Our Bodies, Our Lives
By Dr. Tristi Muir

A guaranteed laugh in any movie? Bladder control. But when you’re the person experiencing an inability to “hold it,” jokes can be embarrassing and isolating.

Fear of ridicule can lead many women to avoid activities that may cause bladder leakage. First you stop jumping on the trampoline with your kids and soon you’re avoiding many activities you once enjoyed.

Urinary incontinence is actually quite common — affecting 45 percent of women. Risk factors associated with urinary incontinence include obesity, depression, childbirth, hysterectomy and medical problems such as diabetes and stroke.

While leakage of urine can have a variety of causes, there are two common types of incontinence.

“Stress incontinence” is caused by a weakening of the support muscles of the urethra. Sometimes coughing, sneezing, laughing or exercising can cause enough abdominal pressure to push a small amount of urine through a weak urethra.

“Urge incontinence” happens when a bladder spasm causes leakage. The spasm can cause leakage of just a few drops or as much as a full bladder. It can be triggered by running water, opening a heavy door, or for no discernible reason. Women with overactive bladder and urge incontinence are the friends who are able to give you a “star rating” on all the bathrooms in her area.

What can women do to prevent urine leakage?

Strengthening the pelvic floor is a great place to start. Getting pelvic muscles into better condition won’t happen overnight, but after a woman performs two months of dedicated Kegel exercises, her pelvic floor will be stronger and more capable of preventing coughs, sneezes and laughs from causing urine leakage.

Women who leak with sudden urgency can benefit from combining Kegel exercises with a maneuver called “the Knack,” which can calm the bladder when it’s in spasm.

While many women believe they are performing their pelvic floor muscle exercises correctly, sometimes they aren’t contracting the right muscles. A woman’s gynecologist can confirm she’s doing it right and help with technique.

Smartphone apps and YouTube videos showing how to perform pelvic floor exercises properly can also be of great help. And women with incontinence can benefit tremendously by working one-on-one with a pelvic floor physical therapist.

For those women who find that pelvic floor muscle exercises don’t solve their incontinence problems, a urogynecologist can offer further treatment strategies.

The prevalence and severity of incontinence increase as we age. In fact, among women 80 to 90 years of age, 55 percent are incontinent. But it doesn’t have to be a normal part of aging.Women shouldn’t feel that regression to diapers is something we need to accept.

The “Golden Years” is a term that should be associated with enjoyment and experience, not the color of urine.

Our Bodies, Our Lives focuses on issues surrounding women's sexual, gynecological and emotional health. Dr. Tristi Muir is the director of the UTMB Pelvic Health and Continence Center at Victory Lakes. Learn more at utmbhealth.com/pelvichealth.