March 28th 2006 - Under Construction
One out of three women are estimated to suffer from urinary incontinence although few will speak of it openly. In most cases this follows childbirth, where damage from episotomies, tearing or scarring, stretching of muscles, hernias of the pelvic floor muscle or damage to nerves can cause urinary leakage. Often the problems decline during the first years after birth, returning later in life as weight gain, hormonal changes, fibroids and declines in Kidney qi take place, subjecting the urethera and bladder to greater stress.
There are four major types of incontinence
Curiously many women have never learned to urinate properly. They may be tense, or trying to hurry during breaks at school or work. Instead of sitting down and relaxing the outer sphincter of the urethera, they bear down. This causes the bladder to relax and close, and they must rely upon squeezing the bladder with their abdomen to force liquid out. Working at cross purposes with our anatomy means that the body is being sent mixed signals and can set up bad urinary patterns that can eventually cause incontinence.
What are the major risk factors for incontinence? Women are more at risk for urinary incontinence than younger men because their urethras are shorter than in men (around two versus 10 inches)and because women bear children. Men usually do not catch up until old age when an enlarged prostate gland causes incontinence.
The more children a woman has the greater the risk for incontinence as a middle-aged adult. 30% of women under 50 who have borne children are incontinent. The risk is highest with the first child, and there is an increased risk in women who have their first child over age 30. Inducing labor with Pitocin causes more risk for urinary incontinence later on since medically induced labor tends to subject the muscles and nerves in the pelvis to greater force than does natural labor.
Women who engage in high-impact exercise are susceptible to urinary leakage, particularly if they have a low foot arch. Shock to the pelvic area is increased as the foot makes impact with hard surfaces. Those at highest risk for urinary leakage are gymnasts, followed by softball, volleyball, and basketball players.
Studies have reported a higher risk for mixed incontinence in women who are current or former heavy smokers (more than a pack a day).
Being overweight is a major risk factor for all types of incontinence. The more a woman weighs, the greater her risk.
Older Women have more urge incontinence women with one or more of the following with diabetes or two or more urinary infections in the past year.
Kegels done properly
What Chinese medicine can do
Types of treatment
1. Dr. Anna Margherita Sassone, Clocktower Gynecology (212) 664-1200 and
Gina Healy, RPT specializing in urinary incontinence. See www.clocktowergynecology.com Located on West 39th Street in Manhattan
2. See www.4woman.gov/ faq/urinary.htm for a good illustrated overview of incontinence.
3. Special kegel exercisers are not necessary. Often using the resistance of an internal vibrator or sex toys can improve kegel strength. See http://www.goodvibes.com/cgi-bin/sgin0102.exe?FNM=58&T1=1+3+BE+BE04&UID=2005071921553987&UREQA=5&UREQB=4&UREQC=3&TRAN85=N for an example of a toy suitable for kegel training.
4. See http://www.wheretostopwheretogo.com/content/a_message.jsp for a free copy of the Fromer guide to travel with an overactive bladder.
5. Go to http://www.nafc.org/pdfs/2QRT2005QC.pdf for the National Association for Continence
6. To order the NAFC Pelvic Floor Exercise Kit for Women with a motivational video, audio instructions and an informational brochure, for $15 call 1-800- BLADDER.
7. http://www.morehead.org/wellconnected/000050.htm has illustrations of various diagnostic tests and of the urinary bladder system.
8. For an example of electrostimulation units see http://www.utahmed.com/liberty.htm
9. A simple biofeedback unit for kegels can be seen at http://www.pelvicfloorexerciser.com/page3.html
Acupuncture and Herbs by Karen Vaughan, L.Ac in Park Slope and Manhattan.
118 East 37th Street, New York, NY 10016
Brooklyn, NY 11215