Leaky Pipes and What To Do About Them

Patient Expert

Most of us can deal with hot flashes (barely), the weight gain and the mood swings, but perhaps the MOST embarrassing and annoying aspect of menopause is urinary incontinence, "leaky pipes," as some TV commercials refer to it.

It happens at this stage in our lives because of the loss of hormones in our vagina and lower urinary tract means a loss of muscle tone in that area. It usually starts as a little leakage when we cough or sneeze or laugh. For me, it started when I was jumping on our trampoline with my teenage kids. Of course I was laughing like crazy but every time I jumped, I peed a little bit. I thought something must be terribly wrong with me. In fact, it was normal. I was in perimenopause (pre-menopause), the most common time that women experience urinary continence. I was embarassed and I hated it.

I had heard about Kegel exercises when I was pregnant but didn't take them very seriously. Bladder control wasn't on my radar screen. Then when I had little leaks here and there, I started taking them more seriously.  Some non-invasive and non-prescription strategies seem to have worked so far.

There are two types of incontinence, urge incontinence and stress incontinence, which is more common. It might happen when you laugh, or at exercise or yoga class. Your urinary sphincter muscle looses some of its elasticity as you age.   Childbirth can also affect the nerves in that area, and nerves are what make muscles contract. For reasons I don't understand, smoking can also affect the nerves in the pelvic region. Age affects all nerves and the ones in our pelvic region are no exception.

But don't think you are destined for  adult diapers because most likely you are not

Here are some steps you can take that may help control incontinence, if not make it go away altogether:

  1. Not surprisingly, when your bladder is full, it's more prone to leaking. So an easy way to avoid a leaky bladder is to empty it more often. This has actually worked wonders for me. I used to wait till the last minute to run to the bathroom. Now when I get even the slightest urge, I empty my bladder.
  2. Caffeine is a diuretic, and a bladder irritant. Decaf coffee is still a diuretic. Switch to herbal teas or even better, plain water.
  3. Work your pelvic muscles. Making them stronger can help "hold in" your bladder urges but also exercising those muscles-as with any muscles-increases blood flow and makes for healthier tissues, including muscles and nerves. Doing Kegel exercises means working your vaginal muscles. See out sister website, http://www.incontinencenetwork.com for directions on how to do these exercises. They work!
  4. Topical estrogen, placed at the opening of the vagina, has demonstrated that it can help with blood flow and innervation to the urethra, and that helps muscle tone. If a lack of estrogen is the case of your incontinence, this could be an easy solution. Topical estrogen is absorbed only slightly into the bloodstream, so it doesn't have the same effect as hormone replacement therapy (HRT) that you take orally.

There are more invasive ways to deal with stress urinary incontinence but my advice is to try these first. The other kind of incontinence, urge incontinence, is more often treated with a prescription, but there are side effects. Your doctor can help you determine which type you have, but before you reach for a prescription drug, you may want to consider these alternatives.