Ester Marsh: Another ‘pink elephant’ no one likes to talk about

  • Posted: Monday, May 19, 2014 12:40 a.m.

Urinary incontinence is the involuntary loss of urine and it’s a common condition in men and women of all ages, says the American Urological Association.

The two main types of urinary incontinence are:


• Stress incontinence, which can cause leakage when you cough, sneeze, exercise, laugh, or strain to lift something heavy.

• Urge incontinence, which is an unexpected, sudden urge to urinate, one that’s so strong it can be hard to reach the bathroom in time.

Today I want to touch on stress incontinence. A very dear friend of mine asked me once, “I am peeing my pants while doing jumping jacks as I am teaching my class, what do I do?”

“Welcome to the club!” I said. “It has been happening to me soon after my third child was born.”

“What do you do?” she asked.

“Tell your class when teaching, if you don’t want to pee your pants like me, do it like this!”

It is something many people — mostly women (but also men) — are dealing with, especially after childbirth. One reason for stress incontinence can be the trauma that muscles and tissues surrounding the bladder experience after childbirth. And some men can experience the same problems after prostate surgery. Additional factors can be obesity, diabetes or use of certain medications and urinary tract infections.

There are some things you can try to correct this problem. The first step is pelvic floor exercises (also called “kegel exercises”) using the muscles you use if you would try to stop, or keeping from urinating. Contract the pelvic floor muscles for 10 seconds, and then relax them for 10 seconds. Repeat 10 times. Do these exercises three times a day. The great part of kegel exercises is that you can do them anywhere, any time!

Also helpful can be “bladder retraining”; this means you urinate on a schedule whether you feel like you have to go or not. In between those times, try to wait until the next scheduled time. Initially you schedule them at least every hour. Gradually you increase the time until you eventually are urinating every 3-4 hours without leakage.

Other measures to prevent stress urinary incontinence are:

• Regulate your bowels to avoid constipation.

• Quit smoking if you smoke. It will reduce coughing and bladder irritation, and smoking can also increase your risk of bladder cancer.

• Avoid alcohol and caffeinated beverages, especially coffee; all can over-stimulate your bladder.

• Avoid foods and drinks which may irritate your bladder such as spicy foods, carbonated beverages, citrus fruits and juices.

Other ways of coping with stress incontinence are:

Use the restroom before you leave for a run or aerobics class. Wear protective incontinence pads to catch the urine leaks (Poise has small ones similar as a panty liner for light leakage that work great). Bring extra protection and a change of clothes.

Just because urinary incontinence is common does not mean it is normal. You should consult your primary physician, gynecologist or urologist for further treatment options if the above exercises and lifestyle changes do not make a difference. Treatment may include medications, advanced strengthening and retraining the pelvic floor muscles with the help of a physical therapist who specializes in women’s health or surgical intervention.

And please remember that you are not alone.

Ester Marsh is health and fitness director at the J.F. Hurley YMCA.

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