There are many reasons why a health problem can be difficult to live with. Some conditions cause symptoms that can have a severe effect on our lifestyles – arthritis, for example, can drastically reduce mobility. Other conditions can be difficult to live with because we feel we have to keep them secret – thus there are some conditions, such as libido problems, that are often left untreated only because sufferers are too embarrassed to seek help.
Then there are conditions like urinary incontinence. It’s bad enough that urinary incontinence can have a big impact on our enjoyment of life, but what’s even worse is that it can also be awkward and difficult to discuss with others, and can have a big effect on our self-esteem and self-confidence.
Urinary incontinence is a loss of bladder control. It is often referred to simply as “incontinence”, although to be strictly accurate it should be distinguished from faecal incontinence, a similar condition affecting bowel control. Another term sometimes used for some forms of urinary incontinence is “overactive bladder”.
Urinary incontinence can take a number of different forms, such as a frequent, urgent need to urinate, increased urination during the night, and accidental leakage of urine. Some forms of incontinence cause urine leakage when sufferers cough, laugh, or sneeze. Incontinence experts generally put the most common types of incontinence into three main categories:
Stress incontinence, despite its name, is not caused by having a stressful job or lifestyle! It’s actually a result of weakened muscles in the pelvic floor. These muscles normally support the urethra, the tube from the bladder that urine travels through as it leaves the body. When they become weak – often as a result of pregnancy and childbirth – they may give insufficient support to the urethra when laughter, sneezing, coughing, or similar activities cause increased abdominal pressure. This in turn can lead to urine leakage.
Urge incontinence occurs when our bladder muscles act involuntarily – we may feel a sudden need to urinate, and involuntarily do so straight away, rather than holding on until we reach a toilet. Urge incontinence is a result of poor muscle control, and not of muscle weakness. Urge incontinence is sometimes referred to as an “overactive bladder” or, when it has specific causes related to nerve activity, as “reflex incontinence”.
Stress incontinence and urge incontinence often occur together; when they do, the condition may be referred to as mixed incontinence.
Overflow incontinence, as the name suggests, is the consequence of an overfull bladder – a bladder so full that it leaks or dribbles urine. There are two main ways that a bladder can be overfull in this way; it may be that the muscles that empty the bladder have become weak, or it may be that there is an obstruction blocking the urethra so that only a small amount of urine is released during intentional urination. Although there are many causes of overflow incontinence, it is perhaps best known because it is a key symptom of benign prostate enlargement which should be assisted by a doctor to ensure that it is benign. Medically diagnosed benign prostate enlargement affects a significant proportion of Australian men.
Incontinence is believed to affect about four million Australians, many of whom accept it as a normal part of the ageing process. Almost three quarters of those sufferers are women.
Of course, many children also suffer from incontinence; this is not generally a cause for concern as learning bladder and bowel control are normal aspects of growing up, but where it persists in school-age children it may be wise to discuss it with a doctor.
It’s a sad fact about incontinence that many sufferers find it embarrassing. There’s no logical reason for this – incontinence is no more the fault of a sufferer than arthritis, the flu, or a cold, and none of us are embarrassed by those ailments. There are some illogical reasons why incontinence embarrasses us, of course; we may associate lack of bladder control with childhood teasing, or perceive it as a lack of self-control rather than as a medical complaint.
In reality, though, incontinence is almost always the result of a medical problem, and as with any medical problem, the best approach to management or treatment will only be possible once we are willing to discuss it openly and frankly with a doctor.
As well as finding the best approach to management or treatment, there is another reason to discuss incontinence with a doctor: it may be a sign of a more serious problem. While some people may dismiss incontinence as just another part of the ageing process, this is just plain wrong – incontinence is not just a result of normal ageing, and it should always be diagnosed by a doctor.
Incontinence may also become worse over time, and seeking advice from your doctor when symptoms first appear is a key step in preventing this from happening.
Far too many sufferers of incontinence dismiss it as a trivial problem that is not worth seeking advice about. Some resort to “home-made” solutions such as the use of sanitary napkins, rather than finding out about approaches to management that are specifically aimed at incontinence. Others may devise strategies for coping with incontinence rather than improving it, such as visiting the toilet more often, even when they don’t need to, or avoiding physical activities that could cause urine leakage.
Of course, it is wise and far better for incontinence sufferers to seek doctor’s help in dealing with their incontinence.
There are some natural approaches that may be especially helpful, and that are readily accessible.
Cranberry can help to reduce urinary odour, so that any leakage that does occur is less noticeable. Combined with incontinence pads, the deodorising action of cranberry may be a solution for some incontinence sufferers. Cranberry is available as berries or as a juice, and is particularly popular in capsule form since cranberries themselves have a rather sour flavour.
Another herbal approach is pumpkin seed, which can help by supporting normal, healthy bladder function and good urinary function. Like cranberry, pumpkin seed is available in capsule form for convenience.
Most adult incontinence sufferers are women, and many of them will first experience incontinence symptoms either during and after pregnancy, or after menopause. The main way that pregnancy can contribute to incontinence problems is fairly straightforward – carrying a baby in the same part of the body that houses the bladder and numerous other internal organs puts extra pressure on the pelvic floor, weakening it and leading to stress incontinence. Hormonal changes during pregnancy and menopause can also lead to reduced muscle strength in the abdominal area. Also, in some cases, childbirth itself may cause damage to some muscles and nerves in the pelvic area.
As well as herbal approaches such as cranberry and pumpkin seed, there are other natural measures that can help with stress incontinence. One of the most popular and effective is exercise – specifically, pelvic floor exercises called Kegel exercises. These exercises are designed to strengthen the pelvic floor and can help to improve bladder control. Of course always check these strategies with your doctor.
Men can certainly experience stress incontinence due to weakened pelvic muscles, just as women do. However, a more common cause of incontinence in men stems from compromised prostate health. Many men experience prostate problems as they grow older – broadly speaking, some 60 percent of Australian men aged over 60 (rising to 80 percent of men aged over 80) will experience urinary symptoms resulting from medically diagnosed benign prostate enlargement.
Typically, the cause is constriction of the urethra where it is encircled by the prostate gland, just below the bladder. This constriction makes it difficult for a sufferer to empty the bladder properly, which means that it is full again very soon after a trip to the toilet. The result is often overflow incontinence, and a frequent need to urinate. This can be particularly difficult to live with because it interrupts sleep so often.
Because medically diagnosed benign prostate enlargement isn’t the only problem that can affect the prostate, it’s very important for men over 50 to have their prostate checked regularly – even before any symptoms like incontinence appear. But once benign prostate enlargement has been medically diagnosed, it’s good to know that there are natural approaches that can help with the incontinence symptoms.
As well as helping with bladder function generally, pumpkin seed can also support prostate health, and may be especially useful when combined with other prostate herbs such as saw palmetto, which is widely recognised as a herb for prostate health.
If you are experiencing incontinence, you should consult a doctor in order to identify the underlying cause, and the strategies that may help to manage the problem. Your doctor will also be able to help determine whether you are eligible for the Australian government’s Continence Aids Assistance Scheme, a program designed to provide help to sufferers of more severe forms of incontinence. If you’re like many GLOW readers, you are likely to want to arm yourself with as much information as possible while you’re waiting for professional advice. Some good sources of information include:
- Most local public libraries
- Reputable websites such as www.continence.org.au and www.bladderbowel.gov.au
- State and national continence support organisations, such as the Continence Foundation of Australia who offer a national helpline, 1800 33 00 66
You can also call one of the Golden Glow® naturopaths on Freecall 1800 067 347.
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