If you’re a woman who experiences urinary urgency, frequency and/or incontinence – you’re not alone. Of the approximate 25 million Americans who experience these symptoms, an estimated 75 percent to 80 percent are women. Women are more likely than men to have such problems largely due to the trauma the body experiences during pregnancy and child birth. Also contributing are the hormonal changes that come with menopause, as well as the very structure of the female urinary tract itself.

Barring health conditions that can cause these problems, such as neurologic injury, birth defects, stroke, multiple sclerosis and physical problems associated with aging, loss of bladder control is common among otherwise healthy women.

But women should know one thing with certainty: Loss of bladder control is not a normal part of the aging process.

“It’s the biggest myth,” said urogynecologist Adam S. Holzberg, D.O., Co-Division Head, Division of Female Pelvic Medicine & Reconstructive Surgery at Cooper University Hospital. “It’s not something the mature woman just has to accept, and it’s not something to be ashamed of or to ignore. It should be discussed with your doctor. These problems can be correctable,” Dr. Holzberg said.

Today, there are more treatments for these issues than ever before. The choice of treatment, whether medication therapy, lifestyle changes, physical therapy, surgery, a supportive device, nerve stimulation, or a combination thereof, depends on the type of problem, how serious it is and what best fits a woman’s lifestyle.
Remember, if you suffer from bladder-control problems, tell your doctor. Under a doctor’s care, problems can be treated and often cured.

In the meantime, Dr. Holzberg offers some behavioral strategies to help you improve your bladder control:

Manage Your Fluid Intake

If you drink large amounts of fluids daily and are bothered by frequent trips to the bathroom, try this:

• Don’t carry a water bottle or large container of fluid around with you.
• Use a smaller glass or cup.
• Take small sips instead of large gulps.
• If your mouth is dry, try sugar-free gum or candy instead.
• Spread out fluids during the day instead of drinking large amounts at one time. This is especially important before leaving the house. If you get up to void more than two times per night, limit fluids after dinner.

Avoid Fluids and Foods That Can Irritate the Bladder

Some chemicals in our beverages can behave as diuretics and bladder irritants. If you’re sensitive to these chemicals, they may cause you to make large amounts of urine or may aggravate bladder spasms resulting in a more frequent need to urinate. Some common bladder irritants are:

• Caffeine – Try to stop or at least reduce your caffeinated beverages, such as coffee, tea and cola, to see if your bladder control improves. If you drink a lot of caffeine, taper down slowly to avoid a caffeine withdrawal headache.
• Artificial Sweeteners – Beverages that contain artificial sweeteners, such as aspartame or saccharin, can irritate the bladder. Diet Pepsi, Mountain Dew or Coke, then, would be especially problematic because of the artificial sweetener and the caffeine.
• Acidic Foods – Citrus juices and fruits, tomatoes and tomato-based products are high-acidic foods that can irritate the bladder. Try stopping the suspected irritant for a week or two to see if it makes a difference.

Strengthen Your Pelvic Floor Muscles With Kegel Exercises

To learn more about what women should know about bladder-control problems, view the transcript from our recent Health eTalk web chat with Adam S. Holzberg, D.O. He discussed “Bladder Matters: Urinary Incontinence in Women” and answered questions from visitors and patients live on cooperhealth.org. Click here to view the transcript now.

Most bladder-control problems are caused by weak pelvic muscles, which help prevent urine leakage. Identifying the correct muscles to exercise is important. These are the same muscles you would use to stop the flow of urine midstream. Your doctor or nurse can help make sure you’re contracting the right muscles for Kegel exercises. Once you have correctly identified the muscles, you contract and hold the squeeze for a few seconds and then completely relax the muscles before the next squeeze. (For more detailed instruction on how to perform Kegel exercises, visit www.mypelvichealth.org.)

Suppress the Urge – “Freeze and Squeeze”

If you have trouble reaching the bathroom before you start losing urine, try this. When you get the urge to urinate:

• Stop and stay still. Sit down if you can.
• Squeeze your pelvic floor muscles quickly 3 to 5 times; repeat as needed.
• Relax the rest of your body and take a deep breath.
• Concentrate on suppressing the urge.
• Distract yourself to get your mind on something else.
• Wait until the urge subsides, then walk to the bathroom at a normal pace.
• Don’t ignore the initial urge.

Train Your Bladder

Once you’ve mastered the urge-suppression technique, you can now train your bladder to increase the time between the initial urge and the time you actually void.

Simply follow the urge-suppression technique but instead of walking calmly to the bathroom once the urge subsides, wait a few minutes before voiding. At first you may only be able to postpone voiding by one minute, but keep trying to increase the interval between the initial urge and the time you actually void until you are only voiding every three to four hours. Like any new technique, this takes practice and time to master, so try it at home initially until you become more successful.

Control Your weight

Being overweight puts extra pressure on the bladder. Weight loss will relieve some of that pressure and help you regain bladder control.

About Adam S. Holzberg, D.O.

Dr. Holzberg and Cooper’s expert team of Urogynecology specialists are obstetrician-gynecologists with additional training in problems that affect a woman’s pelvic floor—the network of muscles, ligaments, connective tissue and nerves that help support and control the bladder and other pelvic organs.  Learn more about Dr. Holzberg and Urogynecology at Cooper by visiting Cooperhealth.org’s physician directory.