“I laughed so hard tears ran down my legs.”
When you can’t hold back the tears…ok, what I really mean is urine…while coughing, exercising, sneezing, laughing, or lifting something heavy…it is called “urinary stress incontinence” and is a common phenomenon in postmenopausal women. The result is either a small little tinkle of urine or a complete flood and loss of control.
Remember, first things first! We need to identify and treat the cause. This calamitous experience happens for a variety of reasons—and simply being aware of them can help you manage and “keep it inside.”
As you near menopause, your estrogen levels do begin to drop, and this can contribute to not only your pelvic muscles weakening but the urethral tissue becoming thinner, less resilient and less elastic… leading to reduced control over urination.
Other contributing factors to be aware of are certain medications such as diuretics or steroids, which can have urinary incontinence as a side effect. With my patients, I always go through the side effects listed of any medications that they are on. You would be surprised how many clinical complaints are actually due to them.
Chronic constipation can also weaken the pelvic floor muscles, making it harder to hold urine. Being overweight can put extra pressure on your bladder as well, worsening the situation.
Believe it or not, food sensitivities can also exacerbate the issue, causing irritation and inflammation to the bladder.
Although associated with menopause, urinary stress incontinence is not a given! By taking charge and correcting the specific contributing factors, this—like so many other “menopausal symptoms”—can be an “optional” issue.
Here are some tips and tricks…
- Review and increase awareness of the side effects of any medications you are taking.
- Rule out food sensitivities. I often recommend the “Eat Right For Your Type” blood-type diet for a period of four weeks to effectively help rule out foods that might have become irritants. It is an inexpensive and effective modality.
- Reach and maintain an ideal weight to reduce pressure on the bladder wall.
- Correct constipation. Increase fiber and by all means stay hydrated…drinking at least half your body weight in ounces a day…and reduce caffeine and alcohol.
- Strengthen your pelvic floor muscles by using Kegel exercises. Regular exercise can strengthen and build endurance to the group of muscles that control the opening and closing of your urethral sphincter (where the pee comes out). Kegel exercises are the standard and most effective treatment for incontinence caused by poor muscle tone, but you have to do them! The first step is to properly identify the correct muscle group. As you begin urinating, try to stop the flow of urine without tensing the muscles of your legs. It is very important not to use these other muscles, because only the pelvic floor muscles help with bladder control. When you are able stop the stream of urine you have located the correct muscles. Feel the sensation of the muscles pulling inward and upward. It feels like squeezing your buttocks so as to not pass gas. Consistency is the key when doing these exercises, so plan on 10 minutes, two times each day. Morning and evening are good times for most people, but the important thing is to choose times that are convenient for you so you can develop a routine. No one will know what you are doing, so you can do these anywhere! Begin with tightening and relaxing the sphincter muscle as rapidly as you can for one minute. Take about a minute rest and then contract the sphincter more slowly holding for a count of three, gradually working to increase the count to 10. Then go back to the rapid contractions for a minute. Make sure to relax completely between contractions. If you stay consistent, you will start to see marked improvement within three to six weeks.
- Vaginal estrogen therapy might also be helpful, so see a qualified menopause practitioner, such as a licensed naturopathic doctor to assist in treatment options.
These simple and noninvasive interventions can not only lead you once more to crying tears of joy, but can contribute to your overall well-being!