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Urinary Incontinence

By Shyrlena L. Bogard, MD, FACOG

Urinary incontinence (UI) is a bothersome problem that many women experience. It can be occasional and resolve with little or no treatment, or it may be a chronic problem that worsens over time. Either way, leaking urine can be a major social embarrassment and cause women to avoid the activities they enjoy most. The fear of leaking with the swing of a tennis racket or wetting one’s pants while sharing in laughter can be isolating. Not knowing if she can make it to the bathroom before ruining her clothes is a challenge that can cause some women to skip a night out dancing all together.

Many women with urinary incontinence believe they are alone and find it difficult to discuss. In reality, nearly 50 percent of women experience involuntary leakage of urine, and it occurs more often in women than in men. This is due to the effects of pregnancy, childbirth, and the hormonal changes associated with menopause. These normal life events may cause injury and weakening of the muscles and nerves of the pelvic floor and bladder. Women are also more likely to experience symptoms of an irritable bladder, which increases the risk of leaking urine.

Types. There are three general types of urinary incontinence. The most common is stress urinary incontinence, which is the little bit of leaking that occurs when a woman coughs, laughs, sneezes, jumps, or picks up something heavy. It can happen in young women who participate in active sports, as well as women who have given birth vaginally, or older women whose estrogen levels have decreased. The second most common is urge urinary incontinence, which occurs when the bladder is irritated, such as during a urinary tract infection. This causes the feeling of “gotta go right now,” but leaking occurs before making it to the bathroom. The final type of incontinence occurs due to a bladder that overfills with urine and is usually associated with nerve injury.

Managing the condition. Although urinary leaking is a common issue for many women, there are treatment options that can alleviate the problem. First, identify any drinks, foods, and mediations that cause UI and alleviate them if possible. This includes caffeine, sugary foods, alcohol, carbonated drinks, and some medications such as those used to treat high blood pressure.

It is important to note that medical considerations include urinary tract infections, pregnancy, hormonal changes, weight gain, surgeries, and some diseases that cause neurological damage.

Treatment. After a thorough evaluation, a doctor may prescribe medication if necessary. Also behavior changes, like bladder training and exercises to strengthen pelvic muscle may be recommended.  Other times, women may require surgical or nonsurgical procedures to correct anatomical changes that cause involuntary urinary leakage. Being prepared to have a full discussion with a health care provider will assist in getting appropriate treatment quickly.

Urinary incontinence may be a normal part of life, but it does not have to be a permanent part of your life. Seek help early and take back your freedom.

Dr. Bogard is a board-certified gynecologist specializing in intimate wellness, advanced hormone optimization, and aesthetic vaginal reconstruction. She serves as the medical director of the Intimate Wellness Institute in Palm Springs and can be reached at (760) 904.4994. www.IWIPalmSprings.com

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