You've been struggling with the embarrassment and discomfort of a bladder control problem for some time now. Maybe you hoped it would just go away on its own, but things aren't getting any better. In fact, they're gradually getting worse.
You're ready to make some changes, but what exactly can you do? There are some simple strategies you can try on your own that may just help improve your bladder control problems.
Doctors often call these strategies "behavior therapies." They're safe, easy, effective and inexpensive. These techniques can be used before resorting to other types of treatment, such as medications or surgery, or in combination with them. Sometimes behavior therapies may be the only treatment you need.
Focus on fluids and food
How much fluid you drink and the types of food you eat may influence your bladder habits.
Too much fluid
Drinking too much fluid of any kind makes you urinate more often. If you drink too much fluid over a short time, it can over whelm your bladder and create a strong sense of urgency. If you exercise a lot or work outdoors on a regular basis, you may need to take in additional fluids. But rather than drink a large amount at once, try drinking fluids regularly throughout the day.
Drink most of your fluids in the morning and afternoon and eliminate alcohol and caffeinated beverages if you're having to get up several times a night to urinate. Fluids come from any beverage you drink, not just water, and also from foods such as soup. If you're experiencing bladder control problems, you may want to try to limit your fluids to between 6 and 8 cups a day.
Too little fluid
Too little fluid makes your urine highly concentrated with your body's waste products. Highly concentrated urine is dark yellow and has a strong smell. It can irritate your bladder, increasing the urge and frequency with which you need to go. Concentrated urine can also lead to a urinary tract infection — for women at risk — which can in itself cause urge incontinence.
Some foods and beverages can irritate your bladder as well. Caffeine and alcohol both act as diuretics, which means that they increase urine production. This can lead to increased frequency and urgency of urination.
Certain acidic fruits — oranges, grapefruits, lemons and limes — and fruit juices, spicy foods, tomato-based products, carbonated drinks, and foods that contain artificial sweeteners may irritate your bladder. Why these foods sometimes cause irritation isn't exactly understood, and bladder irritants differ from person to person. A food that might be a bladder irritant to one woman may not bother another woman at all.
If caffeine or alcohol is a regular part of your diet, try eliminating it from your diet for about a week to see if your symptoms improve. Avoid foods that might be bladder irritants for about a week. Then gradually — every one to two days — add one food back into your diet, making note of any changes in urinary urgency, frequency or incontinence.
You might not even have to eliminate your favorite foods entirely. Simply cutting down on the amount you consume might help, too.
Try bladder training
When you have an overactive bladder, you can become accustomed to urinating frequently or at the slightest urge. Sometimes, you may go to the bathroom even if you don't have the urge but you want to avoid a possible accident. After a while, your bladder begins sending "full" messages to your brain even when it's not full, and you feel compelled to go.
Bladder training, or retraining, involves adjusting your bathroom habits. You go to the bathroom on a set schedule — even if you have no urge to urinate — gradually increasing the time between bathroom visits and emptying your bladder completely when you go. This allows your bladder to fill more fully and gives you more control over the urge to urinate.
A bladder-training program usually follows these basic steps:
Find out your pattern. For a few days, keep a diary in which you note every time you urinate. Your doctor can use this diary to help you establish a schedule for your bladder training.
Set your bathroom intervals. Using your bladder diary, pinpoint the amount of time from one bathroom break to the next. Then extend that interval by 15 minutes. So, if your usual interval is one hour, you work to extend that interval to an hour and 15 minutes.
Stick to your schedule. Once you've established a schedule, do your best to stick to it. Start by urinating immediately after you wake up in the morning. Thereafter, if an urge arises but it's not time for you to go, try as hard as you can to wait it out. Rhythmically contracting and relaxing your pelvic floor muscles may help you wait it out until the urge goes away. If you feel that you're going to have an accident, go to the bathroom but then return to your preset schedule.
Increase your intervals. Gradually lengthen the time between trips to the bathroom until you reach intervals of two to four hours. You might do this by extending your intervals an additional 15 minutes each week until you reach the desired goal. Be sure to increase your time limit slowly, so that you give yourself the best chance for success.
Don't be discouraged if you don't succeed the first few times. Keep practicing, and your ability to maintain control is very likely to increase.
Strengthen your weak pelvic muscles
Your pelvic floor muscles and urinary sphincter help control urination. You can strengthen these muscles by regularly doing pelvic floor exercises, commonly referred to as Kegels. The pelvic floor muscles work to open and close the urethra, and they support the bladder as you exert yourself doing everyday activities such as walking, standing, lifting and sneezing.
To perform Kegels, squeeze your pelvic floor muscles as if you're trying to stop your stream of urine. Your doctor may recommend that you do a set of these exercises three or four times a day to treat your bladder control problem. Kegels are especially effective for women with stress incontinence, but can also help reduce or eliminate urge incontinence. If you're having trouble identifying your weak pelvic floor muscles, ask your doctor for help or to refer you to a specialist who can teach you the proper way to do these exercises.
Control contributing factors
Certain medications, excess weight and smoking may indirectly contribute to bladder control problems. If you address these factors, bladder-specific techniques — such as avoiding bladder irritants and bladder training — may be even more likely to work.
Manage your medications. Examples of drugs that may contribute to bladder control problems include high blood pressure drugs, heart medications, diuretics, muscle relaxants, sedatives and antidepressants. If you develop problems with incontinence or difficulty urinating while taking these drugs, talk to your doctor. You may be able to avoid urinary side effects by taking another medicine.
Maintain a healthy weight. Being overweight also may contribute to bladder control problems, particularly stress incontinence. Excessive body weight puts pressure on your abdomen and bladder during physical activity, limiting the mobility of your urethra and resulting in leakage. If you're overweight and you're experiencing a bladder control problem, losing weight may be one way to help.
Stop smoking. Heavy smokers tend to develop a chronic cough, which can place added pressure on the bladder and aggravate urinary incontinence. Improving urinary incontinence may be one of many benefits of stopping smoking.
Your role in treatment
Behavior therapies can improve bladder control with a minimum of side effects. Your doctor can help you in many ways — by teaching you how to implement different therapies, providing you with feedback and helping you manage your medications — but you also play a vital role in your treatment.
These techniques take some time and practice before you begin seeing results. But persistence pays off. If you stick with the program, you'll more than likely see an improvement in your symptoms. And if one of these approaches doesn't work, talk with your doctor about exploring other treatment options that may serve you better.