Options to Help Women’s Bladder Control Issues

by Jeanie Lerche Davisf for WebMD Feature — May 5, 2003

reviewed by Brunilda Nazario, MD

We’ve seen the TV commercials. When you gotta go, you gotta go, go, go. But make no mistake, it’s no laughing matter. Occasional urinary incontinence happens to millions of Americans – and up to 25% of women are affected by it. “It’s an enormously prevalent problem,” Rony Adam, MD, a urogynecologist at Emory University School of Medicine, tells WebMD. It is important to look for options to help women’s bladder control issues.

Norman Zinner, MD, professor of urology at UCLA, “It is an exceptionally common problem, very troublesome. It causes a lot of lost workdays, embarrassment, and shame. Many women think it’s part of getting old, but it isn’t.”

For some women, the cure may be simplistic — drink less water, says Adam. “People are drinking lots of water these days, maybe 10 liters of water a day. I have a lot of patients who think they have stress-related urine leakage, but we find out they’re flooding themselves with water. That can overwhelm the most normal bladder.”

Also, what you drink can stimulate the bladder and make it more sensitive, he says. Caffeine is a diuretic that stimulates the bladder muscle. Coffee, tea, soda drinks, chocolate – especially dark chocolate – have caffeine. Cut the caffeine, cut the problem.

Stress-related urine leakage, typically activity-related, is loss of urine when you sneeze, laugh, or exercise, which puts pressure on the bladder. It is the most common type of bladder control issues in women, doctors say. “It’s an architectural problem,” says Adam. The support system for the bladder has been damaged – through pregnancy and childbirth, or possibly the effects of aging, he explains.

Another bladder control issue is the occasional urge to urinate that is so strong you cannot reach the toilet in time – even when your bladder contains only a small amount of urine. “The bladder does not stay calm; it contracts and squeezes whenever it feels like it,” says Adam. “When it feels full, it contracts. It’s like bladder action before potty training.”

As women get older, bladder control can deteriorate. Declining estrogen causes vaginal and bladder tissues to atrophy, leading to occasional incontinence, he explains. Also, gaining too much body weight puts pressure on the urinary system, which can cause bladder control issues.

Even occasional constipation can lead to occasional urinary incontinence – the proximity of the bowel and bladder mechanisms can lead to problems with both, says Adam. “It may be a coordination of nerve impulses, since the nerve supply to the pelvis and the rectum is the same.”

With occasional incontinence issues, exercise may work. Adam first helps resolve any occasional constipation problems. Then, he teaches women to do Kegel exercises (which strengthen muscles supporting the pelvis) and biofeedback (to retrain bladder muscles). “Basically, women are learning to deal with it a little better – to squeeze before you cough, which helps keep the bladder in position,” Adam tells WebMD.

Estrogen creams can make the vagina more pliable, which helps women regain control. Also, an E-string (a small, flexible plastic ring placed in the vagina) can deliver just enough estrogen to solve the problem. “You don’t feel the ring; you can have intercourse with it. It stays in place for three months at a time, and it works for both kinds of incontinence,” says Adam. “Bladder training”-learning new muscle control techniques-can help.

The Alternative

Peipei Wishnow, PhD, helped develop BetterWOMAN, a 20-herb mix based on a formula used in traditional Chinese medicine. The mix can be taken for stress-related urine leakage, occasional urge incontinence and for frequent urination, she tells WebMD. Wishnow heads the company that produces BetterWOMAN.

The herbal mix “naturally moderates hormones, so it strengthens bladder muscles naturally, to help women regain control,” she tells WebMD. “It also improves blood circulation in the bladder area and modulates neuromuscular function.”

In her two-month study of 45 women, there were 75%-80% improvements in urinary function. Those women who continued taking the herbs after the study’s end also had some “sexual benefits” – increased vaginal lubrication, increased libido, and more orgasms, she reports.

“Very, very good results,” says Wishnow. “Women don’t have to suffer.”

SOURCES: Rony Adam, MD, a urogynecologist at Emory University School of Medicine, Peipei Wishnow, PhD, president of Interceuticals, Inc.. Norman Zinner, MD, professor of urology at UCLA. News releases, Eli Lilly and Company, Yamanouchi Pharma America, Cohn & Wolfe Healthcare, Interceuticals, Inc.. WebMD Medical News: “HRT Increases Risk for Incontinence.” WebMD Medical Reference from Healthwise: “Urinary Incontinence in Women.” © 1996-2003 WebMD Inc. All rights reserved.

Note: This is the Abstract of the original article, edited to conform to the dietary supplement regulations.