Bladder control problems are extremely common, affecting up to one in three women at any given time. They can range from losing a few drops of urine when coughing or sneezing to larger accidents. Other symptoms might include frequent urination, bladder pain and leakage.
Bladder control issues are typically caused by problems with the muscles and nerves that help hold in urine. They are often associated with events that occur in many women's lives— pregnancy, childbirth and menopause. Other common causes include obesity; recent pelvic surgery; certain medications such as diuretics; illnesses including stroke, diabetes and multiple sclerosis; and physical changes due to aging.
The most common cause of bladder control issues is stress on the bladder. Coughing, sneezing, laughing or other types of physical activity can allow small amounts of urine to escape. Sometimes women may also experience uncontrollable urges to urinate; these are caused by abnormal nerve signals that cause the bladder to spasm and empty. Other symptoms experienced by some women include the need to urinate eight or more times a day, or bladder overflow, in which a full bladder leaks unexpectedly, or a combination.
Many women feel embarrassed or ashamed because of their bladder problems and are hesitant to talk to their doctors. It has been estimated that fewer than half of women with bladder control problems report the condition to their physicians. However, bladder issues are treatable for women of all ages and often entirely manageable. Communicating clearly and honestly with your health care provider is a key factor in a successful outcome. Your doctor may treat you directly or refer you to a urogynecologist or urologist who specializes in women's urinary tract issues.
Depending on the type and severity of the problem, a wide range of treatment options exist. Your doctor may recommend pelvic floor therapy, consisting of exercises to strengthen the muscles surrounding the bladder. The most common of these exercises, called Kegels, consists of tightening and releasing the muscles that hold in urine. When performed for five minutes a day over three to six months, Kegels can greatly improve muscle tone in the bladder area.
Your doctor might also suggest behavioral modifications such as weight loss; avoiding coffee, tea, alcohol, and carbonated beverages; or quitting smoking. On a practical level, wearing absorbent products regularly can help women with leakage problems to resume their normal daily activities. Today’s products have evolved to be more comfortable and discreet than products in the past.
Another treatment option is a pessary ring. This is a stiff ring that a doctor or nurse inserts into the vagina. It pushes up against the wall of the vagina and urethra to reduce stress leakage. Your doctor may also prescribe medicine that blocks the nerve signals that cause frequent and urgent urination or topical estrogen creams to tone the vaginal muscles. If your bladder has moved out of its normal position, most commonly as a result of pregnancy or childbirth, surgery may be necessary to return it to its original placement..
Women with bladder control issues shouldn't suffer in silence. This is a problem shared by millions of women. The most important thing to remember is that bladder control issues can be treated or managed, and most women are able to resume active and rewarding lives.