Regain bladder control
Few people want to talk about incontinence, but the condition is more prevalent than you might think. According to the latest statistics from the Centers for Disease Control and Prevention, nearly 45 percent of people over the age of 65 struggle with bladder control.
In older populations, urinary incontinence can be the result of weak bladder muscles, an enlarged prostate, or nerve damage from diseases like diabetes (the risk of which can increase with age). Older adults can also have conditions like arthritis, which can make it difficult to get to the bathroom quickly, says the National Institute of Aging.
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.
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"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 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 you — and your doctor — keep track of your bladder training.
During biofeedback, electrical sensors monitor muscles and allow you to get a sense of what's happening in your body — and 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."
In case you need another reason to quit smoking, add "antidote to incontinence" to the list. "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, South Carolina.
Researchers are still learning about the benefits of acupuncture, but experts agree that the technique is safe if it's performed by a well-trained practitioner. If you do decide to try acupuncture, make sure that the person is licensed or certified.
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 people in a state of deep relaxation and heightened concentration. This state may help you feel more in control of your body — in this case the bladder and muscle contractions.
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.
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