Woman in discomfort

Don’t Make Me Laugh, Cough or Sneeze

Do you have to use the bathroom again?  – Yes, actually, I do.
And, if you’re like 1 in 3 women, you might be leaking a little, which is known as stress incontinence. Many women are also dealing with a sense of urgency, you know the feeling that you have to go and you need to go right this minute, get out of my way.

Why this happens?

There are numerous reasons why this happens, and most of the time it’s a combination of:

  • Loss of estrogen in and around your entire pelvic region
  • The forces of gravity pulling down the bladder and the nerves and muscles that prevent leaking into positions where they’re not as efficient.
  • Stretched and strained pelvic floor muscles from pregnancies and weight gain.
Normal Female Anatomy
This is an illustration of where your bladder was located when you were in your 20’s
Cystocele Female Anatomy
This is where your bladder might be now at midlife

Did you notice that the back of the bladder is sliding down creating a sort of second pouch? This is known as a cystocele and can make it more difficult to completely empty your bladder.

What you can do

Vaginal Estrogen
Do consider starting some vaginal estrogen which will you’re your muscle tone. 

Pelvic Floor Physical Therapy
Fear not and while you’re out buying more absorbent pads, call your health care provider for an evaluation or use the Pelvic Health Physical Therapist locator on the American Physical Therapy Association’s Section on Women’s Health website.

These are not your Mother’s Kegels! Seriously, there’s more that can be done now without medication and/or surgery. My patients are happily surprised that they are some much drier after just a few sessions with a pelvic floor physical therapist.

Double Voiding
If you feel that even after you think you empty your bladder that 10 minutes later, you have to go again, then you’ll probably benefit from a little nurses trick – Double Voiding.

Remember that little second pouch of the bladder that slides down? Well that holds urine. So, to move any urine that’s trapped there, and reduce back and forth trips to the bathroom, here’s what you can do:

  • Sit on the toilet as you normal would and empty your bladder
  • Then, stand up and bend over at the waist to help move any remaining urine into the upper pouch of the bladder
  • You can do this 2-3 times as long as you don’t get dizzy
  • Then sit back down and urinate
  • It’s likely that you’ll have about ½ to 1 full ounce of urine

I sure hope this helps.

Read more about all things related to midlife and menopause in my award-winning book The Hot Guide to a Cool Sexy Menopause.

BTW, I donate all of the proceeds from the sale of the book to FAME Hospital and Clinic in Tanzania, where I volunteer

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