A Sense of Urgency

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy


Bladder issues such as urinary tract infections, overactive bladder, interstitial cystitis, and incontinence are the top healthcare problems in the United States today. The best-selling items in pharmacies are now adult diapers, reaching 2.2 billion dollars in sales per year.

As men and women age, the incidence of bladder problems and urinary incontinence increases for both sexes. These problems are far more common in women, but many women just ignore them, thinking that leaking small amounts of urine when sneezing or laughing are not a real medical problem. They may feel too embarrassed to seek assistance, or they may look at it as just another normal part of aging.

Incontinence is defined as the involuntary release of urine and, while it often accompanies aging, it can be caused by many factors. For example, removal of the uterus can lead to weakening or prolapse of the bladder, resulting in incontinence, simply due to the lack of physical support from that organ. Incontinence can also result from a lack of estrogen, which weakens the bladder and urinary tract structures. Diseases like diabetes or the aftermath of stroke can cause incontinence. Constipation can also be a source of incontinence, as a result of straining. Men with benign prostatitis can develop incontinence. People with a history of bedwetting during childhood are more likely to experience some incontinence as an adult.

As incontinence becomes more frequent or worsens, coping behaviors increase. Using sanitary napkins or other feminine hygiene products, refusing to travel, mapping out the location of toilets, urinating again (just in case), avoiding fluid intake, stopping exercise, and wearing dark clothes can all be indicators of a problem with incontinence.

So, what can be done to help control incontinence, or at least deal with it better?

Some women try using feminine pads to catch the urine released unexpectedly with incontinence. However, those pads are not designed to capture the amount of fluid that may be present. The adult incontinence pads are a much better choice because they are designed like kitty litter, to form a gel when in contact with fluid, and they can also help control odor.

For women who are overweight, losing even just five to ten pounds can dramatically reduce incontinence. Dietary changes, such as eliminating caffeine and avoiding spicy foods that can irritate the bladder, may help some people reduce incontinence. Fluid management throughout the day, and especially within three to four hours before bedtime, may be necessary to control “urge incontinence” (another name for overactive bladder). Avoiding alcoholic beverages may be essential for some people because it contributes to the loss of muscle control.

Many healthcare practitioners recommend Kegel exercises, which strengthen the pelvic floor muscles, for reducing incontinence. Dr. Michael Platt of the Platt Wellness Center suggests adding testosterone, applied vaginally daily, because it helps rebuild the muscles that have atrophied. He also believes that adrenaline may be part of the equation when it comes to understanding the causes for incontinence, and suggests that progesterone (as the natural balancer of adrenaline) may be used to reduce it. In addition to bioidentical hormone therapies, prescription drugs and surgeries are also options that may provide relief for some people.

If you are experiencing incontinence (or are close to someone who is), it is best to speak with a healthcare practitioner about it early on, so they can help you explore remedies before the problem escalates.

  • “Pharmacists Talking Bladder Health Out of the Water Closet: OAB, Incontinence, UTI, and Interstitial Cystitis” by Diane K. Newman, DNP, FAAN, BCB-PMD; a presentation at The American Pharmacists Association Conference, 2012.
  • The Platt Protocol for Hormone Balancing: A Wellness Manual for Healthcare Practitioners, an unpublished manuscript by Michael Platt, MD