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dear doctor

Most Women Wait 7 Years to Tell a Doctor about Bladder Issues

About 10 million women are incontinent. In other words, you’re not alone.

Photo credit: Trunk

Urinary Incontinence Health Risk Assessment

Q: I love going to group fitness classes at my gym and standing in the front row, where I can see the instructor up close. But I have been hiding in the back lately because of a humiliating issue…I keep peeing a little during my workout! The first time it happened, I thought it was a one-time accident, but it keeps happening. I now dread the gym because I’m so anxious and embarrassed about my lack of bladder control. I haven’t told anyone about this, and I am starting to get really depressed. What is going on? Please help!

Sincerely,

"Urine Trouble"

Dear Urine Trouble,

Please don’t be embarrassed or worried. Urinary incontinence—a fancy term that refers to the involuntary leakage of urine—is very common.

In fact, while it may make you feel isolated, you are far from alone. About 10 million American women are currently dealing with urinary incontinence. Like you, many women suffer in silence: It’s estimated that less than half of incontinent women share their bladder control issues with a healthcare provider. And if they do, on average they wait seven years to see a doctor about it! That’s seven years of frantically scouting out the bathrooms of every public place you visit. Seven years of avoiding long trips. And seven years of living in fear while at the gym. Seven years of letting your bladder rule your life - it doesn’t need to be this way.

What most women don’t know is that urinary incontinence is usually highly treatable. The first thing you should do is schedule an appointment with a urogynecologist (a physician with special training in urology, gynecology and obstetrics) or a urologist. It’s important to pick someone you are comfortable with and who you can be completely open with, so be sure to ask your primary doctor for a recommendation or do your own research by reading reviews of specialists online. 

Your chosen doctor will want to know your full medical history in order to determine the underlying cause of your condition, which varies from person to person. You should be prepared to share details of any pregnancies and deliveries you’ve had, as well as if you’re experiencing menopause, since these can all be major causes of urinary incontinence. (This, in addition to pelvic anatomy, is why the condition affects way more women than men—I know, not fair!) Your doctor will then do a urine analysis and other tests to help zero in on the underlying problem.

I encourage you to share how the loss of bladder control is affecting your life physically, socially and emotionally. This will help your doctor establish a short and long term treatment plan that’s right for you.

A short term plan may include the use of absorbent products, such as pads, adult diapers and disposable underwear. I know this doesn’t sound like the most glamorous thing in the world, but these products are now super discreet and comfortable, and they can do wonders for easing your anxiety, especially at the gym.

Your long term treatment plan should address your incontinence head on. It might include a combination of remedies, such as:

  • Modifying your diet (e.g., limiting your intake of alcohol, caffeine and carbonated beverages, which may irritate the bladder; eating high-fiber foods to prevent constipation/straining which puts pressure on the bladder)
  • Doing Kegels, now known as pelvic floor muscle exercises (exercises to strengthen the pelvic floor muscles, making it easier to hold in urine)
  • Retraining your bladder (a type of behavioral therapy in which you gradually hold in urine for longer and longer periods of time to prevent emergencies and leaks)
  • Taking medication (they work by blocking the chemical signals to your brain that make you feel the urge to go even when your bladder isn't quite full)
  • Eliminating some existing foods or medications that may cause incontinence

The important thing to remember is you really can get this common problem under control. All you have to do is swallow your pride and ask a doctor for help. The front row of fitness class awaits!

“Share how the loss of bladder control is affecting your life physically, socially and emotionally. This will help your doctor establish a short and long term treatment plan that’s right for you.”
Jill Maura Rabin, MD
Dr. Jill Maura Rabin, Urogynecologist

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Published September 15th, 2018

Urinary Incontinence Health Risk Assessment