Natural vs Conventional Incontinence Treatment
Comparing Approaches
Naturopathic Approach
Naturopathic treatment addresses incontinence through pelvic floor physical therapy to strengthen and coordinate pelvic muscles, bladder retraining protocols, dietary modifications removing bladder irritants, optimizing bowel function to reduce pelvic pressure, treating underlying conditions like UTIs or constipation, botanical support for urinary tract health, weight management, and stress reduction. Treatment is individualized based on incontinence type (stress, urge, or mixed).
Conventional Approach
Conventional treatment begins with behavioral modifications including scheduled voiding and fluid management, progresses to pelvic floor physical therapy, medications (anticholinergics for urge incontinence), vaginal estrogen for postmenopausal women, and procedural interventions including bulking agents, pessaries, or surgical options like mid-urethral slings for stress incontinence or InterStim for urge incontinence. Treatment is stepped based on severity and incontinence type.
Benefits & Considerations
Naturopathic Treatment
Benefits
- +Pelvic floor therapy highly effective for stress incontinence
- +Addresses underlying causes and contributing factors
- +No medication side effects
- +Can restore normal function without surgery
- +Treats related issues like pelvic pain or prolapse
Considerations
- −Requires 8-12 weeks of consistent pelvic floor exercise
- −Needs patient commitment to therapy exercises
- −May not be sufficient for severe anatomical defects
- −Pelvic floor therapy may not be covered by insurance
Conventional Treatment
Benefits
- +Medications provide relatively quick symptom relief for urge incontinence
- +Surgical options effective for severe stress incontinence
- +Vaginal estrogen helpful for postmenopausal atrophy
- +Multiple treatment options if first choice ineffective
Considerations
- −Anticholinergic medications cause dry mouth, constipation, cognitive effects
- −Surgery carries risks and doesn't address underlying weakness
- −Mesh complications with some surgical procedures
- −Medications don't strengthen pelvic floor
When to Consider Naturopathic Treatment
Naturopathic care with pelvic floor therapy is first-line treatment for stress incontinence, mixed incontinence, or urge incontinence in younger women. It's ideal for postpartum incontinence, mild to moderate symptoms, or patients wanting to avoid medications and surgery. Pelvic floor therapy should be tried before considering surgical intervention in most cases.
When to Seek Conventional Care
Seek immediate evaluation for sudden onset incontinence, incontinence with pain or blood in urine, neurological symptoms (numbness, weakness), severe prolapse visible at vaginal opening, complete inability to control bladder, or incontinence not improving with 3 months of pelvic floor therapy. Severe stress incontinence causing significant quality of life impact may require surgical evaluation. Underlying neurological causes require urgent medical workup.
Frequently Asked Questions
Can pelvic floor therapy really cure incontinence?
Yes, research shows pelvic floor physical therapy can cure or significantly improve stress incontinence in 60-70% of women who complete the program consistently. It's also effective for urge and mixed incontinence. Success requires 8-12 weeks of dedicated exercise practice. Pelvic floor therapy is considered first-line treatment before medication or surgery for most types of incontinence. However, severe anatomical defects or neurological causes may require additional intervention.
Why do I have incontinence after childbirth?
Pregnancy and childbirth stretch and weaken pelvic floor muscles and connective tissue supporting the bladder and urethra. Vaginal delivery, particularly with forceps or prolonged pushing, increases risk. Many women experience postpartum stress incontinence with coughing, sneezing, or exercise. The good news is most postpartum incontinence responds excellently to pelvic floor physical therapy. Ideally start therapy 6 weeks postpartum rather than assuming it's permanent or normal.
References
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Dr. Sanika Kshirsagar, ND
Doctorate of Naturopathic Medicine (ND)
Bastyr University, Kenmore, WA
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