Incontinence
Urinary incontinence is the involuntary leakage of urine, affecting approximately 50% of women at some point in their lives, with prevalence increasing with age, childbirth, and menopause. Types include stress incontinence (leakage with coughing, sneezing, exercise), urge incontinence (sudden strong urge followed by leakage), and mixed incontinence (combination of both). While extremely common, incontinence is not a normal part of aging and significantly impacts quality of life, physical activity, social engagement, and emotional wellbeing. Many women suffer in silence, unaware that effective treatments exist.
Symptoms
- •Leaking urine with coughing, sneezing, laughing, or physical activity
- •Sudden, intense urge to urinate with difficulty making it to the bathroom in time
- •Frequent urination including waking multiple times at night
- •Continuous or frequent dribbling of urine
- •Difficulty fully emptying the bladder
- •Avoiding physical activities or social situations due to fear of leakage
- •Using pads or protective garments daily to manage leakage
Causes & Risk Factors
- •Pelvic floor muscle weakness or damage from pregnancy, childbirth, or aging
- •Pelvic floor muscle hypertonicity or coordination problems
- •Declining estrogen during menopause affecting urethral tissue integrity and strength
- •Chronic coughing, constipation, or heavy lifting increasing intra-abdominal pressure
- •Neurological conditions affecting bladder control signals
- •Bladder irritation from urinary tract infections, certain foods, or beverages
- •Obesity increasing pressure on bladder and pelvic floor structures
Naturopathic Approach
Naturopathic treatment for urinary incontinence focuses on strengthening and retraining the pelvic floor, addressing underlying causes, and supporting tissue health. Pelvic floor therapy is foundational, teaching proper muscle engagement, coordination, and strengthening through targeted exercises and potentially biofeedback. For postmenopausal women, supporting vaginal and urethral tissue health through topical therapies or systemic hormone support may be beneficial. Nutritional strategies identify and eliminate bladder irritants while optimizing hydration and supporting connective tissue health. Herbal medicines can reduce inflammation, support tissue integrity, and modulate overactive bladder symptoms. Lifestyle modifications include proper lifting mechanics, managing constipation, maintaining healthy weight, and bladder retraining techniques. Functional assessment identifies contributing factors such as chronic urinary tract infections, hormonal deficiencies, or dietary triggers. This comprehensive approach aims to restore continence, improve quality of life, and enable women to return to activities they love without fear of leakage.
Related Modalities
Frequently Asked Questions
Is incontinence just a normal part of aging or having babies?
No, while incontinence becomes more common with age and childbirth, it is not an inevitable or normal consequence that you must accept. Pelvic floor dysfunction is treatable at any age. Many women achieve significant improvement or complete resolution of symptoms with proper pelvic floor therapy, lifestyle modifications, and supportive treatments. You don't have to live with incontinence.
Will pelvic floor exercises really help?
Yes, when done correctly. Research shows that supervised pelvic floor muscle training significantly improves or resolves incontinence in 60-80% of women. However, many women perform Kegels incorrectly or focus only on strengthening when coordination or relaxation is needed. Working with a pelvic floor physical therapist ensures you're using proper technique and addressing your specific dysfunction pattern for optimal results.
Do I need surgery?
Most women do not need surgery for incontinence. Conservative treatments including pelvic floor therapy, lifestyle modifications, and supportive therapies are highly effective first-line treatments. Surgery is typically reserved for severe cases that don't respond to conservative care or specific anatomical issues like significant prolapse. Always explore non-surgical options first, as they carry no surgical risks and often provide excellent results.
How quickly will I see improvement?
Many women notice some improvement within 4-6 weeks of starting pelvic floor therapy and lifestyle modifications. Significant improvement typically requires 8-12 weeks of consistent pelvic floor exercises and treatment. Severe or long-standing incontinence may take 3-6 months to see substantial improvement. Success requires commitment to exercises and recommended lifestyle changes, but most women who stay consistent achieve meaningful results.
References
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Dr. Sanika Kshirsagar, ND
Doctorate of Naturopathic Medicine (ND)
Bastyr University, Kenmore, WA
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