More than 20 percent of women have a condition called Stress Urinary Incontinence (SUI), which causes leakage of pee smack dab in the middle of a workout, estimates The National Association for Incontinence (NAFC). SUI is characterized by a weakening of the pelvic floor or sphincter muscle that often happens as a result of childbirth. It places an increased pressure on your bladder that, when paired with coughing, sneezing, or hitting up your favorite fitness class, may cause leakage. Omar Duenas, MD, an OBGYN at Rinovum Women’s Health, explains how to avoid SUI by making bladder retraining part of your daily exercise regimen.
"Bladder retraining is a behavioral therapy technique that helps women regain control over urination," he says. "Oftentimes, it’s necessary for women who have delivered children, endured significant fluctuations in weight, or experienced chronic back issues." Over time, your pelvic floor gets stretched out and weakened. "Exercise—like any other sudden pressure on the bladder including sneezing, laughing and coughing—can result in incontinence. At the end of the day, no exercise is a bad exercise. But core workouts certainly increase the chances for more leakage and prolapse," explains Dr. Duenas.
Fortunately, both Dr. Duenas and NAFC have recommendations for strengthening up your pelvic floor muscles. The OB/GYN says that Kegel exercises are by far the number one thing he recommends to patients. “Kegel exercises are probably the most common technique in bladder retraining because they strengthen the pelvic floor muscles, which support the bladder and urethra," he says. The how is fairly simple, too. "We usually recommend [that patients use] the muscles that they would use to stop the urinary stream ,or to hold in gas to find the pelvic floor muscles." Once you've located the correct group of muscles, tighten the pelvic floor like you're lifting a marble for three to five seconds. Repeat 10 to 15 times each day.
If you're a bit of an overachiever, the NAFC also recommends scheduling your bathroom visits so that you're ever so slowly increasing the amount of time between each trip to the toilet. "Once you’ve determined how frequently you use the bathroom, you add 15 minutes to that time. Let’s say you go to the bathroom every hour. During retraining, you will aim to go every hour and fifteen minutes," explains the association. However, Dr. Duenas has one caveat. "It’s important to not actually stop the urinary stream while voiding, because it can result in re-training your brain and bladder. In time, sending this wrong signal to your brain can result in incomplete emptying of the bladder, which increases the likelihood for leaks and the risk for a urinary tract infections," he warns. So don't challenge your stream while you're on the toilet.
Once you've got the hang of both techniques, the OB/GYN says you'll have to have patience before your work starts kicking in. "These exercises require time and women usually don’t see results until after 3 to 6 months of performing them without any interruptions. Still, one in three women across the U.S. suffer from stress urinary incontinence and light bladder leaks, so it’s not a perfect science," says the doctor.
Even so, he stresses that the practices have helped plenty of women take back control of their go-to, sporty endeavors. "It’s important [women] understand they are not alone," he says, adding that if physical therapy and the above exercises don't move the needle, the over-the-counter device—Revive (which eliminates the need to wear pads and liners during a workout) might also be an option for you
Of course, (as always!) consult your doctor first. You should be able to move in whatever ways make you feel like you're living in technicolor, so enlist your physician to help you do just that.
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