Urinary Incontinence: 5 Solutions to Try

Statistics indicate that 1 in 4 women over 40 experience some degree of urinary incontinence, but most of those women have no idea how common their issue is, because nobody ever talks about it.  I recently spoke with LA urogynecologist Cynthia Hall on the subject, and she said that her patients are even reluctant to discuss it with her. "They'll say, 'Oh no, I'm not incontinent,' but if I then ask, 'Do you ever leak just a few drops when you're running to the bathroom, or when you sneeze?' then they'll admit that they do," says Dr. Hall. She's on a mission to reduce the stigma surrounding poor bladder control, because it can reduce women's quality of life unnecessarily. "They think it's embarrassing and that it's just a normal part of aging that they have to suffer through, and because they don't talk about it they don't realize that there are solutions."

There are two types of urinary incontinence, and both become far more common after the age of 50.  "Stress incontinence" is the label for leaking urine when you cough, sneeze, laugh, exercise, or otherwise do something that causes your urogenital muscles to lose control. "Urge incontinence" describes when you start to pee before you can make it to the toilet.  Both, obviously, can be messy and embarrassing, and women who suffer from them often adjust their lifestyles as a result. "Some patients tell me that they've stopped running or exercising because it makes them leak, and some women don't go out as often and are afraid travel," says Hall. "It's stressful for them to go to new places if they don't know exactly where the bathroom is."

Luckily, there's a list of treatments for urinary incontinence, and tricks that can make it easier to live with. Here are a few of your options:

1. Wear pads specifically designed this issue, such as the TENA Ultra Thins (just 1/3 of an inch thick but super-absorbent). "Women make the mistake of using menstrual pads but pads designed for urine work much better," says Hall.
2. Commit to doing those Kegels. To help you isolate and strengthen the right muscles down there, Hall recommends a program called Core Wellness. "Strengthening the pelvic floor can really help with both types of incontinence," she says.
3. Talk to a doctor about lifestyle modifications and behavioral therapies that might help. "For instance, caffeine, alcohol and artificial sweeteners can all worsen urge incontinence," says Hall.  "I'm not going to tell you to avoid those things forever, but maybe don't have a big cup of coffee before a long drive."  Experts can counsel you in techniques such as "timed voiding," which involves making yourself pee at certain intervals, even if you don't feel the urge.
4. Talk to your doc about prescription solutions. There are a number of drugs on the market that help with overactive bladder.  Like most drugs, they come with side effects, but if you don't like one there are a variety of options to try until you find one that works for you.
5. If none of the above does the trick, you should probably consider a more permanent solution.  As Hall points out: "If you have to wear a pad every day when you're 80, that's not so bad, but who wants to wear a pad every day at 45?"  Through minimally invasive procedures you can have a small plastic sling inserted around your urethra, or injections (similar to the cosmetic ones dermatologists use on faces) that have similar results.

Obviously your doctor can give you more personalized advice (and if your gynecologist can't help, talk to a urologist or urogynecologist) , as long as you get over your embarrassment and talk to her about it.  As Dr. Hall's advice makes clear, an unreliable bladder doesn't have to hinder your quality of life.