The Scariest Article You'll Ever Read About Your Ladyparts
"Why can't I control my bladder?"
If you're like me — and about 18 million other women, according to the
National Association for Continence — and lose a little pee whenever you have a
sneezing fit, you have stress urinary incontinence (SUI), a condition that
causes you to leak small amounts of urine due to physical pressure from
coughing, laughing, lifting, running, and the like. Anna Albrecht, 44, of
LaGrange, IL, sprung her first leak at the gym. "I started skipping rope, and
splash! Suddenly I was all wet," she says. "I was mortified."
Blame it on: A weakened seal between your bladder and urethra (the
little tube you pee out of). Typically, women who've stretched their
pelvic-floor muscles during childbirth are the most afflicted, especially if
they had a large baby or pushed for two or more hours. Weak pelvic-floor
muscles can be a trigger too. But just being female is a risk factor, whether
or not you ever give birth, Romanzi says. Studies also show that obesity and
smoking increase your risk. One third of women with SUI also have overactive
bladder (OAB), a debilitating condition in which you suddenly have a strong
urge to pee or your bladder muscle spontaneously contracts, sending a wave of
urine into your pants.
The fix: The good news about this embarrassing condition is that the
treatment is simple and effective. Pelvic-floor exercises such as Kegels, which
tone and strengthen the muscles around the bladder and vagina, have been shown
to stop leaks. In fact, up to 70 percent of women who do pelvic exercises with
a trained physical therapist see significant improvements after three months,
Romanzi says. (Note to self: Start doing Kegels!) Anna fixed her problem by
regularly doing exercises that target the "pelvic pyramid," a group of deep
muscles in the abdomen, back, and pelvis. (Go to totalcontrolprogram.com to
find a comprehensive regimen developed by the Women's Health Foundation.)
Another alternative is the injection of a filler that temporarily plumps up the
urethral seal, making it leak-proof. There are also minimally invasive
procedures, such as tension-free vaginal tape and the transobturator sling,
that support the urethra and bladder by means of a ribbon or sling threaded
through the vaginal wall.
For women with OAB, treatments include pelvic-floor exercises, dietary changes,
biofeedback, bladder training (or timed voiding, meaning you go to the bathroom
at specific times), Botox injections, and medication. "Look into pelvic-floor
exercises and other nonsurgical treatments before committing to an operation or
chronic medication," Romanzi says. Talk to your gynecologist to decide which
approach is best for you.
Kegels 101: Strength-Train to Hold on Down There
Doing Kegel exercises can help prevent future pelvic-floor disorders by
bolstering those muscles. Bonus: It'll also improve your sex life by giving you
more control over vaginal contractions, leading to more powerful orgasms and
greater sensation for you and your partner, since you'll be better able to grip
him during intercourse, says Ilana Addis, M.D., a urogynecologist at the
University of Arizona College of Medicine in Tucson. Here's how to get the best
1. Locate your sweet spot. Before you can start strengthening your
pelvic floor, you've got to know where it is. You know the muscles you squeeze
when you're trying not to pee? Those are your pelvic floor muscles.
2. Learn the right moves. "Kegels, like any other exercise, are most
effective when you do them in sets," Addis says. Squeeze for 10 seconds, then
relax for a few seconds. Do three sets of 10 contractions a day. Eventually
work up to 15 contractions for 15 seconds.
3. Turn them into a habit. To keep your muscles toned, you've got to
exercise them every day. Make Kegels a part of your routine by piggybacking
them onto another daily habit, such as making your morning coffee, brushing
your teeth, or showering.