Marie A Savard MD
Overactive Bladder (OAB) & Incontinence
Urinary Health

Dr. Marie's Help for Incontinence

A 2008 article in the “New England Journal of Medicine” revealed that 25 percent of perimenopausal women and 40 percent of postmenopausal women report leakage of urine. ThirdAge medical expert Marie Savard, M.D., author of “Ask Dr. Marie,” says that the main causes of this annoying condition are decreased estrogen levels and aging pelvic muscles that are losing strength. She adds that obesity can exacerbate the condition, as can asthma, diabetes, a chronic cough, and medications such as diuretics, antihistamines, and antidepressants.

“There are two types of incontinence, ‘stress’ and ‘urge,'” Dr. Marie says. “The word ‘stress’ doesn’t refer to emotional stress. It means pressure on your bladder. If you have weak muscles, that pressure causes urine to leak. This can happen when you laugh, cough, or just wait too long to go to the bathroom.”

She went on to explain that urge incontinence — also called irritable bladder syndrome, overactive bladder, or spastic bladder – is a condition in which your bladder empties even if it’s not full in spite of your attempts to hold it. This disorder is sometimes caused by diabetic neuropathy but is most often simply related to aging.

Dr. Marie says she can’t promise you a 100 percent cure, but that she can certainly help you gain more control. She deals with the problem herself and advises that your first line of defense should be to make sure you always have access to a toilet. “Just do as I do and check out the location of the bathroom everywhere you are,” she says. “Also, go often even before you feel the need!” Beyond that, she has tips for keeping the leaks at a minimum.

Often referred to as Kegels after Dr. Arnold Kegel, the gynecologist who created them in 1948, these exercises are the single most effective treatment for stress incontinence. Just as with any other muscles, you either “use it or lose it.”

Finding the muscles is easy. When you’re urinating, imagine that somebody accidentally comes into the bathroom and startles you. Your instinct will be to squeeze your muscles to stop the flow.

Dr. Marie recommends doing your Kegels three to five times a week by squeezing and holding for five seconds, then releasing and repeating for a total of ten repetitions. She says you will notice improvement in six to eight weeks and that after three to six months you may be cured, or nearly cured.

She speaks from experience. “Once I got past an initial aversion to doing Kegels, they became a routine part of my life,” she says. “I’m proud that I had the power to strengthen the muscles and alleviate my problem to a great extent.”