
photo: Daniela Vladimirova
Isn’t it strange that a condition that affects up to a third of all women, especially those over 40, is such a hush-hush topic?
Well let’s face it, no one wants to talk about the tendency to pee their pants whenever they hear a good joke.
(Okay, if you’re wondering what this could possibly be about and you’ve never noticed such a problem in your life, this article is probably not for you. Guys, that probably means you! Go on, there’s lots of other fun stuff to read on this blog, No, really – get out of here!)
Most women are too embarrassed to even mention this to their doctors. Especially if it’s only a once-in-a-while problem. And so we continue to suffer in silence, and worse – sometimes we even suppress our healing laughter for fear of the consequences.
It’s not just laughing of course; coughing, sneezing, movements like jumping and dancing can release some of that tightly held bladder control.
This is known as ‘stress’ or ‘giggle’ incontinence, and is the most common form of this unwelcome condition.
You’re Not Alone
I’ve started a crusade to get this thing more out in the open – and to spread the word about some of (relatively) easy fixes for the problem (depending, of course, on the degree of intensity.) That’s because it’s all gotten a little out of hand for me in recent years. And I’m just like everyone else – usually too embarrassed to discuss it, even with my friends.
That potty training shame goes deep apparently.
Urinary incontinence affects 10-35 percent of all women, with 35 billion American women throwing down cash for pads and treatments. In fact more menstrual pads are sold for incontinence than for menstruation!
Symptoms vary from the occasional drip now and then, to needing a drawer full of Depends. For most this condition fluctuates throughout the reproductive cycle.
Causes of urinary incontinence
Loss of hormonal support in the vagina and lower urinary tract at midlife can be a culprit for many women. Others notice the onset of urinary incontinence after giving birth. Sometimes neurological disorders can result in incontinence.
If this is something you’ve been keeping secret, it’s time to let go of the shame. You’re not alone in this, really and truly, so don’t be afraid to talk to your doctor or health practitioner. Believe me, he or she has heard it before!
I’ve struggled with a few urinary tract issues throughout my life – and I have no problem announcing that I have a pea-sized bladder when I’m getting up for the thirdntime in an hour to use the bathroom. But the incontinence was only a vaguely annoying affliction that occasionally appeared just before my period. It reared up during my pregnancies and in the weeks after childbirth. But nothing to get my undies in a bundle about (sorry!)
Then, as perimenopause kicked in I began to notice a greater frequency to the problem.
The worst was when it was time to do jumping jacks (or some other crazy jumping move) at the gym. I wouldn’t even feel like I needed to urinate, but as soon as I started bouncing up and down…well, ooops. Not enough to be noticeable to anyone else, but certainly enough to make me uncomfortable.
And it didn’t matter whether I used the bathroom directly before the workout. Jumping jacks always caused those pelvic floor muscles to wimp out. Even worse than the gym is when I’m out at a music show and get kind of excited about the dancing (as in jumping, feet leaving the floor.) Oopsie time again! Talk about feeling like an old lady!
It used to happen mostly during the week before my period, but now that I have no idea when my period will be, I guess it’s just during certain hormonal cycles. The severity of my own urinary incontinence seems to ebb and wane, and now that I’ve done a little research and begun implementing some fixes, it’s definitely more on the wane – and it can be for you too!
Turn Off The Drip
The good news is that at least 80% of women who battle urinary incontinence can regain almost normal control through natural means. The number one way to turn this thing around is by practicing the good old Kegel. Add in a few other lifestyle changes, plus perhaps a few herbal teas, and your laundry needs may lessen.
1) Do Your Kegels
Most of us learned about these famous exercises (named for the gynecologist Arnold Kegel who invented them in 1948) while we were pregnant – or while a friend was pregnant. Turns out, we’d have been better off if we’d kept up the practice in the years of raising the kids. (I know, I know, they told us to do that – but who really kept on kegeling once their baby was crawling?
Kegels strengthen the muscles of the vagina, pelvic floor and urethra, allowing more control over the release of urine. Plus there’s the added benefit that toning all of these muscles can increase sexual pleasure (always a welcome prospect at midlife!)
Now, I’ve known for years that I ‘should’ do more Kegels to address this intermittent issue of minor pants peeing – but I’d always forget. Recently I got serious, read up on them again and boy was I glad because I realized I’d kind of forgotten how to do them. Or maybe there’s an update on the system, but yeah – it makes a difference to pay attention to correct practice of the Kegel.
HOW TO DO KEGELS:
Squeeze your vaginal muscles (the same ones you would use to halt the flow of urine) and hold for a slow count of ten. Relax for five seconds and then repeat. Best if you do five sets of these at least three times a day. It’s important to clench only the vaginal muscles – you can practice while urinating to see which ones they are. Kegels don’t work the same if you are contracting other muscles at the same time (such as abdominal or buttock muscles) so it takes some practice to get this right.
Dr. Kegel advised five clenches before getting out of bed, five more once up and then five every half hour throughout the day – that’s a lot! Even 10 a day will help. Studies have shown women who do 40 a day for three months have controlled or cured their incontinence.
Silly to skip it really, since it only takes about a few minutes out of our day – plus you can actually do other things while you are doing your Kegels, at least once you get the hang of it. But – if you’re a bit absent minded like me – how to remember?
Well, I got this nifty new intention setting app for my phone, so now I set it to chime at me every day at a specific time with the simple words: KEGEL! My inner child loves this.
No smart phone? You could also set up a reminder on your computer calendar if it is enabled for that. Just like those five minute movement breaks I wrote about a few months ago – your calendar could give you a quick reminder to Kegel.
If all this tecchie stuff sounds a little ridiculous to you, just find a way to remind yourself each day. Those little notes placed in conspicuous places work for a while – until you forget to notice them. That’s when its time to move the note to another location.
Soon the habit will be built. The trick is to actually do the Kegels AS SOON AS you see the reminder. Otherwise, well you know. It’s gone again.
This simple technique is often all that is needed to curtail urinary incontinence. Try Kegeling religiously for 30 days and note the difference.
If the improvement isn’t enough for you, or you want to do even more, there are other options to dealing with this pain in the you-know-what. (Just full of puns today…)
2) Kegel Exercise Weights
As the name implies, this is billed as an improvement on the plain old Kegel. I’ve never tried them, but Dr. Christiane Northrup talks them up in her book, The Wisdom of Menopause , so who am I to argue? It’s based on an ancient Chinese technique (and that was probably about more than treating incontinence!)
Basically these are cone-shaped weights that you insert and hold in place at least five minutes twice a day, gradually increasing your time to 15 minutes. Northrup says the cones allow you to automatically use the correct muscles. If you’re using these consistently, you can expect improvement within 4-6 weeks. You can find some here
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2) Find The Pattern, Keep a Record
Almost as important as the Kegel is to find out what circumstances and/or substances exacerbate the problem. Use a special notebook or datebook to record when you experience incontinence, how severe it is, foods or activities that preceded the problem.
Sometimes just an awareness of the triggers can help you to get rid of the problem.
3) Cut back or eliminate the caffeine
Everyone’s least favorite recommendation (well at least some of us.) Yet, unfortunately caffeinated beverages are bladder irritants. So if urinary incontinence is a serious problem in your life you might want to see how it goes if you at least reduce how many cups of coffee and tea, or sodas you drink in the day.
4) Add in the unsweetened cranberry juice.
This stuff is like a magic healing bladder potion. I’ve seen so many women heal bladder infections simply by drinking cranberry juice. But I’m not talking about that sweetened stuff. You have to get the bottle that specifies “pure and unsweetened” on the label. But don’t drink it straight! Dilute about 2 tablespoons per 8 ounces of water – and drink as much as you can during the day. Cleansing and refreshing!
If this just doesn’t float your boat, you can also purchase cranberry in capsule form.
5) Make friends with a Dandelion – root that is.
Dandelion root is known to tighten the bladder sphincter. Try it as a tea (use raw rather than roasted roots), or as a tincture or in capsules.
6) Smooth urinary tract with herbal allies.
Certain herbs and foods have a ‘mucilagenous’ quality which coats and soothes the urinary tract. Not only can these work to prevent dribbles, they will also strengthen the area to prevent bladder and urinary infections. Try corn silk, flax seeds, goldenrod, marshmallow or plantain leaf.
7) Create healthy relationship boundaries
Dr. Northrup points out that natural approaches only go so far to alleviate midlife pelvic problems such as urinary incontinence. It’s crucial to take a look at underlying emotional issues, which in the case of the pelvic region often have to do with your need to reclaim your own individuality and creative power. This can often mean getting more assertive about your boundaries with others.
If this notion is ringing some bells in your psyche, I suggest you claim some time to look within and meditate on how such a change could look in your life. (You can even do a few Kegels while you’re doing this!
Please note: if your incontinence is severe, painful or appears to be due to an infection, get yourself to a medical professional for an examination.
I hope you got in a few Kegels while reading this! Even if incontinence is not a problem for you, Kegels are still your friend for life!
If you’re hip to some natural tips that I haven’t included here, please share in the comments.
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Thank you for writing this post Sarah.
Being a woman, though it is not brought up in conversation, we have been made aware of urinary incontinence for example after childbirth and the need of pelvic floor exercise.
Lesser known and even less talked about is that men develop prostrate problems as they age. I am adding this link for all of the men and the important people in their lives. http://www.youtube.com/watch?v=90ZQPNOo5vE
@Priska Thanks so much for that helpful info and link, Priska! You’re absolutely right – this is not an issue exclusive to women! It’s certainly more common to women – and my guess is it’s most common in women who have given birth – but it’s a hush-hush topic for all kinds of people. Too bad we have to feel much shame around it.
I did do some Kegels while reading this, Sarah! I’m just like you were – I know how important Kegels are, but I have a hard time remembering to do them. What is the intention app you referred to? Perhaps that might be helpful for me.
I know it may have felt a little silly to write this post, but it’s really important stuff! So many of us have embarrassing little “incidents” when we really don’t need to. So, THANK YOU, for putting this out there!
@BobbiEmel , Glad I got you kegeling while reading Bobbi! The app is called “Intention Reminder” and is meant not just for goals and reminders but deeper intentions too. It was recommended to me by Bridget Pilloud , I believe she knows the 2 women who put it together. It’s one of the 99 cent ones – but I thought I could afford it…:-) Check it out!
“No, really – get out of here!” Don’t be so mean, Sarah
Just because I’m a guy doesn’t mean I don’t have a passing familiarity with the issue.
Ah, more than a passing familiarity… among other things, I’ve had that fun ole procedure known as a cystoscopy. The beautiful travails of being me. If only I was born a women – then it would all be normal.
The doc gave me a bunch of pills. When I told him they didn’t help, he too told me I should have been born a women.
Okay, fake anger aside – this is perhaps the most useful of your not-for-a-male-audience articles I have ever read. Perhaps. We shall see. Time to do some kegels.
@HappierHuman Wow, you have edified me Amit! I knew that men dealt with this sometimes, but didn’t realize that even younger guys sometimes faced health conditions that could cause the problem. But I can’t say I’m too impressed with your doctor’s understanding and advice! Hope the kegel idea helps – if not, I be there are some resources out there for similar exercises for guys. And you’ve convinced me: I think I’ll take out that ‘mean’ line. I’m glad you didn’t ‘get out of here!’
I’m with Amit. This indirectly affects guys as well.
Well done, Sarah!
And if a couple guys took the time to read it thoroughly, logic would follow it’s well-written and interesting, right? (It is)
@RebootAuthentic Thanks for the encouragement on the writing! And I’m so glad the topic didn’t stimulate too much of hte ‘ewww factor’
Great article. This was a really big concern for me recently as I had a vaginal hysterectomy. My fear of causing additional or exaggerated symptoms, was enough to keep me following the docs orders to the letter. Now that I have the okay to get back to working out, it is the time for kegals. I definitely have an issues with remember, but I just thought of something I can link it too. I have a reminder on my phone for drinking water, I can just add the kegals at the same time.
Thanks for bringing us out of the closest!
@LoriLynnSmith Oh, glad this was useful and spoke directly to your situation Lori. Now I have to go look up that sort of hysterectomy – it’s one I’m not familiar with.
And yes – getting in the habit of doing your kegels whenever you drink water is a perfect way to incorporate them into your life. You probably want to do several sessions each day. And then you’ll be strong as ever I bet, and good to go (when you want that is LOL).
Brilliant and much needed article, thank you so much.
Glad it could be helpful to you Molly!
Hi Sarah,

Hope you don’t mind me reading all the way through despite being warned off
I think it’s useful for everyone to be talking about this, even if it only helps to lessen the ‘embarrassment’ factor.
We’re all getting older and, male or female, we’ll all have potentially embarrassing issues to deal with as a result. Like others have said this affects men, too, and if I am lucky enough to dodge this problem I’d want to be informed enough to be able to support my wife if she was ever affected.
Cheers,
Dave
Thanks Dave! I sure do love to listen to the words of an open minded man. And you’ve reminded me to take away that warning sentence! Clearly there are guys who don’t mind reading about this stuff – even if it’s not something that affects them personally. Plus, I’m on a mission to end the stigma on this subject that does not NEED to be embarrassing! So glad your interest was held till the bottom of this lengthy piece!