Sharon Denise Allison-Ottey
Ask Dr. Sharon

Urinary Incontinence

Posted by Administrator (admin) on Dec 11 2007
Ask Dr. Sharon >> Ask Dr. Sharon

Dear Dr. Sharon,

I am a 46 year old AA female and I heard you speak at a women’s conference. I was too embarrassed to ask you this question publicly but I need help. I have very embarrassing problem, when I laugh, cough and even sometimes when I have sex; I have “little accidents” with my urine. This is becoming a major issue for me and I don’t know what to do. I wear a pad most of the time but I can’t stand the smell of urine that I always have. It is very embarrassing when I have sex with my boyfriend –there is no way to hide the accident. This makes me avoid having sex and even being close to him and this is taking a toll on my relationship. Aren’t I too young for this? Please help.

Dallas, Texas

Dear JK,

I really wish that you had asked your question because you would have found that you are definitely not alone—many women have this same issue. According to most estimates, more than 13 MILLION Americans have the same problem, the medical term is urinary incontinence. Unfortunately, women are twice as likely to have urinary incontinence vs. men. You are definitely NOT alone and women in the early 20s have often reported this problem as well as women that are older.

What is urinary incontinence and Why you?

Urinary Incontinence: You know me—let’s break down this big medical school term; this simply means that you are leaking urine when you don’t want to. There are many types which include: stress, urge, mixed and overflow incontinence. I am going to focus on stress incontinence as this is the most common in women.

Why? There can be several reasons why you have developed incontinence. This is a bigger issue that an occassional accident because you can’t get to the bathroom on time. The situations that you describe are quite common--- leaking when you laugh, cough or have sex.

  • Reasons why people may develop urinary incontinence:
    • Past pregnancy and vaginal delivery
      • Multiple births with “big” babies put you at increased risk
    • Obesity/Overweight
      • Especially if you have a lot of “belly” fat
    • History of hysterectomy or other pelvic surgery
    • Menopause and the lowered amount of hormones
    • Bladder stones
    • Diabetes
    • Stroke
    • Problem with the urinary tract
    • Smoking
    • Medications and other chemicals may make the incontinence worse. Examples are: Fluid pills, some herbal products, some blood pressure medications, and an increase in caffeine intake (tea, coffee, and) sodas.

What Can You Do?

Please make an appointment with your physician—either your primary care physician or your gynecologist. You must make sure that this is urinary incontinence and not another condition. Tell them openly what you issues are and write down your symptoms. I would recommend that you fill out the urine diary below and take it in—it’s called a urinary diary—may seem gross but I’m trying to help ya!

Quick Tips to Help with Incontinence :

  • See your doctor
    • There are medications, biofeedback and other treatments that can be utilized. Additionally, you need to get DIAGNOSED and not diagnose yourself.
    • Fill out the urinary log and take it with you to show your doctor.
    • Just be open and TELL him/her about your issues—they will not be shocked!
  • Regularly do Kegel exercises. The main muscles are attached to the pelvic bone and act like a hammock, holding in your pelvic organs (bladder, uterus, etc…). Many times the pelvic floor muscles are weak which leads to urinary incontinence and leaks. If you do the exercises correctly and regularly you can strengthen the muscles. Stronger muscles lead to less urine loss for many women and increased awareness of pelvic area. A side benefit; do these while having sex and both you and your partner will enjoy the squeezing sensation!
    • This is what you do:
      • To isolate these muscles pretend that you are stopping and starting the flow of urine by squeezing your muscles.
      • You can do these anytime and anywhere—no one will know that you are “working it!”
      • To make sure that you are squeezing the right muscles, I recommend that you sit or lie on the bed and place your index finger inside your vagina. Squeeze the muscles as tightly as you can—you should feel them contract around your finger. If you feel the squeeze of the muscles—you know that you are doing these correctly. Now, many people are just CRAZY--- “Dr. Sharon-- I can’t put my finger inside my vagina!” Well, that’s another topic--- this is not masturbation—this is YOU taking care of YOU! Anyway--- you should feel comfortable touching yourself! If it’s a huge leap—get your husband or significant other to help you but email me because we need to talk about you being comfortable with your body.
      • Now that you are squeezing the correct muscles, the full exercise is that you squeeze and count to 10 then relax for 10 and repeat for at least 5 minutes.
      • I recommend that you work yourself up to counts of 15 and that you repeat this four to five times a day (at least) with sets of 20 repetitions. The more you repeat the exercise the stronger your muscles and the better the results. You should see results in just a few weeks. Additionally, by concentrating on your pelvic muscles—you may awaken some feelings that you thought were GONE!
  • Exercise
    • Exercise and fitness helps with overall muscle tone.
  • Decrease caffeine and alcohol
    • Coffee, tea, chocolate, herbal products and other items that contain high amounts of caffeine should be limited. Alcohol also increases leaks and should be limited.
  • Put yourself on a urinary schedule
    • This will keep the bladder empty and help reduce the amount of the leaks.
    • Most recommend that you go to the bathroom every 2 -3 hours on schedule even if you don’t feel that you have to go.
    • Fillout the urinary diary and you should see a pattern.

Last changed: Dec 11 2007 at 1:44 PM


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