Sex, Exercise, and Stress Incontinence

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The Emotional Toll of Female Incontinence

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Menopause and Urinary Incontinence

Bladder Sphincter MuscleWomen don’t have to accept occasional bladder leakage as just another side effect of menopause or aging. In many cases, there are things you can do to stop and even prevent urinary incontinence.                    

Overview

Urinary incontinence (UI) is also known as “loss of bladder control” or “urinary leakage.” Millions of women experience UI, and the frequency of involuntary loss of urine becomes more common as you get older. The loss can be very minor—you might only leak a few drops when you laugh, exercise, cough, or pick up heavy objects. Or, you may experience a sudden urge to urinate and can’t keep it in, resulting in an accident.

Women can experience UI throughout their lives, but most episodes are the result of pressure or stress on the muscles and nerves that help you to hold or pass urine. Hormone changes could also affect muscle strength. Therefore, UI is more common in women who are pregnant, giving birth, or going through menopause.

Estrogen, a hormone that helps regulate monthly cycles, may protect against heart disease, and may slow bone loss, also helps keep the bladder and urethra healthy and functioning properly. As you near menopause, your estrogen levels begin dropping. This lack of estrogen may mean that your pelvic muscles are no longer able to control your bladder as they did before, and that urethral tissues may have weakened. As estrogen levels continue to drop throughout menopause and after, UI may become worse. 

A few different types of urinary incontinence are associated with menopause. These include:

Stress Incontinence

The most common kind of bladder control problem in older women is stress incontinence. Weakened muscles can’t hold back urine when you cough, exercise, sneeze, laugh, or lift something heavy. The result can be a small leakage of urine or a complete loss of control. This type of incontinence is most often caused by physical changes that result from pregnancy, childbirth, or menopause.

Urge Incontinence

When your bladder muscles squeeze incorrectly or lose the ability to relax (so that you always feel the urge to urinate even when your bladder is empty), you may experience leaking or loss of control. This is sometimes called “overactive bladder.”

Understanding The Risk

Menopause isn’t the only cause for bladder control problems, but combined with one of the following conditions, your risk for developing urinary incontinence increases.

Drinking Alcohol or Caffeine

Drinks with alcohol or caffeine fill the bladder quickly, which means you have to urinate more often.

Infections

Infections of the urinary tract or bladder may cause temporary UI. When the infection is cleared, UI will likely also be resolved.

Infections

Damage to nerves can interrupt signals from your bladder to your brain so that you won’t experience the telltale signs that you need to urinate. Therefore, you will not be able to control urination.

Certain Medications

UI can be a side effect of some medicines, such as diuretics or steroids.

Constipation

Chronic (long-term) constipation can affect bladder control. It can also weaken pelvic floor muscles, making it harder to hold in urine.

Being Overweight

Carrying excess weight increases your risk for UI. The extra weight puts pressure on the bladder and can cause UI or make it worse.

Treatment Options

How your urinary incontinence is treated depends on several factors, including the type of incontinence you’re experiencing. Many doctors will begin initial treatments by suggesting possible lifestyle changes. These include:

  • cutting back on caffeine and alcohol consumption
  • gradually retraining your bladder to hold more urine by only urinating at certain, pre-planned times of the day
  • striving to lose weight to reduce the pressure on your bladder and muscles
  • using Kegel exercises to strengthen pelvic floor muscles

Your doctor may recommend more involved treatment options, especially if they don’t think lifestyle changes are helping. These options include:

Medications

Medications can reduce the symptoms of and treat some types of UI.

Nerve Stimulation

Electrical stimulation of pelvic muscles may help a person regain control of the bladder.

Devices

A pessary is the most commonly used device for the treatment of stress incontinence. This device is inserted into the vagina and helps reposition the urethra in order to reduce leakage.

Biofeedback

You can work with a therapist to better understand how your body works and learn how it alerts you that you need to use the bathroom. A wire connected to an electrical patch over your bladder and urethral muscles sends signals to a TV screen that alerts you when your muscles are contracting. By learning when they contract, you may be able to gain better control over them.

Surgery

Surgery to repair and lift the bladder into a better position is often the last resort for UI treatment. It’s reserved for people who couldn’t be helped by other forms of treatment.

Written by Kimberly Holland                                                                                              Copyright © 2005 – 2013 Healthline Networks, Inc. All rights reserved.

 

Incontinence & Skin Care

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Skin problems that are caused by urinary and fecal incontinence are hard for both patients and their caregivers to deal with. The most common form is perineal dermatitis, which scientists say happens with a third of patients with fecal incontinence. You may have this condition if you have red, itchy or burning skin on the upper leg and buttocks.

If not taken care of, it can cause skin to flake and rub off. Because this area is hard to reach and comes in contact with urine and stool, wounds that form there have a better chance of getting germs in them. This makes it more likely you can get a UTI (urinary tract infection) and pressure ulcers. But the chance of getting perineal dermatitis can be greatly lowered by taking care of your skin.

You can do this with special cleaners that remove waste and put your skin back in its regular chemical balance, and creams or lotions that protect and heal the skin.

Here are three tips to help protect your skin:

Cleaning RegularlyOne of the most important things you can do to take care of your skin is wash the area each time you have incontinence. You also should wash it after using a catheter insertion or fecal collection system, or if you use absorbent pads and briefs. While absorbent products may make you feel dry, they may leave behind waste that can press against the skin, making it red and itchy.

    1. Balancing Your Skin pHWhen urine and waste rub against your skin, they can change the chemical balance, or pH level, of your skin. This wears down the skin’s thin, outside layer, known as the acid mantle, and can lead to dermatitis and other skin problems. Keeping a slightly acidic pH level helps keep germs from growing on your skin. Some soaps and cleaners can have a bad effect on your skin’s pH. Most bar soaps are highly alkaline (non-acidic), which can take away your natural oils and leave skin dry, red and itchy. But soap that is too acidic also can take away these oils and strip away your skin’s outside layer. So, choosing the right skin cleaner for the area where you have incontinence is very important.
    2. Moisturizing – Applying medicine that has chemicals such as zinc oxide to the upper legs and buttocks after you wash them can help keep skin soft, smooth and healthy. It also keeps it dry and will not wash away when urine or feces rub against the skin. Some products also have ingredients that help stop germs and fungus from growing. Some studies show that the use of skin lotions, creams and other medicine can lower the chance of getting skin problems and sores by 50% or more. Keep in mind, if you have red, sore skin, try using a no-rinse perineal cleaner. It goes on as a foam and does not require rinsing or rubbing, which can irritate sensitive skin. This may be covered by your insurance.

Protecting the skin from incontinence with Fecal Management Systems

There are incontinence products called fecal management systems that can help lower the skin’s exposure to watery waste. Like an indwelling catheter, these are made of a thin, bendable tube with a balloon at one end and a flange at the other that connects to a bag.

The balloon end is put into the sphincter and blown up with a small amount of water to keep it in place, and the tube is taped to the skin.

Fecal management systems can be left in place for several weeks before you have to use a new one. While more study is needed, one small study showed skin health stayed the same or got better in more than 92% of people who used a fecal management system for about four weeks.

Incontinence & Skin Care | Edgepark Medical Supplies Blog.

Urinary Incontinence – What Every Man Should Know

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