Preventing Urinary Incontinence
Urinary incontinence (UI), the loss of voluntary bladder control, occurs commonly in older women. The causes of UI can include having had many urinary tract infections, vaginal infections or irritation, untreated constipation, weak bladder muscles, overactive bladder muscles, weak pelvic floor muscles, diseases that damage nerve pathways from the bladder to the brain, arthritis, gestational diabetes, hip dysfunction, and pelvic organ prolapse. While it’s common, urinary incontinence is also frustrating, inconvenient, and at times embarrassing. By taking a holistic approach, however, it’s possible to prevent and heal UI.
Types of Urinary Incontinence
Stress incontinence: The most common bladder control problem, this is leakage that occurs when a person coughs, sneezes, laughs, lifts a heavy object, or performs any other activity that places increased pressure on the lower abdomen. In general, the bladder is rarely completely emptied. Dribbling is more common than complete evacuation of the bladder contents. This problem is a result of weakened pelvic floor muscles, which can be due to aging.
Urge incontinence: This results from an overactive bladder. The muscle that surrounds the bladder, the detrusor muscle, may involuntary contract, allowing the flow of urine. Frequent urination is a common symptom with this type of incontinence.
Functional incontinence: Characterized by an uncontrollable urge to empty the bladder before you can reach the bathroom, this type of urinary incontinence can be caused by stress, changes in the environment (such as traveling or staying in the hospital), and mobility restrictions.
Reflex incontinence: Some individuals lose the ability to sense when their bladder is full, and this loss of sensation can lead to urine leakage. The most common cause is spinal cord injury or other neurological impairments.
Total incontinence: Defined as unpredictable loss of urine at all times, it’s mainly caused by neurological dysfunction, abdominal surgery, spinal cord injury, or an anatomical defect.
Overactive bladder: Abnormal nerves send signals to the bladder at the wrong times, causing bladder muscles to contract without warning. Women with overactive bladder often urinate very frequently (8+ times a day and 2+ times a night), have a sudden or strong need to urinate immediately, leak or gush urine that follows a sudden urge, and experience nocturia (waking up at night to go to the bathroom).
Do kegel exercises. This involves contracting and releasing the same muscles you use to stop urinary flow, in order to enhance and maintain pelvic floor muscle tone. For the first week of doing kegels, the goal is to flex your pelvic floor muscles for 5 seconds at a time for 5 reps. One rep is flexing for 5 seconds, then relaxing for 5 seconds. If you’re tightening your abs, thigh muscles, or butt muscles, you’re not flexing properly - focus on isolating and only flexing the pelvic floor muscles. After completing the first week, continue to build up to 10 reps of 10 seconds of flexing and 10 seconds of relaxing, and perform this sequence 3 times per day. Always keep in mind that quality is more important than quantity, so stop performing the exercise if you lose proper form. You should see an improvement after 6-12 weeks of continued practice.
Note: Kegel exercises should not be practiced while urinating as this can train your bladder to not empty completely, worsening incontinence and potentially causing UTIs.
Exercise. If you’re overweight, losing weight can reduce the severity of urinary incontinence. Excess belly fat places pressure on the bladder and pelvic muscles. Bladder control can be regained by getting down to a healthy weight.
Treat constipation right away. Straining to empty your bowels weakens your pelvic floor muscles and makes leakage worse. Constipation can be treated with home remedies such as consuming aloe juice or prunes, supplementing with magnesium citrate and cod liver oil, taking substances such as flaxseed oil and psyllium husks, and castor oil packs.
Reduce or eliminate caffeine intake. Caffeine irritates the bladder and can make incontinence worse. Coffee has the worst negative effect, so try replacing it with decaf coffee, herbal caffeine-free teas, or coffee substitutes such as dandy blend. Carbonated drinks, teas including green tea, energy drinks, and hot chocolate also contain caffeine, so cut down on these too and replace them with water and herbal teas.
Reduce or eliminate alcohol consumption. Alcohol is a diuretic, which makes you urinate more often. Cutting down can help your incontinence symptoms.
Ensure adequate magnesium consumption. Magnesium is required for proper nerve and muscle functioning. Having sufficient levels of magnesium in the body can help with urinary incontinence and reduce the need to urinate at night. This mineral helps to relieve incontinence by reducing muscle spasms and allowing the bladder to empty completely. Magnesium can be taken in supplement form or consumed in your daily diet through foods including spinach, Swiss chard, pumpkin seeds, organic yogurt or kefir, almonds, black beans, avocados, figs, and bananas.
Try free form amino acids (collagen powder). Supplementing with collagen helps to strengthen the bladder muscles, which will aid in gaining control of urination. Add collagen powder to soups, stews, and hot drinks.
Supplement with zinc. This has been shown to improve bladder function.
Drink an adequate amount of fluids. Dehydration can cause constipation and bladder irritation. To prevent dehydration, sip water or herbal teas throughout the day (even before you get thirsty), drink half your bodyweight (in pounds) in ounces of water every day, and drink consistently throughout the entire day. It’s also a great idea to start your day off with a mug of warm water with freshly-squeezed lemon juice, another great way to stay hydrated and prevent constipation. You can check to see if you’re drinking enough fluids by looking at the colour of your urine. If you’re well-hydrated, your urine should be pale yellow. Urine that is dark yellow in color usually indicates that you haven’t had enough to drink recently.
Eat a high-fiber diet. It’s important to eat a healthy, whole foods diet to keep your bowels healthy and regular. Dietary fiber provides satiety and adds bulk to stool, which helps with digestion and prevents constipation. Aim to consume about 30–60 grams of fiber every day. Focus on eating plenty of fruits, vegetables, legumes, nuts, seeds, and whole grains.
Exercise regularly. Physical activity helps prevent constipation by stimulating muscular activity of the bowels (peristalsis). Exercise also helps to maintain a healthy body weight, reducing pressure on the pelvic floor, which is directly responsible for bladder and bowel control. Pick an activity that you enjoy to ensure you stick with a regular exercise routine.
Have good toilet habits. You should only go to the toilet to urinate when you feel your bladder is full. If you make a habit of trying to urinate “just in case,” you’ll teach your bladder to signal the urge to urinate when it isn’t actually full. Moreover, take your time on the toilet. Allow urine to flow at its own speed and don’t use your pelvic floor to push out urine.
While urinary incontinence is often considered a normal part of aging, in truth it can be addressed and healed using a holistic approach. With proper nutritional, supplemental, and lifestyle support, you can reclaim the bladder health of your earlier years.