Incontinence

Urinary incontinence is a type of disorder that is commonly associated with menopause in women. In fact, over 40% of menopausal women in the United States suffer from urinary incontinence. It manifests in the bladder’s inability to control urine flow, which can result in many embarrassing and uncomfortable situations for anyone that is experiencing it. It can range from leaking a small amount of urine while laughing or coughing, to having strong urges to urinate that are difficult to control. For this reason, urinary incontinence is considered one of the largest fears that women have as they reach older ages, but it can be treated.

What is Urinary Incontinence

Urinary incontinence, or UI, is a type of inventory seepage or leakage of urine. It is often associated with other distressing problems that have a heavy impact on the quality of life for an individual. UI also normally stems from an underlying condition that an individual has before displaying these symptoms. It mostly occurs when this underlying problem goes unreported to a health care professional.

The severity of this condition usually varies from woman to woman as some women may experience something as small as small trickles of women when bursting into fits of laughter or when sneezing or coughing, while others may notice larger streams of urine that is not provoked by any situation that might force urine out.

Symptoms of Incontinence

Urinating or leaking while:

  • Coughing
  • Lifting
  • Sneezing
  • Standing
  • Sleeping
  • Exercising
  • Bedwetting
  • Engaging in other physical activity
  • Engaging in sexual intercourse
  • Feelings of always having to urinate
  • Bladder never feels empty
  • Frequent nighttime urination
  • Inability to void even when the urge is felt
  • Dribbling urine

UI is something that many women may experience as they get closer to menopause; however, it is not an inevitability of getting older. By understanding the symptoms of menopause, it is possible to treat, or even prevent it altogether.

Different Types of Urinary Incontinence

urinary incotinence
There are three major types of UI, each adhering to a specific set of terms and conditions. These three types are: stress incontinence, urge incontinence and overflow incontinence.

1. Stress Incontinence

Normally seen in women who have had multiple pregnancies and childbirths or suffer from pelvic prolapse, this is the most common and least severe type of incontinence that is experienced by women in the menopausal state. Women that go through this kind of incontinence usually will involuntarily leak while coughing or exercising. This sudden small leakage is a direct result of the bladder walls not being able to sustain the pressure that is applied to them when this strenuous activity takes place. This is a direct result of age wearing on the pelvic muscles, making them weaker which then, in turn, weakens the wall that lies between the vagina and the bladder. The weakness is often caused by an injury to the urethral area, pelvic area surgeries and certain types of medication.

Risk factors for stress incontinence include:

  • Being female
  • Having given birth
  • Chronic coughing

  • Getting older
  • Obesity
  • Smoking excessively

2. Urge Incontinence

This type of incontinence is very intense and sudden leakage of urine due to bladder muscles that contract inappropriately. Urge incontinence can involve one’s bladder emptying during sleep, after drinking a small glass of water or even just hearing the sound of water running. This type of incontinence is also characterized by an incessant need to use the bathroom up to seven times during the day and around two to three times in the night. This is the type of UI that is most common among older individuals. Some medical conditions, such as hyperthyroidism and diabetes can lead or worsen urge incontinence. Nerve damage caused by Parkinson’s disease, Multiple sclerosis, Alzheimer’s disease and strokes can harm bladder nerves and muscles and cause urge incontinence

Risk factors for stress incontinence include:

  • Being Female
  • Bladder Cancer
  • Bladder Stones

  • Neurological diseases
  • Smoking
  • Having given birth

  • Getting Older
  • Obesity

3. Overflow Incontinence

This is the type of incontinence that is most commonly known as dribbling urinary incontinence. In this condition, people don’t feel the urge to urinate, the bladder never fully empties and small amounts of urine continue to leak endlessly. When one has overflow incontinence, he/she is unable to completely empty the bladder when going to the bathroom at a planned time. This makes the remaining urine overflow, which then cause’s leakage. This results in an uncomfortable sensation of never actually feeling relieved after urinating. In this type of incontinence, leakages are normally larger than just a dribble and usually occur in more of a stream of urine. This type of UI occurs most frequently in women that already have some damage to their bladders or women that suffer from diabetes.

Risk factors for stress incontinence include:

  • Tumors
  • Scar Tissue
  • Nerve damage, such as
    multiple sclerosis or shingles
  • Certain medications, such as antidepressants, anti-cholinergics, anti-psychotics, sedatives, narcotics, alpha-adrenergic agonists and beta-adrenergic agonists

Causes of Urinary Incontinence

As we get older, metabolism decreases and as a result, weight gain often occurs. Women approaching menopause go through hormone fluctuation, which can cause weight gain. It is important for women to understand what hormones cause weight gain and why.

Hormonal Causes

One of the main reasons for the emergence of urinary incontinency is due to the estrogen levels dropping so drastically and fluctuating hormones. Estrogen is responsible for keeping the urethra and the bladder lining healthy. Estrogen also regulates the strength of the wall between the bladder and the vagina, so when one’s estrogen levels drop, so does the strength of that area. This drop in estrogen occurs most commonly during menopause.

Other Causes

  • Sex (Women are more likely to suffer from incontinence than men
  • High calcium levels in blood
  • Urinary tract infections
  • Nerve damage from stroke
  • Blocked urethra
  • Diabetes
  • Alcohol (Acts as a bladder stimulant and a diuretic)
  • Aging (bladder holds much less and urine stream is weaker)
  • Over hydration
  • Medications, such as the water pill
  • Caffeine
  • Weight gain
  • Overactive bladder muscles
  • Depression
  • Prolapsed uterus
  • Difficulty walking or moving

Managing Urinary Incontinence

Self-Care

glasswater

  • Kegel Exercises – Kegels, also known as pelvic floor exercises, are designed to strengthen the muscles of the lower pelvic girdle. Doing these Kegel exercises correctly and on a regular basis helps blood and oxygen circulate to the genitals, as well as strengthens the muscles. You can do Kegels anywhere – while driving your car, at work or watching television. To do Kegels correctly, you squeeze your pelvic muscles for about 10 seconds and then rest for 10 seconds. It is recommended to do sets of 10-20 Kegels every day.
  • Watch Fluid Intake – Try to avoid drinking copious amounts of water at one time. Drink throughout the day. Sip water during your workouts. If you get dehydrated, you will end up drinking too much water, causing your bladder to strain. Since caffeine and alcohol stimulate urine production, drink these in moderation.

Dietary Changes

  • Replenishing Your Diet – Eating more calcium-rich foods, magnesium-rich foods and Vitamin E-foods, like green vegetables, nuts and almonds is important to manage urinary incontinence.
  • High Fiber Diets – Maintaining a high fiber diet is essential because constipation can worsen urinary incontinence, so diets should be extremely high in fiber, fruits and vegetables.
  • Stay hydrated – It is still important to drink at least eight glasses of water a day because you don’t want the lining of the urethra and bladder to become irritated. Also, concentrated urine has a stronger smell, so drinking the recommended amount of water can help reduce the odor.
  • Phytoestrogens – Adopt a dietary plan that includes foods that contain phytoestrogens. because these plant estrogens bind to estrogen receptors in your body and can help manage incontinence by strengthening urethral tissue Soy, tofu, beans, tempeh, legumes, seaweed, potatoes, apples and carrots are all wonderful sources of phytoestrogens.
  • Eat more cranberries and blueberries – Cranberries and blueberries contain substances that keep bad bacteria from adhering to your bladder.

Daily Lifestyle Changes

excersise

  • Exercise – Any activity that will increase your physical exertion can make a difference in how often your hot flashes occur. Adopting an exercise regime doesn’t have to be difficult, nor boring. Some ideas: Opting for the stairs at work, walking to the local grocery store, and taking a yoga or dance class with friends or chair workouts in your own home. Exercise increases endorphin levels, which increases your threshold for pain.
  • Stress Reduction and Relaxation – Relaxation exercises, breathing exercises, massage, hypnosis, yoga and visualization techniques are all beneficial ways to help deal with urinary incontinence. Aswini mudra is the name of the yoga exercise that helps with urinary incontinence.
  • Toilet Trip Routine – It is important to schedule a routine for urination. Rather than waiting to go, time your urination and try to go at least every two to four hours.

Urinary Incontinence Treatment

  • Vitamins - Weakened sphincter muscles can be strengthened by magnesium and vitamin E. Vitamin C helps bladder incontinence because it helps fight urinary tract infections, illnesses and diseases. Beta-carotene helps your immune system function properly. Vitamin D improves pelvic muscle strength and could reduce the risk of incontinence, as well. Zinc supports immune function. Taking calcium and magnesium together may improve control of the muscles used in urination Horsetail herb, is known to restore the use of the urinary mucous membranes and is made into a tea.
  • Alternative Medicine – Chinese medicine (acupuncture)) has been a long standing treatment for menopause symptoms around the world. Although it can’t cure urinary incontinence, some people may experience powerful relief from going to acupuncturists. It helps tone muscle and increases blood flow to the bladder. It can also boost the immune system, soothe inflammation and restore hormonal balance.
  • Black Cohosh One of the most commonly used herbal remedies is Black Cohosh, a perennial plant that is a member of the buttercup family. It provides powerful phytoestrogens that mimic the hormone’s effects and bind to hormone receptors in the uterus and other parts of the body, alleviating hot flashes. Black Cohosh is also known to relieve hot flashes efficiently and is a good alternative to HRT. It is also used effectively for treating PMS, arthritis and lowering blood pressure. Red Clover, Dong Quai, Ginseng, Kava and evening primrose oil can be used as natural therapies, although there are some risks involved. Herbal supplements are not as closely regulated as prescription drugs and the amount of the herbal product, quality and safety may vary between brands.
  • Herbal Remedies – Horsetail herb tea is effective in strengthening the connective tissues of the body, as well. Other herbs, such as valerian, thyme, tormentil, uva ursi and chamomiles can help stimulate the circulation of blood in the urinary system. Another commonly used herbal remedies is Black Cohosh, a perennial plant that is a member of the buttercup family. It provides powerful phytoestrogens that mimic the hormone’s effects and bind to hormone receptors in the uterus and other parts of the body, alleviating hot flashes.
  • Electrical stimulation – Electrical stimulation makes the muscles contract, producing an effect quite similar to Kegels, which strengthen the pelvic muscles by contracting them repeatedly. Electrodes are inserted into your rectum or vagina and may encourage the growth of nerve cells that cause the muscles to contract.
  • Medications
    1. Topical estrogen – low-dose, comes in the form of a vaginal cream, patch or ring, helps to rejuvenate and tone tissues in the urethra and vaginal areas
    2. Anticholinergics – calms an overactive bladder
    3. Imipramine – tricyclic antidepressant that can be used to treat incontinence
  • Medical Devices
    1. Urethral inserts – small, tampon-like disposable devices that a woman inserts into her urethra to prevent urine leakage
    2. Pessary – a ring that a woman inserts into her vagina; holds up your bladder to prevent urine leakage