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Too Embarrassed To Tell Your Doc?

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MIND-BODY THERAPIES Hypnotherapy with visualization techniques and mindfulness-based stress reduction are both showing promise for urge incontinence. In one small study, the hypnotherapy/mental-imagery approach helped cut the average number of urge episodes by at least half per week.

Anna Raisor, 56, who works in website technology for a large corporation, had mixed stress and urge incontinence that began in her 30s and kept her from meeting friends for dinner or taking her two children on outdoor adventures. "I went for help when it got so bad I couldn't get in the door after work without an accident," says Raisor, who lives in Oak Park, IL. "The training helped me learn to relax and hold it, even on the commuter train."

QUICK FLICKS Kegels also come in handy, says Florendo: "When you have the urge to go, doing a couple of fast squeezes — called 'quick flicks' — can calm the bladder."

STILL LEAKING? Try acupuncture. In one Oregon Health and Science University study of 85 women, just four weekly sessions reduced accidents 59%. And there are many medications — tolterodine (Detrol) and solifenacin (Vesicare) are well-known ones — your doctor may prescribe.

 

Scenario 3

Burning pain and frequent urges, plus cloudy urine and sometimes fever

DIAGNOSIS A urinary tract infection (UTI)

WHAT'S HAPPENING Thanks to its short length and its proximity to the rectum, a woman's urethra practically encourages bacteria to come on in. Sex leads to nearly 80% of bladder infections before menopause. Low estrogen after menopause boosts UTI odds by making the vaginal wall thinner and more susceptible to bacteria, which can be transmitted to the bladder, Dr. Abbasy says.

STAT About 50% of women have had at least one UTI; some 20% to 30% get repeat infections, often as frequently as every few months.

BEST FIXES Skip the cranberry juice — two cups a day worked no better than a placebo juice to stop repeat UTIs in a 2010 University of Michigan study of 319 women. Instead, try:

ANTIBIOTICS Generally, doctors prescribe a three- to seven-day course of a bacteria-fighting drug like sulfamethoxazole and trimethoprim (Bactrim) or ciprofloxacin (Cipro). "But drug resistance is growing," Dr. Whitmore says, "so you may need a different antibiotic to stop an infection." If you tend to have recurrent UTIs, your doctor may prescribe a longer course of a low-dose formula. In a 2011 European study of 221 women prone to repeat UTIs, those who took antibiotics were half as likely to have another infection as those who took capsules containing a cranberry extract.

ESTROGEN CREAM For postmenopausal women, topical estrogen cream, applied in very small quantities on or inside the vagina, strengthens tissue in the urinary area, says Dr. Whitmore.

EVERYTHING YOUR MOM SAID Wiping front-to-back, especially after a bowel movement; changing out of a wet bathing suit pronto — Mom was right. (Urinating after sex, which she might not have mentioned, is also wise.) Probiotics, found in yogurt with live active cultures (check the carton), may help, too. So can wearing cotton-crotch underwear, which makes the area drier and less bacteria-friendly.

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