Help for embarrassing leaks

Q:

I started experiencing incontinence 20 years ago during pregnancy, but the leaks used to only happen occasionally, when I coughed. Now that I’m 45, I sometimes can’t even hold it in on the walk to the bathroom. What’s the best way to solve this for good?

A:

You’re not alone! This is a combination of stress (leaking with a cough or laugh) and urge (leaking when you can’t suppress the urge) incontinence. But just because 50% of women experience urinary incontinence doesn’t mean you have to put up with it.

Strengthening your pelvic floor muscles, which can be compromised by pregnancies, weight gain, menopause and aging, is key to preventing leaks. To accomplish this, I suggest doing Kegel exercises: Squeeze your pelvic muscles (as if holding in urine) for 5 seconds, then slowly release. Do 10 reps three times a day.

Your bladder is also trainable, and many women inadvertently train it in the wrong direction. In an attempt to prevent leaks, it’s common to use the bathroom “just in case” when you don’t really need to. But this teaches the bladder to feel fuller sooner, leading to urges that are harder to hold in. To counteract this, try waiting for longer periods before urinating, taking deep breaths if you feel an urge and distracting yourself. You can also experiment with your fluid and caffeine intake. And while you work through this resetting process, consider wearing a pad designed for bladder leaks (like Poise Ultra Thin Pads, Walmart.com).

But if you’re still experiencing leaks after six weeks, talk to your doctor. She can offer other treatment options or a referral to a pelvic floor physical therapist, who will assess your pelvic floor function to correct imbalances and prevent leaks.