Yes, You Can Stop Wetting Your Pants

Once you hit perimenopause or even before, your urine may start leaking in small drips or gushing like a waterfall — when you’re not in the bathroom. This can happen hourly or once a year.

You do not have to live this way. There are solutions.

Why You Shouldn’t Ignore Urinary Incontinence

Leaking urine is very common. By the time they’re 80, 60 percent of women have some sort of pelvic floor dysfunction, including incontinence, prolapse, a bulge of the vagina or even fecal incontinence. The numbers are probably higher than that because many women are embarrassed and don’t tell anyone -- even their doctors.

Will you die because of urinary incontinence? No. But it is directly related to results that can severely disrupt your life. In fact, one of the top reasons patients get admitted to nursing homes is that their families are tired of changing their diapers and mattress pads. Additionally, urinary incontinence can lead to disorders including:

• The acid in urine can burn the skin off your vulva, causing ulcerations and infections of the skin.

• If you wake up several times a night to pee, you’ll be exhausted during the day. Poor sleep hygiene is related to memory loss and dementia.

• Incontinence can lead to anxiety, depression and isolation.

All of these situations can lead to increased morbidity.

Understanding Stress Incontinence vs. Overactive Bladder

Visit a urogynecologist to find out what’s causing your issue. Chances are you’ll learn you have one of the two major issues: an overactive bladder or stress urinary incontinence.

An overactive bladder essentially means you feel you need to urinate now. One-third of women diagnosed with overactive bladder have it so badly that they can’t make it to the bathroom in time. Others don’t leak urine but they go to the bathroom more than eight times a day or wear protective pads daily; most would never mention this to their doctor.

Stress incontinence, or SUI, means your pelvic floor muscles are so weak they let urine through when you want to hold it in. That might be when you laugh, cough or sneeze, or possibly when you put pressure on your abdominal muscles while exercising.

Among other negatives, these issues can be costly. Pads and diapers are expensive. Ironically, insurance might cover a urogynecology visit, so that might be more budget-friendly than purchasing supplies.

Whether you merely feel the need to pee urgently or actually lose control and wet your pants, urinating will be top-of-mind 24/7 — not a fun way to live your life.

8 Effective Treatments for Urinary Incontinence

With the right diagnosis, you can curtail your urinary issue.

• Lose weight. If your BMI is 25 or higher, losing 10 percent of your bodyweight can cut your urinary incontinence problems in half. Slim down using diet, exercise or the new GLP-1 medications, among other methods.

• Have a sleep study. Obesity can lead to sleep apnea, meaning you don’t get enough oxygen during the night and ultimately might wake up several times and then pee. Do a special test to see if you’d benefit from a CPAP machine at night.

• Do pelvic floor physical therapy. Book an appointment with a licensed pelvic floor physical therapist with a master’s degree or doctorate and a certification in women’s health. These highly educated professionals will assess your situation to figure out which muscles and ligaments contribute to your issues, then work with you to strengthen those areas. You can start this PT — usually covered by insurance — while waiting to see a doctor who’s a pelvic floor specialist.

• Apply vaginal estrogen cream. For an overactive bladder, vaginal estrogen cream is liquid gold. Smear this product onto your finger then into your vagina and it will replenish estrogen, which decreases from perimenopause on. Diminishing estrogen can lead to vaginal dryness, thinner vaginal tissues, bladder irritation, overactive bladder and urinary tract infections, so rejuvenating the tissues can prevent urine leakage. It’s usually inexpensive or free via insurance or independent discount pharmacies.

• Get a pessary. It’s a medical-grade silicone device that you can insert, and remove at will, that decreases stress urinary incontinence by applying pressure to your urethra, the tube urine flows through.

• Try urethral bulking. If that’s not enough, consider an in-office procedure that essentially bulks up the urethra like “filler” fills in facial tissue. About 70 percent of women find it effective.

• Be stimulated. A doctor can use a neurostimulator device in the office to address issues with the bladder nerves, helping overactive-bladder patients.

• Get surgery. If these actions don’t work, ask about surgical options including an FDA-approved mesh sling that hangs like a hammock under your urethra to prevent leaking.

No one treatment will be 100 percent effective, but they’re all likely to lift your burden quite a bit.

This content is not AI generated.