Is Prevention Possible?
Reviewed by: Joanne Poje Tomasulo, M.D., ACOG
If you’re a woman under 45, you’ve got about a one in five chance of having urinary incontinence (an inability to control urine flow). If you’ve given birth, your risk is even greater. If you’re older, it’s higher, too. And if someone in your family has problems with bladder control (your brother’s bedwetting as a kid doesn’t count), your risk rises further still.
You can’t change those things. So what can you do? Plenty, it turns out. A healthy lifestyle can greatly lower your chances of having bladder problems now and in the future. “Each of us can take steps to reduce risk factors,” said Nancy Muller, executive director of the National Association for Continence. The key ones:
Control your weight
“Being overweight is one of the big preventable risk factors for incontinence,” said C. Seth Landefeld, M.D., chief of geriatrics at the University of California at San Francisco, who recently chaired a National Institutes of Health panel on the topic. “If you’re 30 or 40 pounds overweight, particularly in the abdomen, that’s putting a lot of pressure on your bladder.” Even modest weight loss can reduce that pressure: One study found that overweight women who lost 5 to 10 percent of their weight (8 to 16 pounds if you’re 160 pounds) suffered significantly less incontinence.
If you smoke, quit
Stress incontinence, when you “leak” while lifting or laughing or coughing, is the most common form for women in their 30s and 40s. The most common cause of chronic coughs? Here’s a hint: There are 20 of them to a pack.
Stay fit
Exercise, such as a walking program, is a key part of any weight-control strategy, of course.
Strengthen your pelvis
The pelvic “floor” has muscles that control urination, which is why these are called pelvic floor exercises (or, more popularly, Kegels, after the doctor who invented them). The exercises help maintain lifelong bladder control. “There’s always a benefit from strengthening this muscle group. Learning Kegel exercises should start as early as possible, and certainly after a woman has her first baby.” said Jane Frahm, PT, supervisor of women's physical therapy services at Detroit Medical Center’s Rehabilitation Institute of Michigan. (There’s a sexier reason, too: the same muscles are involved in orgasm. Said NAFC’s Nancy Muller, “Pelvic floor exercises also enhance sexual vitality.”)
Get annual checkups
You may not get sick often, but going in for an annual physical will help you stay healthy and lets you build a relationship between you and your doc. Developing that rapport with your doctor now can make it easier to talk about embarrassing conditions (such as incontinence) if they come up later.
Manage pregnancy
Baby coming? If you haven’t learned Kegels yet, do so now to help prevent bladder problems during and after your pregnancy, as well as ease delivery and speed recovery. And talk to your obstetrician about avoiding an episiotomy: Cutting the muscle between your vagina and rectum increases the size of your vaginal opening before birth, but it’s rarely necessary. Ironically, doctors once believed it might reduce incontinence risk. Not! “Routine episiotomy does not prevent urinary incontinence, and it increases the risk of fecal incontinence,” said Dr. Landefeld.
You already have a million reasons to eat right, stay toned, not smoke, and get regular medical care. You may want to add learning Kegels to your physical fitness list. But the basis of a lifestyle that promotes bladder health is pretty much just doing the things you already know are good for you. |
