Bladder leakage – what you can do (Part 1)

Hey Ladies: Happy Friday!

I had a few inquiries after my last post about leaky bladders. Some people were shocked at what I revealed (that’s what we are here for, right?) and many admitted they have the same issues as I described in my post.

That’s good, we are talking about it and sharing information!

I told you about different kinds of incontinence but what do we do about it?


1. Kegels – When I asked my doctor about it several years back she told me to do kegels. The problem is she didn’t tell me how. A friend of mine told me her physical therapist said most women do them wrong.

How To Do Kegel Exercises –

You may have heard of Kegel exercises—the squeezing and releasing of the pelvic floor muscles—as a way to strengthen your sex life. But, since they target the muscles that wrap around your urethra, they can also work wonders for bladder control: Research shows that up to 70% of women with stress incontinence who regularly exercised their pelvic floor experienced improvement.

That said, the exercises—named for gynecologist Arnold Kegel, MD, who first wrote about them in 1948—are not as easy as they seem. At least half of women with urinary incontinence have difficulty isolating their pelvic floor muscles, says Benjamin Brucker, MD, a urologist at NYU medical center. If doing Kegels on your own hasn’t been working for you, you might be using the wrong muscles or an improper technique. Try these tips to make sure your pelvic floor gets the best workout possible:


What’s the right way to do Kegels?

  • To get a sense of which muscles you’re working, try to stop urinating mid-stream. That’s the area you want to target during Kegel exercises.
  • Imagine squeezing a pebble with your vagina.
  • Try your Kegels in front of a hand mirror. If you’re doing them properly, your perineum, or the skin-covered area between your vagina and anus, should contract with each rep.

Ideally, each rep should last 10 seconds, but that’s no easy feat. Start with at least 4 or 5 reps of 2-second holds, 2 or 3 times a day, and increase your hold time week by week.

2. Medications – I had no idea there were medications for a leaky bladder. Someone told me recently they take a medication for it and it helps but not totally. See, who knew?


Taken from

Medications for Incontinence – Incontinence and Overactive Bladder Center – Everyday Health// // // // // //

Urge Incontinence Medication
Anticholinergic and antispasmodic medications are most often prescribed to help with urge incontinence (feeling a strong need to urinate even if your bladder isn’t full). These drugs relax the bladder muscles to prevent spasms or contractions, and also may increase bladder capacity. Options include:

One caveat: People with angle-closure glaucoma or urinary outflow obstruction should not use anticholinergic agents.

Studies have shown that the longer-acting forms of these drugs tend to control incontinence better with fewer side effects, which can include dry mouth, constipation, headache, and blurred vision. Since you shouldn’t increase fluid intake while combating incontinence, doctors recommend that patients suffering from dry mouth try sucking on hard candy or chewing gum to promote production of saliva.

Antidepressant medications like doxepin (Sinequan) and imipramine (Tofranil) have also been used for the treatment of incontinence.

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Stress Incontinence Medication
Stress incontinence, which involves urine leakage whenever you sneeze, cough, laugh, lift something heavy, or in some other way place stress on your bladder, is rarely treated with medications, as none are FDA-approved specifically for the condition. Many physicians will first recommend Kegel exercises or surgery, and then, if neither of those is successful, consider off-label use of some other drugs, including:

  • Alpha-adrenergic agonists. These drugs send chemical signals that cause your urinary sphincter to tighten, reducing or eliminating urine leakage. Pseudoephedrine (Sudafed) is the most commonly recommended alpha-adrenergic agonist, and is available over-the-counter. However, the FDA has not approved its use in treating incontinence.
  • Estrogen replacement therapy. Hormone therapy can improve the strength of the urinary sphincter in post-menopausal women. But hormone therapy has been linked to breast and ovarian cancer, and is being used more judiciously by physicians.
  • Duloxetine (Yentreve). This drug has been approved by the FDA for the treatment of depression under another brand name, Cymbalta, and is used by European women to treat stress incontinence. It works by increasing levels of serotonin and norepinephrine, which are believed to strengthen the urinary sphincter muscles. Physicians in the U.S. sometimes prescribe the drug off-label to treat incontinence, too, but its effectiveness should be weighed carefully against possible side effects, which include nausea, headache, constipation, dizziness, and dry mouth.
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