Yes, You Can Hold It In. Here Are the Tricks

One day you’re heading for the bathroom and, before you get through the door, urine pours out. Then it begins to happen periodically. Or maybe you just leak small amounts when you cough, laugh or sneeze, or for no obvious reason at all … five times a day.

These uncomfortable, embarrassing and odorous instances are common in women, especially as they age. Know this: They can be stopped or at least curtailed. The causes are generally either an overactive bladder, meaning your bladder muscles contract before you want them to; or a related condition, stress urinary incontinence, which means you leak urine when you cough, sneeze or laugh even if your bladder isn’t full.

There are ways to retrain your mind and/or your body.

Three Types of Incontinence

Women can have any of three types of bladder control issues. The treatments are different, so get assessed by a doctor before trying to fix your problem.

• Overactive bladder. That’s when urine leaks out, in small quantities or in gushes. You feel like you have to go. Now. So, maybe every 15 minutes, you run to the bathroom. Often, barely a trickle emerges.
• Stress urinary incontinence. This refers to urinating small or large amounts when coughing, sneezing or exercising.
• Overflow. With overflow, your bladder leaks when it’s full. This is rare, and more common in men.

What To Do If You Have Trouble Holding It In

Women often shrug off incontinence issues as part of aging. Seek help, though, and you can solve your problem -- or at least tame it.

You can start with these tactics.

• Write it down. Make a “bladder diary.” For 24 hours, write down every time you urinate, drink a caffeinated beverage, drink a non-caffeine beverage, feel an urge to urinate, leak (detailing the quantity), and change a pad or diaper. Save the info to share with your doctor, as concrete information will not only help you track your situation, it will help with the diagnosis.
• Be careful what you consume. Artificial sweeteners, coffee, and many caffeinated and herbal teas can irritate the bladder.
• Mention it to your gynecologist. The doctor will give you information on the physiological and psychological elements of incontinence. If you think your doctor isn’t taking your problem seriously, get another opinion. Do not get discouraged.

Next Steps in Medical Intervention

Luckily for women with overactive bladders and/or stress incontinence, there’s a medical community willing and able to help. You might find yourself visiting a urogynecologist, a doctor who specializes in the pelvic floor. From there, once you’re assessed and diagnosed, you might proceed to a pelvic floor physical therapist.

Together, these professionals will diagnose which type of incontinence you have, what dietary changes might help it, which exercises might make it better and when it’s necessary to have a surgical or nonsurgical procedure.

Here’s some of what they might recommend, in addition to keeping a bladder diary and cutting back on bladder irritants.

• Kegel exercises. If you have stress urge incontinence, your doctor will test to make sure you do Kegel exercises correctly. (Many women do them incorrectly and can make their bladder issues worse instead of better.) Then, you’ll receive instruction on how to do several different types of Kegel exercises every day; each version strengthens the pelvic floor muscles in a different way.
• Bladder training. Much like potty training for toddlers, some women can retrain their minds to control their urinary urges. If you lose control when approaching a toilet, nearing a running shower, putting a key in the door or encountering another trigger, you’ll be taught tricks to change your reaction. That might mean walking away then doing a series of rapid Kegels, and returning only after the urgency has ceased. This might also involve scheduled toilet trips or other tactics.
• Supplements. Some doctors recommend trying supplements containing magnesium, which is believed to relax the bladder.
• Biofeedback. This involves having a trained expert use an electronic gizmo to retrain your brain-bladder connection.

More Advanced Medical Ways to Address Female Urinary Issues

If low-tech, non-surgical techniques don’t do the trick, your doctor might suggest a more aggressive alternative, including:

• Pessary. Your doctor might insert a pessary, which is a ring that fits into your vagina. This nonsurgical option supports your inner parts, like a bra for your bladder, and sometimes cures or curtails incontinence.
• Transurethral bulking. This low-risk surgical option involves narrowing the urethra by injecting a substance such as collagen around it. It has an improvement rate of at least 70 percent. You’ll likely need to have it redone every few years.
• Mid-urethral mesh slings. A second surgical option, this involves inserting a 1-centimeter strip of polypropylene mesh sling under the urethra. In part thanks to scar tissue that grows following the 15-minute surgery, this procedure can be up to 90 percent effective and last for life.
• Medications. Some prescription medications can help with bladder control issues.

In the end, you can enjoy your days without a urination-related burden. Women who have received treatment for overactive bladder and stress urge incontinence are often thrilled with the results. They no longer dress only in black since dark colors hide leaks better. They’re less timid about socializing outside the house for fear of an accident in public. And, since they no longer feel unclean, they are more able to be intimate with their partners.

Take charge. Change your lifestyle back to active — with no pads, no leakage and no gushes.