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Women and bladder control

Women of all ages can have bladder problems, but treatment is available to most.

Bladder control problems (incontinence) will affect many women at some point in their lives. If you ever face this problem, you should know that most cases have a diagnosable and treatable cause.

The muscles that hold and release urine may be weakened by pregnancy, childbirth or menopause.

Stroke, multiple sclerosis or physical problems associated with aging can also cause incontinence.

According to the National Institute of Diabetes and Digestive and Kidney Diseases, most bladder problems occur because the muscles that keep your bladder closed aren't working properly. They may have become weak, or they may be too active.

Stress incontinence occurs when the muscles have become weak. Physical movement such as coughing, sneezing or exercising causes small amounts of urine to leak. Stress incontinence may be caused by weakening of the muscles because of:

  • Pregnancy and childbirth.
  • Trauma or injury.
  • Prolapsed (dropped) bladder or vagina.
  • Menopause.

Urge incontinence, sometimes called overactive bladder, results from bladder muscles and certain nerves not working together. It causes leakage of large amounts of urine. The causes of urge incontinence include:

  • A bladder infection.
  • Nerve damage (sometimes due to childbirth).
  • Bladder cancer, inflammation or stones.

If you have incontinence, you need to see a doctor. Although you may feel embarrassed, it's a medical problem and it's not your fault. Chances are excellent that you can be helped.

Your doctor may offer different treatment options, depending on the type of incontinence you have.

Types of treatments

At-home treatment options include:

  • Pelvic muscle exercises. Called Kegel exercises, they take only a few minutes a day.
  • Bladder training. This helps you learn to decrease the urge to urinate.
  • Weight loss. Sometimes extra weight causes bladder-control problems.
  • Dietary changes. Limit or eliminate caffeine (coffee, tea, cola or chocolate) and avoid alcohol.
  • Home improvements. If poor access to the bathroom is causing you to have accidents, renovations can help.
  • Assistance. Healthcare workers can help you get to the bathroom.

Your doctor may also recommend:

  • Muscle therapy. Electrical stimulation or biofeedback. Biofeedback uses machines to create pictures and sounds that show how well you are controlling your pelvic muscles. It may help you learn to control those muscles better.
  • Medication. A doctor can prescribe medications that can strengthen weak muscles or calm overactive ones.
  • Surgery. Your doctor can talk to you about various options.
  • Devices such as a pessary, urethral insert or urine seal.

reviewed 3/24/2020

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