When your bladder isn't as reliable as you'd like, all sorts of day-to-day situations become unexpectedly stressful. Who wants to worry about embarrassing leaks every time you sit down to giggle over an episode of Modern Family? Here are the top ten bladder triggers, and ways to keep them in check.
1. Laughing or sneezing
Why leaks happen
The pelvic floor muscles that support the bladder and urethra are weakened. So when you laugh, the sphincter muscle at the juncture between the urethra and bladder can't hold as tightly as it should.
What to do
Schedule bathroom trips at regular, set intervals. Learning to follow a bathroom schedule is known as bladder training, and over time it can help your bladder relearn how not to release unexpectedly.
Get a referral to a physical therapist who specializes in pelvic floor strengthening. You can learn exercises to regain control over these muscles.
Practice double voiding. If incontinence seems to be related to your bladder not emptying completely, returning to the bathroom after waiting a few minutes can help eliminate residual urine.
Don't get caught out. If you haven't been to the bathroom in a while and someone launches into a joke, don't feel self-conscious about excusing yourself. It's OK to say, "Hold that thought" so you don't miss out on a good laugh.
2. Running, jumping, and exercise
Why leaks happen
"Exercise-induced urinary incontinence" is the term for stress incontinence that happens during physical exertion. When the pelvic floor muscles weaken, the muscles of the bladder and the urethra don't have the support they need to tighten fully and retain urine. Running, jumping, kicking, and any serious exertion can cause a release.
What to do
Don't be afraid to talk about it. It might come as a surprise to know that 30 to 40 percent of women have this problem -- it's not the rare little secret you think it is. Ask your doctor for help.
Sign up for pelvic floor therapy. A specialist will put you through a program of Kegel exercises designed to build up strength in the deep abdominal muscles that support the bladder.
Be vigilant about bathroom trips. Go just before a run or game, and don't be self-conscious about excusing yourself to use the bathroom again during a session.
Don't overhydrate. One eight-ounce glass of water before you exercise is plenty, experts say, but many women drink much more. Save the rest for during and after your training.
Wear a tampon. Inserting a tampon puts pressure on the urethra through the vaginal wall. There are also medical devices called pessaries that do much the same thing.
3. Sex
Why leaks happen
Sexual activity puts pressure on the abdomen, urethra, and bladder, which can trigger stress incontinence. Stimulation and arousal can bring on urge incontinence.
What to do
Limit fluid intake for an hour prior to sex.
Use the bathroom just before sex.
Perform pelvic floor exercises regularly to build up bladder control. Hint: They make sex better too!
Choose sex positions that make incontinence less likely. With the woman on top, it's easier to control your pelvic muscles and the stress caused by penetration; entry from behind puts less pressure on the bladder and urethra.
4. Alcohol
Why leaks happen
Not only is alcohol a bladder stimulant, it's also a diuretic, causing your body to flush out water through the kidneys. So it's a double whammy for those struggling with incontinence.
What to do
Choose water-based mixed drinks. A gin and tonic -- with plenty of tonic -- is much easier on the bladder than straight whisky.
Don't add insult to injury. Mixing one bladder irritant -- alcohol -- with another, such as coke or a citrus juice, is just going to make leakage more likely.
Cut back on the celebrating. You'll enjoy the evening more if you stay dry even if you have to give up that second drink.
Remember your water chaser. Following wine, beer, or a mixed drink with water flushes the irritating alcohol out more quickly.
5. Coffee and tea
Why leaks happen
Caffeine is a double whammy for those with incontinence because it's a diuretic and it stimulates the bladder. So it makes you have to go more often -- and it makes you have to go now.
What to do
Eliminate caffeine as much as possible. That means black tea and chocolate as well as coffee, experts say. If you can't start your day without a cup of joe, keep the refills down, and follow it with a glass of water to dilute the stimulating effects. Also, limit your coffee and tea drinking to mornings. If you're going to be running to the bathroom, you don't want it to be when you're trying to sleep.
6. Soda pop
Why leaks happen
Soda pop can contain carbonation, caffeine, and cocoa-based flavorings, all of which are among the most irritating bladder triggers. And many experts say diet cola's worse than coffee for those with incontinence; with the addition of artificial sweeteners, it contains four different bladder irritants.
What to do
Experiment. When you need an ice-cold refresher, try other options such as lemonade, herbal ice tea, or fizzy water with a splash of juice. When trying to break a cola addiction, gradually reduce your daily intake rather than quitting cold turkey.
7. Medications
Why leaks happen
Medications that relax muscles in other parts of the body often relax the muscles of the bladder and urethra as well. Meanwhile, some medications cause you to produce and expel more urine, while others make you sleepy and less alert. Some examples:
Alpha-blocking medications that lower blood pressure, such as Cardura (doxazosin), Minipress (prazosin), and Hytrin (terazosin), weaken the bladder's ability to hold tight.
Diuretics such as Bumex (bumetanide), Lasix (furosemide), Aldactone (spironolactone), and all the thiazides cause your body to flush liquids.
Antidepressants and other drugs with anticholinergic effects, such as Norpramin (desipramine), Cogentin (benztropine), Haldol (haloperidol), and Risperdal (risperidone), block a neurotransmitter and in the process can cause bladder spasms.
Sedatives and sleeping pills such as Ativan (lorazepam), Valium (diazepam), Dalmane (flurazepam), Lunesta (eszopiclone), and Ambien (zolpidem) relax muscles and make you sleep extremely deeply.
What to do
Check side effects. If you think a medication is affecting your bladder, check the listed side effects to see if urinary problems or incontinence is among them. Even if it's not in the notes, that doesn't mean your experience is invalid. Keep track of how the drug is affecting you from day to day, then talk to your doctor about whether it's possible to switch to an alternative medication.
8. Urinary tract infections (UTIs)
Why leaks happen
When a urinary tract infection irritates the lining of your bladder, the result can be strong, sudden urges to urinate. And you may not even know you have a UTI; some are symptomless, at least at first. There may also be other symptoms, such as itching or burning, discharge, or a fishy or foul-smelling odor.
What to do
Get tested for any suspected case of a UTI.
If you seem to be getting frequent bouts of UTIs or an infection won't clear up, ask your doctor about interstitial cystitis, a chronic condition that can lead to incontinence.
9. Super-tight jeans, leggings
Why leaks happen
There's a reason your doctor tells you to wear loose-fitting clothing to prevent vaginal and urinary tract infections. Airflow prevents moisture from becoming trapped and providing a breeding ground for bacteria. Wearing tight jeans, "jeggings," or thick stretchy leggings for long periods of time can lead to UTIs and bladder infections, which in turn can cause incontinence.
What to do
Give your body a break. If you want to wear tight jeans for a hot date, do so, but slip into your comfies as soon as you get home.
Save exercise leggings for class; shower and change before heading home.
Choose cotton over nylon, and watch that lycra content. The more lycra in the fabric, the more elasticized it is.
Go one size larger.
10. Constipation
Why leaks happen
The lower colon and rectum are located near the bladder and share many of the same nerves. When you have hard, compacted stool in your rectum, these nerves become overactive, with the result that you have sudden and frequent urges to go.
What to do
Bulk up your diet with fiber. Fiber prevents constipation and has the additional benefit of making the urinary tract muscles function more effectively.
Take laxatives temporarily to clear your colon and rectum.
Drink plenty of water at regular intervals.
Eat more fruits and veggies. The water content in fruits and vegetables helps prevent constipation.
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