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4 Common Urinary Problems and How to Treat Them

4 Common Urinary Problems and How to Treat Them

Originally published for Health by Aviva Patz

OK, real-talk time: About half of all women will have urinary problems at some point in their life, according to the National Institutes of Health. And these issues tend to crop up more over time. “Lots of factors come into play,” says Benjamin Brucker, M.D., an associate professor of urology and obstetrics and gynecology at NYU Langone Medical Center. “Hormones change, pregnancy and delivery have an impact, the bladder ages, and other medical conditions that could make pee problems worse become more common.”

Often, though, the solution isn’t clear. There are several types of urinary issues you may be suffering from. Find the treatments and strategies for the most common toilet troubles below.

To beat stress incontinence ...

Stress incontinence refers to urine leakage when movement puts pressure on your bladder: coughing, sneezing, running or other physical activities may trigger this. Your first move is to do pelvic-floor exercises (aka Kegels), which firm up the hammock of muscles supporting your pelvic organs. If you are really wetting yourself, consider a removable device: a vaginal pessary (which physically props up the bladder and urethra) or a disposable vaginal insert (it’s inserted like a tampon and supports the urethra to reduce leaks). Surgery is an option too. Laser and radiotherapy treatments are also being touted as effective for stress incontinence, but the technology is new and needs further study.

To beat an overactive bladder ...

Increased frequency or urgency of urination signals an overactive bladder. Start by cutting back on food and drinks that can irritate the bladder; common culprits include coffee, tea, alcohol, carbonated drinks, artificial sweeteners, citrus and spicy foods. Mastering Kegels (on your own or with a pelvic-floor physical therapist) can also make a difference. “Squeezing and relaxing your pelvic-floor muscles can help ease urgency problems in the moment—or just give you more time to get to the bathroom,” says Jeannine Marie Miranne, M.D., a urogynecologist at Brigham and Women’s Hospital in Boston. Another strategy: emptying your bladder on a schedule, starting with smaller intervals, like on the hour, then working up to every two to three hours. The next step is medication, including anticholinergics, which help prevent bladder spasms, and Myrbetriq, a drug that works by relaxing the bladder muscle. Botulinum toxin (Botox) is a third-line option. It’s injected into the bladder muscle, which may help prevent the muscle from contracting excessively. Another procedure involves stimulating one of the nerves in the leg, which affects the nerves going to the bladder.

To beat interstitial cystitis ...

Pain and pressure in the bladder may be caused by a chronic condition called interstitial cystitis. Pelvic-floor physical therapy helps provide relief, as does stress reduction: “IC tends to flare up under stress,” says Miranne. Low-dose tricyclic antidepressants can help block pain; the prescription medication Elmiron may protect the bladder lining against irritation. Numbing medications delivered to the bladder via a catheter can offer relief as well. Some people find temporary improvement after a procedure called cystoscopy with bladder distention, in which doctors fill the bladder to capacity with water.

To beat a urinary tract infection ...

When you’ve got a urinary tract infection, your doctor will likely prescribe antibiotics. Lower your risk of UTIs by avoiding tight undies, drinking plenty of water, not holding in your pee, peeing after sex, and using a vaginal estrogen cream after menopause to help keep tissues healthier and less prone to infection.

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