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Monday, September 7, 2015

Bladder Solutions That Are Simple: Try Weekly (instead of daily) Kegel's

Jumping Jack (Jane) Dribble? Wet from a few leaks every time you go to the gym, and feel like you can't keep up with the pounding and zumba or cumbia and salsa moves? Lose the 5K race because you stopped for a bathroom break? Terrible! Unfortunately those with bladder issues of leaking with coughing and sneezing, find it's even worse at the gym. And that sort of leaking is what gynos mean when they say you have "stress incontinence" the stress is the rumba, the incontinence, the dribble! Bearing down to strain is a medical maneuver called a valsalva, and the strain of the forces of valsalva go directly to the neck of the bladder and affect if we can hold the urine in our bladder or if it leaks. Basic strategies like peeing before you bounce should help a bit, but often more has to happen, like lots of Kegel's, eating a bladder healthy diet, and otherwise trying medical interventions like pessary devices, medication, biofeedback, neuromodulation therapy, PRP therapy, MonaLisa Touch, or surgery. If having surgery, wearing a pessary,  if keeping our bladder empty isn't  helping at all, it's time to try some of the lesser known strategies after you check with your gyno to be sure your anatomy is where it is supposed to be! And by the way, it's ok to only do your Kegel's exercises once a week. This was almost as effective as daily, and much more effective than not doing exercises for bladder leaking prevention.

 Quick Tips: Come in for a pessary fitting.  Get a PRP shot to the bladder neck. Avoid constipation: calcium pills and excess eating of cheese are just two of the many things that can cause constipation, and constipation can make incontinence worse! Vary your exercises with your menstrual cycle! Oddly enough, some researchers in England showed that during the luteal phase (second half, the ovulatory second half, the half before the menstrual period) when both progesterone and estrogen levels are the highest episodes of incontinence were the worst! So think about it, just a bit less pounding later in the month, that's a better time to swim, and stretch and bike, and ahhh, you will be over all a lot drier! And might be kind of nice to know that the right mixing it up on the work out floor is a good for the pelvic muscles as well as the biceps!  Try a tampon before you exercise: you need to have it a bit lubricated, and do not leave it in more than an hour or two, but it might just be enough support to the angle of your urethra and bladder to help you be drier. And, as with all gyno problems , do get in and try to get your anatomy checked. There are things we can tell on exam that you may be able to treat for a quick fix as well. And weight loss, even losing about 5 kg, or about 12 -15 pounds will significantly help the weak bladder. If that doesn't work and you still want to avoid surgery, think of trying duloxetine which is a combined norepinephrine/serotonin reuptake inhibitor that improves stress and mix incontinence in many trials.

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Thank you for your comments and questions. This blog is not intended to replace medical care, but is informational only. We hope you will become a follower or visit Womens Health Practice. We offer a variety of unique services including MonaLisa Touch, Coolsculpting, Labiaplasty, and Gynecoloigic Clinical Research Trials. For more information on menopause see http://www.amazon.com/Menopause-Make-Peace-Change

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