It’s been about 3 months since I first noticed that when I am laughing really hard or shouting (at my kids), I usually pass a small amount of urine into my panties. It happened only twice that first week, but right now it happens more frequently. I have not been able to tell anyone about it yet, it’s embarrassing and it is distressing to me cos I have never ever met anyone who has had this happen to her. What do I do?
What I think you have is stress incontinence, and while you may not have had it happen to anyone around you, it is not totally uncommon. One more reassurance is that it can be managed with some therapy and a lot of patience. For yours and other readers of Virtue Digest’s sake, I want to talk a little in-depth about it, so pardon me if this reply is long.
Urine is usually stored in the bladder when produced till one has a chance to urinate. The bladder is kept closed by a sphincter (a lock made from muscles) until one voluntarily decides to go. In the event where urine is released involuntarily when one is exerting some abdominal pressure (the kind that occurs when we try to lift a heavy load, laugh out, cough, sneeze, exercise or even just stand up from sitting), it is called stress incontinence- not related in any way to emotional or psychological stress.
It is commoner in women who are pregnant; women who have had multiple vaginal deliveries, surgeries to and around the urinary tract, long lasting infections of the urinary tract; women who have reached menopause; obese women and women with chronic cough.
Some DIY therapy for stress incontinence include: going to urinate frequently even before you feel an urge to, reducing your overall fluid intake to minimise bladder pressure, avoiding activities that trigger the episodes, losing weight, treating any cough or infection of the urinary tract.
A very important part of the therapy is pelvic floor muscle exercises. It helps to strengthen the muscles that control urination, defecation and it has been shown to cause an improvement of symptoms if not a cure in a lot of cases. It is done by pretending you are urinating and then holding it. It is very important to make sure you are exercising the right muscles.
The next time you have to urinate, start then stop and feel the muscles of your vagina, bladder or anus get tight. Do this over and over until you get it because one may be tensing the abdomen, buttocks or the thigh muscles instead of the deeper muscles which are our target. If you can, put a finger in your vagina and feel the muscles contract. When you have learned to do this exercise correctly, proceed to contract the muscles 5 times, holding each contraction for a count of 5. This equals 1 set. Then do one set every hour while you are awake. The exercise can be done while driving, reading, watching TV etc. soon, you will be able to hold each contraction for a count of 10 as the muscles get stronger.
I want you to urge you to commit to this exercise for about 3-6 months in order to achieve full results during which time you could wear and frequently change panty liners in order to minimise wetness and odour.
In the meantime, you NEED to see a doctor for proper evaluation of the cause. There are some medications and surgeries that you may require that only your doctor can prescribe.
I wish you full recovery soon, dear Anonymous, and a full life free from embarrassment.
NOTE TO ALL READERS: I want to recommend the pelvic floor muscle exercises described above to every woman of childbearing age, especially to pregnant women and women who have just delivered recently. It does not just prevent stress incontinence, it prevents prolapse of your pelvic organs as you grow older too. And by way of motivation, have you heard that there are exercises that strengthen your vaginal walls and help make sex more satisfying after delivery? They are the same!
ABOUT THIS COLUMN: Dear Dr Tola is written by a female medical doctor to give you medical advice on women health issues, correct answers to your questions and current information on trending health news. It is however not intended to provide diagnosis and treatment, both of which are frequently inaccurate without a real physical consultation. The author also blogs at toladimeji.wordpress.com.
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