by Marcelle Pick, OB/GYN NP
Bladder issues are like so many health-related concerns — the sooner you attend to them, the easier they are to treat. So here’s what you can do:
See your doctor. If you are noticing any urine leakage or an increased frequency of urination, the first step is to get checked out by your local healthcare practitioner.
When we see women for bladder problems, we first try to figure out what kind of urinary incontinence they are dealing with. Most often this is some form of mixed incontinence that can be treated through alternative therapies.
Exercise. In cultures where women squat to do their work there is very little incontinence. We don’t do that kind of labor anymore — but we’ve got Kegels! Incontinence can often be arrested or reversed with Kegel exercises alone. Named after an American OB/GYN, this simple exercise is really just the “root lock” of yoga without the trappings. You can do it anywhere, anytime — and you should.
To do a Kegel, imagine that you are trying to stop yourself from urinating. Practice both short and long Kegels. You can even do an anticipatory Kegel before you sneeze or cough and prevent leakage!!!
A wonderful extra benefit of Kegels is increased sexual pleasure in both sensation and orgasm. (Male partners are happier too!)
Sometimes women have trouble identifying the muscles that control the bladder and get frustrated attempting Kegels. This can be a natural result of conditioning the brain to ignore bladder stimulation. How many of us are too busy to go to the bathroom when we feel the urge, then “forget” we had to go. Over time, it’s possible that our brain just stops paying attention and we disconnect. It can take some work to get those pathways talking again.
If Kegels don’t seem to be working for you, try insertable cones or balls (available through your doctor or on the internet) to help you train your PC (pubococcygeal) muscle if you’re having trouble. Bio-feedback practitioners use electronic monitors inside your vagina to help you learn how to identify and tone muscles related to your bladder. Both tools can be very effective.
Any kind of physical exercise that engages your core will help strengthen your pelvic muscles, but Pilates and yoga in particular are great inner toners. Both focus on building a firm core or root. They also use deep breathing and mindful movement to reconnect our brain to our bodies.
Acupuncture is another method that has provided symptom relief for some women. It helps tone muscle and increase blood flow to the bladder. It can boost the immune system, soothe inflammation and restore balance to the hormones.
Pelvic physical therapy is sometimes effective in difficult cases. Practitioners use several diagnostic tools, including sonograms, physical exams and lower back screenings to evaluate the cause of incontinence. Treatment may include external and internal pelvic floor massage, relaxation training, biofeedback, strengthening, bladder retraining, and home exercises. This is especially useful when patients have adhesions or physical anomalies due to radiation treatment, injury or surgery. Many women who undergo PPT report increased libido and enjoyment of sex in addition to better bladder control.