an important mineral for proper muscle and nerve function, may also ease incontinent worries.
In a small study at Tel Aviv University in Israel, more than half of the 40 women who took magnesium hydroxide pills twice a day had improvements in their urinary incontinence, and did not wake up as many times in the night to go to the bathroom.
Some doctors believe that magnesium could relieve incontinence because it reduces bladder muscle spasms and allows the bladder to empty completely.
Include magnesium-rich foods, such as corn, potatoes, and bananas in your diet, but talk to your doctor before you start taking magnesium supplements.
Photo: Plamen Petkov
Vitamin D promotes calcium intake and good bone health. Research suggests that it can also reduce the risk of incontinence.
A 2010 study found that women 20 years and older who had vitamin D levels that were in a normal range were less likely to have any type of pelvic floor disorder, including incontinence.
Unfortunately, many women are short on the sunshine vitamin. Be sure to meet your daily requirement (600 IU of vitamin D a day for women) with fortified milk, eggs, and fish.
During biofeedback, electrical sensors monitor muscles and allow you to get a sense of what’s happening in your bodyand make changes that reduce incontinence.
“Physical therapists use biofeedback to help patients understand what muscles they should contract during Kegel exercises, and/or to improve the performance of these muscles by providing a visual feedback to the patient during the training session,” says Dr. Zimmern. “It’s very beneficial in general, but potentially a bit costly depending on insurance coverage, and requires perseverance on the part of the patient.”
A pessary is a ring-like device that is inserted into the vagina to lift and support the vagina and bladder. It can help decrease stress incontinence, the type of incontinence associated with coughing or exercise.
“Some vaginal devices have been designed to support the bladder neck, in the same way a tampon can work,” says Dr. Zimmern. “They require good local hygiene and sometimes the use of hormonal cream to avoid vaginal wall irritation.”
Pessaries can remain in place for about a week, and some women end up using the device indefinitely.
In case you need another reason to quit smoking, add “antidote to incontinence” to the list. Nicotine can irritate the bladder.
A small study conducted at the Aristotelian University of Thessaloniki in Greece suggests that heavy smokers are more likely to be incontinent than nonsmokers.
“Smokers tend to cough more than non-smokers and long-term, chronic coughing has been considered a risk factor for developing stress urinary incontinence and/or pelvic organ prolapse,” says Dr. Zimmern.
If you have incontinence, you might consider acupuncture. Amber Addison, a licensed acupuncturist, has worked with incontinence patients in her private practice in Greenville, SC.
The imbalance stems from not only the bladder and kidneys but from other parts of the body such as the lungs and heart, Addison says. “Most of the time it’s a combination of two or more system imbalances that causes overactive bladder.”
While Addison emphasizes that it’s not a quick fix, she reassures, “I have had success with every person I have treated for incontinence.”
In hypnotherapy, a hypnotherapist puts the patient in a state of deep relaxation and heightened concentration. This state may help patients feel more in control of the bodyin this case the bladder and muscle contractions.
In a decades-old study published in the British Medical Journal, of 50 women who underwent 12 hypnotherapy sessions in a month, most showed improvement.
More recent research hasn’t been as positive. Still, researchers seem to think it has potential.
Cut out caffeine
Caffeine, a diuretic, can contribute to bladder irritation and stimulate muscle contractions, which can both cause incontinence.
“Caffeine is known to excite the brain, and since the control of the bladder is in the frontal lobe of our brains, it has an excitatory effect on the bladder as well, along with a slight diuretic effect,” says Dr. Zimmern. “It’s best to avoid or restrict its use when you have incontinence, especially the urge form.”
It sounds counterintuitive if you always have to go, but drinking enough water and other fluids is crucial in managing incontinence.
If you don’t stay hydrated, you may end up constipated, which can irritate the bladder and cause incontinence. Dr. Zimmern recommends drinking between six and eight cups of fluid a day. Just be sure to drink the bulk of them during the day, so you don’t find yourself rushing to the bathroom during the night.
And, keep in mind all the fluids that you drink, not just water, Dr. Zimmern says. Those cups of coffee, soda, and other beverages count toward that eight-cup limit, too.