Women's Issues 65+
“I suffer from bladder leakage when I exercise and when I laugh. Are bladder exercises (like Kegel) actually effective? What are some helpful products you recommend for this issue? ”
Dear A Little Embarrassed in San Diego,
Thank you so much for your trust and being willing to share the private issue of mild incontinence with me. I would like you to know that there are many Americans who have the same issue—over 33 million Americans suffer from some type of urinary incontinence or bladder condition. Thus, there’s no need to feel embarrassed as I can assure you that you are in good company. Let’s talk about solutions that can improve your circumstances.
In terms of your questions, below are my answers:
1) Are bladder exercises (Kegel, etc.) actually effective?
First, how incontinence is treated depends in part on what type of incontinence you have. Speak with your doctor to get an accurate diagnosis. We have to know what causes your incontinence before giving you a treatment because only when we treat the symptom with a proper treatment according to the causes will it get better.
There are many reasons that can cause incontinence:
Urinary tract infections, which can cause temporary problems
Constipation can cause urinary incontinence if it causes pressure
Hormonal changes, diabetes, dehydration, surgery, weakened or damaged muscles, and medications can lead to incontinence.
Stroke, dementia, and delirium can also lead to incontinence if the brain does not send or receive bladder or bowel signals effectively.
Immobility can cause incontinence if getting up and to the toilet or taking off pants takes a lot of time and effort.
Sometimes, incontinence disappears on its own, such as one caused by alcohol use. However, if this is not the case a doctor needs to treat the underlying problem such as those listed above. Speak with your doctor to receive an accurate diagnosis.
After that, non-medical approaches such as bladder exercises would be a good choice. In terms of Kegel exercises, here are some facts you might want to look at:
Four in 10 women improved their symptoms after trying Kegel exercises
Kegel exercises are not for everyone. Since Kegel exercises help prevent the weakening of pelvic floor muscles, which support your uterus, bladder, small intestine, and rectum, the exercises will not help your urinary symptoms and cause more problems if your symptoms are caused by the tightened pelvic floor muscles.
It may take 4 to 6 weeks before you notice any improvement in your symptoms.
Kegel exercises work differently for each person. Your symptoms may go away totally, you may notice an improvement in your symptoms but still have some leakage, or you may not see any improvement at all. But even if your symptoms don’t get better, Kegel exercises can help prevent your incontinence from getting worse.
You may need to continue doing Kegel exercises for the rest of your life. Even if your symptoms improve, urinary incontinence can come back if you stop doing the exercises.
For more information on Kegel exercises, please look at https://www.womenshealth.gov/a-z-topics/urinary-incontinence
2) What are some helpful products you recommend for this issue?
There are many products to help you manage urinary incontinence, and below are things that you need to consider before you purchase a product:
How much urine you lose
Comfort
Cost
Durability
How easy it is to use
How well it controls odor
How often you lose urine throughout the day and night
Some products you might want to consider:
Inserts such as pessaries, urethral insert, and disposable vaginal insert, and pads
Adult diapers and underwear (here is one underwear product designed by an alumni at Brown University and you might want to look at: https://www.dearkates.com/pages/size-chart and the articles about it: https://alphamom.com/pregnancy/leak-free-stylish-undies-by-dear-kate/)
Bed and chair protection
Something to keep your skin dry
You can find most products at your local drugstore, supermarket, or medical supply store. Ask your health care provider for a list of incontinence care products.
The National Association for Continence may be able to help you find products. Call toll-free at 1-800-BLADDER or visit the website: www.nafc.org. You can buy their Resource Guide that lists products and services along with mail order companies.
For more information about the products, please look at the website of MedlinePlus, a service of the National Library of Medicine (NLM), which is part of the National Institutes of Health (NIH): https://medlineplus.gov/ency/article/003973.htm
If you have more issues, please go to your doctor. If your doctor is not helpful, you should see a urologist, gynecologist, gastroenterologist, or geriatrician. Some geriatric care centers and gynecological practices have special clinics devoted to incontinence.
Here is another resource you might want to look at:
Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/urinary-incontinence/symptoms-causes/syc-20352808