Squeeze Before You Sneeze

by Robyn Kutka, ND

You sneeze – you leak!
You laugh – you leak!
You cough – you leak!
What’s a girl to do? Well there’s certainly more options than pantyliners and always keeping an extra change of clothes on hand.  This form of urine leakage or “incontinence” may be affected by the tone of the pelvic floor and its surrounding musculature as well as hormonal imbalance.  Dr. Robyn Kutka routinely assess pelvic floor health in women of all ages and can help you determine if hormone balancing, kegel exercises or pelvic floor therapy can help you get relief from urinary incontinence.  Schedule your appointment today, and read on for more information on urinary incontinence and its causes. 

Women are twice more likely to suffer from urinary incontinence than men, and an estimated 1 in 3 women over the age of 60 are estimated to have bladder control problems. For many women, these issues start to occur with perimenopause and changes in hormones, although changes in weight and pelvic surgeries can also contribute to incontinence problems. Maintenance of bladder control is a balance between the sphincter muscles of the urethra and the detrusor muscles of the bladder. Pelvic floor health is essential in maintaining continence. A collection of multiple small muscles, the pelvic floor can be thought of as a basket supporting the bladder and uterus. As women age, gain weight, have children or undergo hysterectomy, it’s common for this “basket” to drop as a result of decreased tone and vascularity. As the pelvic floor muscles lose their tone, cystocele, rectocele, incontinence (urinary and fecal) and decreased vaginal sensation may become lingering health concerns. Just like exercise and weight lifting keep biceps, abs and quads tight; toning exercises and weight lifting can do the same for the pelvic floor. Kegel exercises for the female pelvic floor can be done with or without vaginal weights and, when performed consistently, can help prevent and/or treat decreased vaginal tone and the issues that may accompany it, including incontinence – specifically stress incontinence. Affecting approximately 15 million women in the United States, stress incontinence is the most common form of incontinence and is defined as involuntary urine leakage occurring in conjunction with physical stress such as running, sneezing, laughing or coughing.

Stress incontinence tends to increase with age and is a particularly common complaint in menopausal years. While toning exercises can be very effective, estrogen is essential in maintaining the tone and vascularity of the vaginal tissues including the sphincter at the urethral opening and the “basket” that supports the bladder. With the estrogen deficiency that can accompany menopause, a decrease in the normal vaginal tone and vascularity can be seen, significantly increasing a woman’s risk of stress incontinence. A comprehensive treatment plan for stress incontinence should include strengthening exercises along with proper hormone balancing to ensure adequate muscle tone.

Women with estrogen deficiency and complaints of urinary incontinence may benefit from estrogen supplementation, and specifically from vaginal estriol. Estriol supplementation in conjunction with pelvic floor exercises can reduce or alleviate symptoms in more than 65% of women experiencing stress incontinence, especially if implemented within the first year of symptom appearance.

In addition to estriol supplementation and pelvic floor exercises, incontinent patients may benefit from avoiding bladder irritants such as caffeine and alcohol, creating a bladder retraining schedule and receiving physiotherapy treatment when performed by a certified practitioner.  Suffering from urinary incontinence? Call today to schedule an evaluation.

-adapted via Labrix Clinical Services, Inc.