Private health

Q:

I’ve been doing Kegels for a month and it’s definitely helped with my urinary leaks, but I still have accidents when I work out. It’s so embarrassing—as is the prospect of wearing bulky adult diapers to yoga class. What else can I do?

A:

Kegel exercises are one of the best natural ways to control urinary incontinence since they strengthen the pelvic-floor muscles that support the bladder and urethra. I always advise my patients who experience leakage to perform three to four sets of 10 Kegel contractions each day. But it can take six to eight weeks for the exercises to have the intended effect. In the meantime, as you’ve experienced, exercising, coughing and sneezing can put pressure on the bladder that pelvicf loor muscles can’t yet withstand, causing leaks.

Thankfully, pads and panties designed to absorb urine have come a long way over the past decade, and there are a variety of slim-fitting designs available at drugstores. One to try: Viita Protection Underwear (available at CVS), which holds up to 1⁄2 cup of urine. But if they’re still too bulky for you, there are other options I can suggest: Research has shown that inserting a tampon, which supports the bladder and urethra from beneath, before working out can stem exercise-induced leaks in up to 86 percent of women. Just be sure to remove it as soon as you’re finished exercising since leaving a tampon in place when you’re not menstruating can dry out vaginal tissue.

These methods should keep you dry and comfortable during exercise until the Kegels strengthen your pelvic floor sufficiently to stem your urinary leaks. But if you’re still experiencing accidents after two to four weeks, I advise seeing your doctor, who can recommend other strategies.