Although bladder problems are more common than you'd suspect—more than 40 million American women experience sensitive bladders and bladder leaks—it's a somewhat taboo topic. Women are hesitant or embarrassed to discuss it, or, if they do, it's often in hush-hush tones.
So you think you can't understand your bladder?
Here are the facts … straight from the bladder's mouth.
Q. It's nice to finally meet you. You've done a good job of holding my urine throughout my life (with a few slipups here and there), but we've never had an opportunity to chat. Tell me a little about yourself.
A. I'm a balloon-shaped muscle that sits in your pelvis, and, as you know, my main job is to store and release urine. My job seems quite simple: When I fill with urine, I relax, and when it's time to release urine, I squeeze. But it's hard work! There's a tiny tube, called the urethra, that carries urine from your body into me. Ring-like muscles, called sphincters, help keep that urethra closed so the urine doesn't leak from me before you're good and ready to let it go.
Q. In a perfect world, you'd do the job you were intended to do and hold the urine until we were prepared to part with it. But—and please don't be offended by what I'm about to say—sometimes you fail miserably. Can you explain why?
A. It can be a pretty complicated process for me to work seamlessly, actually. Your body and I need to work as a team. Not to put the blame on someone else, but you have to realize that there are so many other body systems involved, and if any one of these are not working properly, then all bets may be off. For instance, pelvic floor and sphincter muscles can be weak; the nerve signals from the bladder to the brain to let it know I'm full can be intercepted or misinterpreted; shifting hormonal levels can affect my lining. And then, I may release some urine, even though I don't mean to. So sorry. It's not intentional.
Q. Is it just women who leak urine? And does it just happen as you get older?
A. No and no. Men leak urine too, but not as commonly as women do. And though urine leakage is more common in older women, it can affect women of all ages.
Q. What are some things that make you lose control?
A. Lots of things. For example, coughing, sneezing or exercising can be taxing on even the best of bladders. Even laughing hard can test my limits (and I like a good laugh just as much as any other organ does). When a woman is pregnant or has given birth, when she goes through menopause—these are the times they often start resenting me, wishing I could hold it together better than I do.
Sometimes I malfunction because of weak muscles. Other times, I leak because of damaged nerves, and certain medicines people take can dull my nerves, too. If you're overweight, it can put a lot of pressure on me, and I can't always shoulder my responsibility.
Q. What else?
A. There are conditions and/or diseases that can affect the way I work: diabetes, Parkinson's, multiple sclerosis and even stroke. Also, things like pelvic or back surgery, a herniated disk or radiation can really make my job tough.
Q. How can women help you do your job better?
A. Just because I leak when you get older, you shouldn't give up on me or think you just have to live with it. You can do things to gain control over me. This is one instance where I'd welcome your influence and involvement.
It all starts with communication. It might be embarrassing, but that's the first step in getting help. You do your job and I'll do my best to do mine.
Find a doctor whom you can talk to and who has experience working with women with urine leakage. You might have to seek out a specialist, like a urogynecologist or a urologist whose specialty is treating women with urinary problems.
You may want to start with the easiest things first, like Kegel exercises, which strengthen the pelvic muscles and don't require any equipment. You can do them anywhere, any time! It takes about six to eight weeks to see results. Click here to help you understand more about Kegels.
There are other things to try besides that, like making planned visits to the bathroom (called "timed voiding"), dietary changes (certain foods and drinks affect urination, especially caffeinate beverages and citrus fruits and juices), losing weight, and medicines that can calm muscles and nerves (there are no medicines yet approved to directly treat stress urinary incontinence, but these may help).
Q. It's encouraging to know that women don't have to just sit idly by and accept this as a fact of life.
A. Absolutely! I have so many other things to share with you. I'm happy there are so many options, because frankly, I get a bad rap so often. There is the pessary, a plastic ring worn in the vagina that helps support its walls; there's a treatment called electrical nerve stimulation. And if all else fails, there's surgery, although it only works with stress—not urge—incontinence.
Q. Lastly, is there anything else women can do to give them peace of mind?
A. There is, yes. Always Discreet has developed a product to give you peace of mind. There are three options that offer absorption, comfort and odor protection: an ultra-thin panty liner, a heavier pad and underwear.