If you have urinary incontinence or if your incontinence problem seems to be getting worse, take stock of your medicine cabinet. Commonly used drugs could be the cause of your incontinence, or at least be a contributing factor.
If you suspect medications may be worsening urinary leakage or even causing it, let your doctor know about all the medicines you take, both prescription and over-the-counter. That way, your doctor can help determine whether these medicines should be adjusted or stopped, or if a treatment should be modified.
Here are the most common drugs that can worsen or cause urinary incontinence:
1. High Blood Pressure Drugs and Incontinence
Also called alpha-adrenergic antagonists or alpha blockers, these high blood pressure drugs -- including Cardura, Minipress, and Hytrin -- work by dilating blood vessels to reduce blood pressure. In fact, they are often prescribed to men to help with urination problems. In men with an enlarged prostate, a condition called benign prostatic hyperplasia, or BPH, alpha blockers can help relax the muscles in the bladder neck, letting urine flow more easily and improving symptoms of BPH.
In women, alpha blockers can relax the bladder, too. Women taking an alpha blocker who are experiencing urinary incontinence should also ask their doctor if there is an alternative medication available to treat their high blood pressure.
2. Antidepressants and Incontinence
Antidepressants can impair the ability of the bladder to contract, worsening symptoms of overflow incontinence, because the bladder can't empty completely. Other antidepressants may decrease your awareness of the need to go to the bathroom.
If you think your antidepressant is worsening your incontinence, talk to your doctor about switching to another medication.
3. Diuretics and Incontinence
"If you take your diuretic, you are making more urine," says David Ginsberg, MD, a urologist and associate professor of clinical urology at the Keck School of Medicine, University of Southern California, Los Angeles.
That translates to more bathroom visits and a worsening of incontinence symptoms, he says.
"If you need the diuretic, you need it," says Ginsberg. But he recommends you pay more attention to the recommended incontinence treatments, following your doctor's instructions to the letter.
That may mean paying more attention to doing Kegel exercises, designed to strengthen the pelvic floor muscles. Weakened pelvic floor muscles are often the cause of a common type of urinary incontinence called stress incontinence, in which small amounts of urine are leaked, especially when you cough, sneeze, or laugh.
If nighttime incontinence is a problem, you might ask your doctor if you could take the diuretic in the morning, suggests Jennifer Anger, MD, MPH, a urologist at Cedars-Sinai Medical Group in Los Angeles.
That way, the volume of urine would be greater in the morning and hopefully taper off as the day goes on.
4. Sleeping Pills and Incontinence
Only a small percent of people with incontinence have a problem with bed-wetting, according to Anger, who estimates that about 10% of patients with incontinence wet the bed. However, sleeping pills may pose a problem for those with incontinence at night.
"Sleeping pills can make things worse, because people don't wake up [when their bladder is full]," she says.
As an alternative, cut down on caffeine so you sleep better on your own, Anger suggests.
Sleep will come more easily if you keep a regular bedtime and wake-up schedule, according to the National Sleep Foundation. You can also develop a relaxing bedtime ritual, such as reading a book or listening to soothing music.
How to Talk About Urinary Incontinence
Bringing up the topic of urinary incontinence with your doctor or your spouse is never easy; most people are at least a bit embarrassed. But open communication can help you find out about the causes of incontinence and whether your medications may be contributing.
One good opener might be something like this: "I have been having bladder troubles."
If you will be visiting a new doctor, and have not yet selected them, you might seek out a doctor of the same sex, if you think that would help you feel more comfortable. Or, you might bring up the topic first with your doctor's nurse.
Preparing for the conversation about urinary incontinence may help you feel more in control. That means being able to answer the questions your doctor is likely to ask, including:
- When did your urinary incontinence symptoms begin?
- Have you had urinary incontinence symptoms before?
- What drugs are you on, and when did you start each of them?
- Do you leak urine with physical activity, coughing or sneezing?
You may find it easier to talk about incontinence if you acknowledge it as a medical condition that needs treatment, just as high blood pressure, arthritis, or high cholesterol does. Treatment options for urinary incontinence are plentiful.