Urinary Incontinence: What Is It and What Can You Do About It
No one likes to talk about it, but millions struggle with it. Urinary incontinence might not make for the best of dinner party conversations, but statistics say it’s likely that a handful of the partygoers have at least one form of it. So let’s get practical and talk about urinary incontinence– what exactly is it, and what can we do about it?
This common condition, sometimes called leaky bladder, basically means loss of bladder control. The severity can vary from slight leakage upon sneezing or laughing to complete loss of urinary control. Either way, it’s embarrassing and can even affect your daily activities. There’s a reason you see a lot of marketing out there for protective undies– 25 million adults in the U.S. suffer from some form of urinary incontinence. Many women wear these padded panties or a sanitary pad every single day, “just in case.”
This condition is more common overall than you might think, but it’s much more common in women than in men. In fact, one in four women over the age of 18 experience some form of involuntary urine leakage. (Read more about these statistics here.) This becomes more of an issue for women as we get older, due to past pregnancies, vaginal birth, and menopause. Urinary incontinence is often genetic; although no gene has been found for it, studies show that women whose mothers and sisters have incontinence are more prone to it as well.
What Is It?
Here’s a quick look at the different types of urinary incontinence to be aware of:
- Stress Incontinence. This happens as the result of doing something, such as coughing, sneezing, laughing, standing up, or exercising. This form of incontinence is an anatomical problem due to the weakening of the tissue around the vagina and bladder, allowing the bladder to drop. A dropped bladder can cause unwanted urine leakage or incomplete emptying of the bladder, both of which are problematic.
- Urge Incontinence. This means you feel a sudden urge to go to the bathroom, but you cannot make it in time. This is more of a neurological problem than anatomical; the nervous system that relays messages to the bladder is not functioning properly. The bladder muscles are contracting too early, before it is time to release. In this case, the bladder is considered overactive.
- Overflow Incontinence. When the bladder is full and simply can’t hold its contents any longer, it releases urine on its own. This can happen when we ignore the urge to go until it’s too late. (Which can happen to anyone-–when you need to go, go!) But it also happens when a bladder does not empty completely.
- Functional Incontinence. A physical disability unrelated to the bladder keeps you from making it to the toilet in time. For example, your arthritis makes it hard to get to the bathroom and unbutton your pants quickly enough.
- Mixed Incontinence. This is a combination of both stress and urge incontinence, and it’s also the most common type of incontinence. If you suffer from this you have both an overactive bladder and a leaky sphincter, as unfair as that sounds.
What Causes It?
So what causes urinary incontinence? Some diseases may increase your risk, such as diabetes, or a neurological disorder, such as a spinal injury or stroke. It can also be caused by something that is easily treatable, such as a urinary tract infection or constipation. But incontinence is also often caused by everyday habits.
What Can I Do About It?
Here are some things you can do to help manage incontinence:
Avoid all diuretics.
A diuretic is any substance that promotes increased production of urine. Two of the worst offenders are:
A great first step is to eliminate all caffeine and alcohol from the diet and see if there is any improvement. Caffeine is a double whammy, as it actually causes increased urinary production and irritates the bladder lining. Certain foods also act as diuretics. If incontinence is a continued problem for you, you may need to watch out for foods that are high in spice, sugar, or acids (think citrus fruits). Also avoid carbonated drinks, artificial sweeteners, and chocolate.
Evaluate water intake.
Obviously, too much water is going to worsen incontinence for some people. But so is too little. When we drink too little water, the urine is highly concentrated and can irritate the bladder mucosa, which leads to incontinence. There is no ‘one size fits all’ when it comes to how much water you need. That depends on a whole list of factors, including diet, activity, temperature, altitude, etc. I encourage my clients to track how much water they are drinking. Often we think we are drinking more of it than we actually are. If bedtime leakage is an issue, stop drinking water within two hours of bedtime. Also, review all medications. Many, such as high blood pressure meds and muscle relaxants, act as a diuretic and can worsen incontinence.
Note: The connection between dehydration and incontinence is actually one of the major risk factors for falling among the elderly. Because they fear incontinence or getting to the toilet in time, they restrict their fluid intake and become dehydrated. That dehydration often leads to confusion and lack of balance. Unfortunately, many of these falls occur as they are trying to get to the bathroom, often in the middle of the night.
Read more about the relationship between water and incontinence in the Drink More Water chapter of our book, Eating to Live, available here.
There are actually two ways exercise can help. First, get specific and strengthen those weakened pelvic muscles by doing Kegels. You can do Kegels almost anywhere and any time. You can do them while you’re reading this article! Just squeeze your pelvic muscles as if you’re trying to stop urine flow. Hold for about 10 seconds, then rest 10 seconds. Do 10-20 of these contractions a day. General exercise can also help, as excess body weight puts pressure on your bladder and weakens the pelvic floor and urethral structures, increasing the chance of leakage.
Supplement with proper nutrition.
A healthy urinary system is key for proper function. Here are some of the most important nutrients for nourishing this important bodily system:
- Vitamin A: protects the mucus membranes
- The complex of B vitamins: supports the energy pathways
- Vitamin C: helps the production and formation of collagen
- Coenzyme Q10: helps with cellular oxygenation
- Magnesium: reduces calcium kidney stones
- Potassium: deficiencies of this nutrient lead to excess protein in the urine
- Valine: maintains nitrogen balance in the body, reduces the work required of the kidneys
It’s Not Inevitable
Although urinary incontinence occurs more frequently as we get older, it does not have to be an inevitable consequence of aging. For many people, simple lifestyle and dietary changes can make a big difference. If urinary incontinence continues to affect your daily activities, please see your doctor or work with a Functional Nutrition Counselor to find additional solutions.