Lifestyle and Behavioral Changes
Do Nothing. Some women who have incontinence aren’t very bothered by it, especially when it doesn’t happen very often, or doesn’t prevent them from doing things they want to do. Very often, however, they suffer with this problem for a long time before bringing it up with someone who can help. They may be under the impression that leakage of urine is considered “normal,” especially for a woman who has had children, or may have gone through menopause. While all women should know that incontinence is very common, even among young, healthy women, it should not be considered normal, at any age.
Weight loss. Maintaining healthy body weight is very important for normal pelvic floor function. As little as a 5-10% decrease in weight in women who are overweight or obese will reduce weekly incontinence episodes by more than half. Weight loss should be part of an early effort to improve urine leakage along with pelvic muscle strengthening and other behavioral changes.
Pelvic floor muscle exercises (Kegel exercises). This is the main component of nonsurgical treatment for urinary incontinence. Numerous studies have shown that learning how to control and strengthen the pelvic floor muscles helps women reduce or eliminate urine leakage. This improvement is seen in leakage caused by physical activities and also with urgency. Women with mild to moderate symptoms experience the greatest improvement. Like any other form of exercise, improvement is a reflection of good exercise technique and dedication to doing the exercises regularly. Specially trained physical therapists can help those having difficulty learning these exercises.
Seek treatment for leg swelling. Many women will notice that as the day progresses their ankles and legs swell. This retained water is removed from the body by the kidneys as urine when the legs are elevated for a while. Many women with this condition will need to get up to urinate multiple times during the night. This can be dangerous because this is related to an increase in falls and bone fracture. Elevate your legs above your heart (lay on the sofa or bed with your legs propped on 2 pillows for 30-60 minutes prior to going to sleep). Talk to your medical doctor about the benefits of a “water pill” or diuretic.
Bladder retraining or bladder drills. This means going to the bathroom on a set schedule. Some some women don’t get the message that their bladder is full until its too late, urinating on a schedule may decrease leakage episodes. The goal of this exercise is to regain bladder control by emptying before the sudden strong urge comes. You or your doctor can decide where to begin after reviewing a completed bladder diary. Typically, women begin by urinating every hour or 90 minutes during the day, whether you feel like you need to or not. The interval between urination is extended every few days as long as leaking accidents are avoided. A comfortable goal to reach is urinating every 2 ½ to 3 hours. The bladder retraining period can take several months and requires motivation. If you are consistent it works very well.
Drink in moderation. What goes in – must come out! Many women drink more than they need for their body to function well. As a result, their kidneys make a large amount of urine and they have to urinate frequently. Generally speaking, eating a healthy diet and drinking 6 8oz glasses of fluid per day is plenty.
Eat plenty of fiber daily to avoid constipation. Use a stool softener if you continue to struggle with constipation to avoid excessive straining with bowel movements.
Avoid bladder irritants. Certain foods are known to irritate the bladder. They cause bladder muscle spasms which make women suddenly feel like they have to urinate often causing them to leak on the way to the bathroom.
Bladder irritants include:
- Caffeine found in coffee, tea, chocolate, cola and some energy drinks
- Citrus foods and juices
- Artificial sweeteners
- Alcoholic drinks
- Restrict drinking after dinner to reduce the number of trips to the bathroom at night.