Urinary Incontinence

Incontinence is a common issue many women experience. Quite often, urinary incontinence begins to occur after childbirth and this often worsens as women progress into perimenopause and then menopause. Initially, women often experience lack of bladder control, especially upon sneezing or laughing. Due to hormonal changes that occur during the progression into menopause, physical changes also occur, such as weakening of the pelvic floor muscles (muscles that keep our pelvic organs in place) reduced bladder tone and changes in urgency control, just to name a few.

What is urinary incontinence?

Urinary incontinence is explained as loss of bladder control and the severity can range from being very mild to quite problematic, impacting day to day activities. Some women may experience an occasional leaking of urine upon coughing or sneezing and others may have an instant urge to urinate that is so sudden and strong, they don’t make it to the bathroom in time. There are many different types of urinary incontinence and they are as follows:

• Stress incontinence: Urine leaks when pressure is placed on the bladder by coughing, sneezing, laughing, exercising, or even lifting something heavy.
• Urge incontinence: When a sudden, intense urge to urinate occurs, followed by an involuntary loss of urine. Urinary frequency also increases and nocturia (the urge to urinate at night) also occurs. Urge incontinence can be related to a minor condition, or an infection, diabetes, or a neurological disorder.
• Overflow incontinence: Frequent or constant dribbling of urine due to the bladder only partially emptying.
• Functional incontinence: When a physical or mental impairment keeps a person from making it to the bathroom on time. For example, this may be related to someone who has arthritis.
• Mixed incontinence: When a variety of the above types of incontinence, are experienced.

What causes incontinence?

As incontinence isn’t a disease but rather a symptom, it can be caused by many factors, such as everyday habits, underlying medical conditions or physical problems. A thorough evaluation of the patient will allow for an accurate diagnosis of possible causes.

Temporary Incontinence

Temporary incontinence may occur when certain beverages and foods are consumed, as they can act as diuretics, stimulating the bladder, and increasing the volume of urine. Such beverages and foods may include:

• Alcohol
• Caffeine
• Decaffeinated tea and coffee
• Carbonated drinks
• Artificial sweeteners
• Corn syrup
• Foods high in spice, sugar or citrus

Certain medication such as blood pressure medications, sedatives and muscle relaxants may contribute as well. Large doses of B vitamins and Vitamin C may also contribute to temporary incontinence.

This type of incontinence only occurs for a short amount of time and resolves once the diuretic foods or beverages are avoided.

Persistent Incontinence

This is the most common type of incontinence experienced, particularly in menopausal women. It almost always occurs because of changes in hormone levels. During menopause, Oestrogen levels reduce, and these declining levels become an issue when looking at the health of the bladder and other structures of the urinary system.

Oestrogen has a strong role with improving the health of the bladder and the lining of tissue that keeps the bladder strong. When Oestrogen levels reduce, the bladder becomes weaker and unable to hold as much urine as it used to. The urethra (tube like structure that aids with urination) also becomes weaker and incontinence can occur.

Treatment options

Depending on the cause of incontinence, treatment options may vary and may differ in their effectiveness.

• Vaginal Oestrogen

The use of vaginal Oestrogen, in the form of a pessary or cream, has been shown to reduce the urge and frequency to urinate and improves the structures of the bladder and urethra. Speak to our friendly team to determine if you’re suitable for vaginal, oestrogen therapy.

• Pelvic floor exercises

The pelvic floor muscles, are a group of muscles that act as a hammock for the pelvic organs and muscles. Over time, with reductions in Oestrogen levels and through child birth and just general aging, these muscles reduce in strength and can lead to reduced control of the urge to urinate. Pelvic floor exercises are quite easy to do however, sometimes it is best to have a chat to a physiotherapist to make sure the exercises are suited to the individual.

*See our ‘Simple Pelvic Floor Exercise’ article for more information.

• Fluid and Diet Management

As mentioned before, certain beverages and food can increase the frequency to urinate. Once these are identified in the person, it is best for them to avoid what is known to worsen their symptoms. This may mean avoiding coffee, alcohol and reducing water intake at certain times during the day.

• Schedule toilet trips

Instead of waiting until your bladder is full to go to the bathroom, it may be a better option to make visits to the bathroom more frequently, to avoid the bladder filling up and increasing the chances of experiencing incontinence.

• Sling procedures

When incontinence becomes problematic and if the bladder becomes very week, to the point where symptoms of incontinence are triggered by general daily activities, medical professionals may recommend a sling. This is an operation where a mesh is placed near the bladder, to ensure it remains closed, especially when coughing, sneezing, or laughing (stress incontinence)

If you have noticed incontinence, speak to our medical team and your health care professionals, to determine the best treatment approach for you.

Written by Annmarie Cannone

M.Hum Nut, Grad Dip Naturopathy, B.App Sci (Naturopathic Studies)