How can you deal with Incontinence?
Did you know that 40 percent of women experience overactive bladders? Take 5 women in a room and 2 of them are affected.
It all starts with the pelvic floor. The pelvic floor muscles are located at the bottom (or floor) of your pelvis. They attach like a hammock from the underside of your pubic bone to your tailbone. When you are sitting, you are sitting on your pelvic floor muscles.
They have two major roles in preventing incontinence. First, they function as sphincters that allow you to hold back urine (like tightening a tap), yet they also allow you to urinate when you desire (like opening the tap). Second, these muscles support all of the abdominal organs, including the bladder.
There are three openings that pass through the pelvic floor muscles in women: the urethra, the vagina and the rectum. Something thick, strong and supportive is needed for all these important bodily functions and the pelvic floor is designed for all these purposes.
TYPES OF INCONTINENCE:
Stress:
This is the most common type. It is induced by physical stress. It occurs with activity such as coughing, sneezing, jumping, exercising, playing sports, standing up from a chair, lifting, turning in bed etc. These activities put increased pressure on the bladder, overpowering the sphincter muscles and causing leakage.
Urge:
This is leakage triggered by a strong uncontrollable urge to immediately urinate. It typically occurs on the way to the bathroom. Triggers such as arriving home, running water, cold weather, mental stress, and worry can make urge incontinence worse.
WHAT IS NORMAL BLADDER FUNCTION
We humans are meant to have control over our bladders. We should empty our bladders five to seven times in a 24 hour period including zero times at night (once a night for senior citizens).
The bladder is a muscle called the detrusor muscle. When this muscle is stretched because it is filling up with urine, it contracts and creates the urge sensation. So that urge feeling is really the bladder softly contracting.
Contrary to popular belief, urges are not commands to go to the bathroom. This is just the bladder's way of drawing attention to itself. After this first mild urge signal, it should quickly and automatically fade away without using the bathroom, allowing you to continue doing what you were doing.
Two or three subsequent urge signals arrive and disappear, each one getting a bit stronger and with the interval between signals shrinking. Still the actual timing of the decision to go or to wait should be up to you. You, not your bladder, should be in charge and able to delay and decide the timing of your bathroom visits.
Once you go to the toilet, you mentally and physically let go of the pelvic floor muscles. The same muscles that keep us dry are the ones that initiate the process of urination. Fully convinced that you are ready to urinate, your brain then sends a signal down to your bladder, telling it to contract and empty. The urine flows out of your bladder, into the urethra tube and out of your body. Note that your bladder was the last participant in this process, not the first, as in the case of someone with urgency, frequency or urge urinary incontinence.
WHAT GOES WRONG?
Why does this process go wrong with so many women? The bladder is a very trainable organ, and it is easy for it to develop some bad habits. For these women, the bladder controls them, instead of the other way around.
Four common urinary conditions are:
1. urinary urgency
2. urge incontinence
3. urinary frequency
4. nocturia
URINARY URGENCY
With urinary urgency, the bladder becomes overactive and gives sudden, forceful urges that are so strong it is extremely difficult to get to the bathroom in time. Arriving home is a very common trigger. This sudden urge that hits you after arriving home clearly has nothing to do with how much urine is actually in your bladder. Other urge triggers include cold weather and nervousness.
URGE INCONTINENCE
If after feeling strong urinary urgency, you do not make it to the toilet in time, then you have urge urinary incontinence which stems from the same problem as urinary urgency.
Urge Incontinence is both a physiological and a psychological problem. It is physiological in that the bladder has lost its ability to regulate its urges and the pelvic floor muscles are not strong enough to keep the urethra closed to prevent leakage. It is also psychological because the brain sees or hears something that stimulates it to go to the toilet and directs it to empty. Soon the woman has no control over her body and her bladder literally starts controlling her life.
URINARY FREQUENCY
This is when you urinate an excessive number of times during the day, drive to the toilet by your bladder. If your frequency is severe, you may feel the need to urinate all day long and you may use the bathroom as often as every 30-60 minutes. What is normal urination and what is excessive? If is normal to empty the bladder every 3-4 hours. This translates to a total of 5-7 times every 24 hours. This should be the goal to work towards.
Sometimes this can start after a UTI or it can develop when pregnant but the habit then sticks around long after having the child. The strategy to ward off leakage by keeping your bladder empty doesn't work either. This is because the bladder is never empty. By the time you have been and washed your hands, your kidneys have probably made another 60ml of urine. By voiding too often on purpose, you inadvertently create a constant need to go to the bathroom. It gets used to being emptied every hour, so it forgets how to stretch and hold more. Pretty soon your bladder starts giving you the urge-to-go signal earlier and earlier, and before long you develop a genuine frequency problem. Sometimes the problem is compounded by anxiety of not knowing where the toilets are in unfamiliar locations - this can make the urgency and frequency worse.
NOCTURIA
This is urinary frequency that happens during the sleeping hours. Even though you are not drinking, and your metabolism is slower while you are resting overnight, an overactive bladder gives you no rest, literally. Getting up once to use the toilet is considered normal for a senior adult. It is not considered normal for a young to middle-aged woman, who shouldn't need to get up at all. In severe cases of nocturia, women rise four - six times per night to go to the toilet. The real shame is that too many women suffer needlessly, because it is totally correctable.
HOW DOES ACUPUNCTURE HELP INCONTINENCE
Studies have shown acupuncture to be effective for the treatment of urinary incontinence. Several controlled investigations find acupuncture safe and effective for reducing the amount of urine leakage and frequency of uncontrolled urine leakage. The investigations reveal that acupuncture outperforms medications and enhances the effectiveness of Kegel exercises and herbal medicines.
The treatment should increase one’s ability to hold urine, decrease the number of times one urinates at night, decrease urinary urgency, and create a smoother urine flow. In addition, patients will usually see an improvement in sexual function over the same period of time.
Together with dietary suggestions to eliminate bladder irritants, pelvic exercises and a physical program to retrain your bladder out of its bad habits, treatments will help you to regain a sense of control once again.
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Doctor of Chinese Medicine,
Registered Acupuncturist AHPRA
Yin Studio:
Founded in 2006 by Cathy Bell, Yin Studio has become a sought-after health and wellness clinic, known for its warm, inviting atmosphere and sincere, compassionate care for its patients.
Cathy Bell provides results-oriented, natural wellness care for people of all ages. Her goal with each patient is a long-term, self-sustained shift in core factors that determine health and wellness. These core factors bridge all levels of being — physical, psychological, even spiritual.
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