Does it feel like your bladder is running your life? Like you have to wear black pants when you exercise because they don’t show the urine leaking out? Like you’re constantly running to the bathroom, or you know where all the bathrooms are in the mall?
I meet women every day whose lives have been changed because of pelvic floor disorders such as urinary incontinence or pelvic organ prolapse. I hear stories about how these women have given up activities they love because of worries about urine leakage or discomfort from a vaginal bulge. Unfortunately many women don’t realize how common these problems are, so they are reluctant to talk about them.
Take back control of your bladder – here are 10 things that you should know:
1. Stop drinking eight 8oz glasses of water a day. There is no medical evidence that doing this is beneficial to your health. Yet, I hear from many patients who believe this amount of water is necessary for good health. In fact, that tip started from a popular weight loss program, but there is no medical evidence that it helps with weight loss. Drink if you’re thirsty, and never feel like you have to force yourself to drink more.
You can help determine your need for hydration by checking the color of your urine. If your urine is the same color as toilet water, you can certainly drink less. If your urine is dark orange, you may need to drink more water.
2. It is NOT normal to leak urine as you get older. It’s just common. It becomes a problem if you think it’s a problem – and if you do, there are good treatments for urinary leakage today. Some involve surgery, but there are plenty of things other than that. You don’t have to live with this. If you find that you are changing your daily actions because of your bladder, it’s time to call your doctor and hear what’s available to get you back out there living your life.
3. Cut out (or cut back on) the artificial sweeteners. If you remove these bladder irritants from your diet, you will notice that you need to urinate less often and with less urgency. This means any diet beverage, sweetened waters, and possibly the packets you’re putting in your coffee or tea. Regular sugar or even honey are better choices.
4. Quit smoking. Nicotine is another bladder irritant, but smoking poses an even greater threat: smoking is the No. 1 risk factor for bladder cancer. Early symptoms of bladder cancer can include urgency urination, blood in the urine, and urinating often. If this sounds familiar, see your doctor. Quitting smoking will have a multitude of good effects for not just your bladder but your entire body.
5. If you lose 10% of your body weight, you can see a 50% reduction in the number of times you leak urine during the day. Weight loss is tough – there’s no doubt about that. But the good news is that you don’t have to lose a lot of weight to see a lot of benefit. Ten percent of your body weight is a tangible goal that can have a huge impact. Maybe that will be enough of an incentive to help you to exercise and achieve your next weight loss goal! Weight has a more noticeable impact on stress incontinence – leakage that happens when you laugh, sneeze, or cough – but it does decrease all types of incontinence. Our research on this comes from patients who have had weight-loss surgery, but you don’t need the dramatic effects of bariatric surgery to make a noticeable change.
6. Do not do Kegel exercises while urinating. Some women’s magazines tell you to practice your Kegels by stopping the urine stream, but getting in this habit can confuse your bladder and your pelvic floor. Urination is about relaxation. Kegels are great – just don’t practice them during urination once you know the right muscles to use. Also, don’t worry about the speed or force of the urine stream. It’s not a contest! It is just important that you are emptying your bladder completely. If you’re worried you are not emptying completely, relax and breathe deeply. Take another minute to sit and let it all out.
7. Don’t just practice your Kegels – use them! Once you know the right way to do Kegels, use them at those awkward moments when you’re worried about leakage. Feel a cough or sneeze coming on? Squeeze! Feel a belly laugh about to happen? Squeeze! Feel that gotta-go sensation and don’t know where the nearest bathroom is? Squeeze! Practice your Kegels several times a day, but then put that practice to good use.
8. Not all bulges are your bladder. Do you feel something new or different in the vaginal area? You might have pelvic organ prolapse, which means that a pelvic organ has “dropped” out of its normal position. But not all bulges are your bladder – you might have a dropped uterus, or your rectum might be protruding upward into your vagina. If this is happening, get it checked out by your gynecologist, but you can also see a specialist called a urogynecologist. Urogynecologists specialize in both the bladder and problems related to the pelvic floor, including vaginal prolapse of any kind. A urogynecologist who specializes in these problems is best able to diagnose the problem and provide you a range of treatment options. Your treatment should be tailored to your body and your life.
9. The color and odor of your urine is related to what you eat. Unfortunately many women think that a change in their urine is only caused by an infection, and they may be treated with antibiotics they don’t need. For example, eating beets can make your urine a dark orange-reddish color, and asparagus can change the smell of your urine. How much you drink can also affect the color and smell of your urine. If you’re worried – get it checked out with a urinalysis and culture. But you don’t need antibiotics unless you really have an infection.
10. A dropped bladder or a bulge does not cause leakage, so fixing a bulge doesn’t fix leakage. It seems very logical to connect the changes in your anatomy to the changes in your ability to control the urine. But particularly problems like urinating too often, getting up in the middle of the night to go to the bathroom, and running to the bathroom are unlikely to get better just by repairing a dropped bladder. The initial cause may be related, so find a doctor who can treat both issues, and make sure you tell that person about everything you’re bothered by.
If pelvic floor disorders are affecting your daily routine, please seek treatment. Life is too busy to be worrying about how your bladder will react.
One in nine women have surgery for urinary incontinence or pelvic organ prolapse, and many other women are treated non-surgically – but so many more are suffering in silence. These shouldn’t be embarrassing problems – they are part of everyday life for many women, and we have treatments that can help you regain control of your bladder, and your life.
Talk to your friends – it’s likely that one of them has taken control of her own pelvic health – see what she did to stay dry. And if you decide it’s time to take control of yours – tell your friends you have this problem, and you’re going to make it better. Your lifestyle changes and positive results might inspire a friend or family member to make changes too.
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- The University of Michigan’s Von Voigtlander Women’s Hospital is among the top urogynecology programs in the country and includes a Pelvic Floor Research Group that is one of the world’s leading research groups. Call 1-855-58WOMAN(1-855-589-6626) to make an appointment.
Megan Schimpf, MD, is a urogynecologist in the Department of Obstetrics and Gynecology at the University of Michigan Von Voigtlander Women’s Hospital.
The University of Michigan’s Women’s Von Voigtlander Women’s Hospital is a leader women’s health care. Consistently ranked among the America’s top gynecology programs by U.S. News & World Report, U-M is committed to unsurpassed patient care for women.