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Too Embarrassed To Tell Your Doc?

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STAT It's the most common form of incontinence in women, affecting one in four from ages 25 through 44 and one in three from 45 through 64.

BEST FIXES Start with low-tech solutions, which significantly improve or even "cure" stress incontinence for most women:

WEIGHT LOSS Dropping pounds eases the pressure on your bladder and pelvic floor, says Kristene Whitmore, M.D., chair of urology and female pelvic medicine and reconstructive surgery at Drexel University College of Medicine in Philadelphia. "In one study, women who lost 17 pounds reduced leaking episodes nearly 50%." Even those who lost a mere three pounds were 28% drier.

SMARTER SIPPING Chugging multiple cups of coffee inflates your bladder like a ready-to-burst water balloon. Instead, sip water or herbal tea slowly, over a half hour or an hour, Dr. Whitmore suggests. Cut back on caffeine, carbonation, alcohol, artificial sweeteners, citrus, and tomato juice, all of which can irritate your bladder.

DAILY KEGELS For nearly half the women in a 2010 study, pelvic-floor-strengthening exercises helped a lot, stopping at lea)

STILL LEAKING? A specially fitted vaginal pessary, a rubber device somewhat like a contraceptive diaphragm, can lift your bladder and keep your urethra shut. Sling surgery uses a synthetic material to support the urethra in a position that reduces pressure. Another option: injections of a gel-like substance to thicken the wall of the urethra. Your M.D. can help you figure out which option is best for you.

Scenario 2

You have sudden urges to go — and can't always hold it

DIAGNOSIS Overactive bladder/urge incontinence (or "tiny bladder syndrome")

WHAT'S HAPPENING Your bladder is calling the shots instead of your brain. "As your bladder fills with urine, it decides when it wants to go — contracting even though the brain hasn't sent the signal," explains uro-gynecologist Shameem Abbasy, M.D., of Swedish Covenant Hospital in Chicago. Diuretic drugs, diabetes, nerve damage, and serious neurological conditions can cause this disconnect, though in most cases, no one knows why the condition develops.

STAT Some 17% of women have experienced the "gotta go now" symptoms of overactive bladder. A third of them also have stress incontinence.

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