Help For Women With Overactive Bladder-Now Available Without a Prescription

Oxytrol Patch For Overactive Bladder

Millions of women suffer from overactive bladder-when you gotta go right now! In the past there are prescription medications used to make women more comfortable. Now the FDA has approved Oxytrol for Women, the first over-the-counter treatment for overactive bladder.

The condition affects more than 20 million American women, according to Merck, the drug’s manufacturer.
It will still only be available in prescription form for men.

Oxytrol helps relax the overactive bladder muscle that leads to symptoms such as the sudden need to urinate and leaking of urine.
Oxytrol for Women is in the form of a patch, applied to the skin every four days, Merck says.

It is expected to hit store shelves by the fall.

Oxytrol in pill form by prescription will still be available. Oxytrol for Women contains oxybutynin, a drug that helps to relax the bladder muscle. It belongs to a class of drug called anticholinergics. It is the first of this class to go over-the-counter for overactive bladder treatment.
Among side effects reported in the studies were skin irritation at the site of the patch, constipation, and dry mouth. Most women who develop overactive bladder are 45 to 60 years old. Many do not seek professional medical help due to embarrassment.

Many women who suffer with bladder problems wait on average seven years before seeking treatment.

Bottom Line: If you are using the restroom more than 8 times a day or three times a night, see your doctor or at least try over the counter Oxytrol.

Incontinence-There’s An App For That

Now an app is available, iDry, that helps men and women suffering from urinary incontinence log data on their urinary symptoms, provides reminders for exercises to help control the condition, and enables users to share progress with their physician. The app can also provide predictions for future success. It is available in a free version and a premium version that allows users to create their own interventions and E-mail charts and log data to their doctor. This is available for iPhone and iPad and more information is available at http://www.idry.org.

Losing Your Urine When You Cough Or Sneeze-Treating Incontinence With a Pessary

Pessary For Treating Mild Stress Incontinence

Stress urinary incontinence or loss of urine with coughing, sneezing, or even bending over to put on your shoes affects millions of American women. Often times a woman is looking for a treatment that does not involve medication or surgery. For certain women a vaginal pessary is an option. A pessary is a removable device placed into the vagina. It is designed to support areas of the pelvis such as occurs with pelvic organ prolapse.
There are a variety of pessaries available, made of rubber, plastic, or silicone-based material. Among common types of pessaries are the inflatable , the doughnut, and the Gellhorn.

Frequent Urination: Causes and Treatments
Gotta go all the time? The technical name for your problem is frequent urination or overactive bladder. In most people the bladder is able to store urine until it is convenient to go to the toilet, typically four to eight times a day. Needing to go more than eight times a day or waking up in the night to go to the bathroom could mean you’re drinking too much and/or too close to bedtime. Or it could signal a health problem.

Why It Is Done
Pessaries are used as a nonsurgical approach to the treatment of pelvic organ prolapse. They are frequently used to treat uterine prolapse in young women during pregnancy. In this instance, the pessary holds the uterus in the correct position before it enlarges and becomes trapped in the vaginal canal.
Pessaries are also used when symptoms of pelvic organ prolapse are mild or when childbearing is not complete. They can be used in women who have other serious chronic health problems, such as heart or lung disease, that make a surgical procedure more dangerous.

Pessaries are sometimes used to see what the effect of surgery for pelvic organ prolapse will be on urinary symptoms. This is called a “pessary test.” If you have a problem with incontinence with a pessary inserted, a separate surgery to fix the incontinence problem may be done at the same time as a prolapse surgery
How Well It Works
Pessaries do not cure pelvic organ prolapse but help manage and slow the progression of prolapse by adding support to the vagina and increasing tightness of the tissues and muscles of the pelvis. Symptoms improve in many women who use a pessary, and for some women symptoms go away.

You will need to see a doctor to be fitted for a pessary which will hold the pelvic organs in position without causing discomfort. Pessaries come in a variety of sizes and should be fitted carefully.

What To Expect After Treatment
Your pessary will be fitted in your doctor’s office. You may need to experiment with different kinds of pessaries to find one that feels right. The pessary needs to be remove, clean, and reinsert the pessary on a regular schedule. Most often this is done by the doctor or his\her staff but some women prefer to do this themselves. The cleaning schedule is determined by the type of pelvic organ prolapse and the specific brand of pessary.

Risks
Possible complications from wearing a pessary include:
• Open sores in the vaginal wall.
• Bleeding.
• Wearing away of the vaginal wall. In severe cases, an opening can form between the vagina and the rectum.
• Bulging of the rectum against the vaginal wall (rectocele formation).

Complications can be minimized by having a pessary that fits correctly and that does not put too much pressure on the wall of the vagina.
In post menopausal women, estrogen (cream, ring, or tablets) is sometimes used with a pessary to help with irritation caused by the pessary.
What To Think About

Pessaries often are an effective tool for managing pelvic organ prolapse without surgery. They may be the best choice if you are a young woman who has not finished having children, if you have been told that surgery would be risky for you, or if you do not wish to have surgery for other reasons.
A pessary may not be a good choice after having a hysterectomy. This is because the walls of the vagina are no longer held in place by the uterus and cervix. Women with severe prolapse following a hysterectomy may have difficulty keeping the pessary in place.
Many women can have sexual intercourse with their pessary in place. But you cannot insert a diaphragm (a round rubber device used as a barrier method of birth control) while wearing a pessary. If you have not reached menopause, you may want to discuss birth control with your doctor.


Bottom Line: Stress incontinence is common condition affecting millions of American women. The treatment with a pessary is an option that does not require the use of medication or surgery.

For more information on women’s health, I suggest my new book, What’s Going On Down There-Everything You Need To KnowAbout Your Pelvic Health. the book is available from Amazon.com

New book on women’s health

Gotta Go Right Now? Here’s How To Discard Your Depends For Your Next Airplane Trip

Don’t Depend on Depends

Many men and women suffer from urinary incontinence making travel difficult or nearly impossible. Here are 10 tips and tricks that you might consider before your next flight to lessen the embarrassment of urinary incontinence.

1. Request an aisle seat in back of plane so you have ready access to the restroom. Reserve your seat ahead of your departure dates. Plan to go to the restroom and empty your bladder before your plane departs. Once on board the aircraft and after take off plan to use the restroom before the drink cart come down the aisle as you may be sent back to your seat before you can use the restroom.
2. Explain your medical condition to flight attendant before take-off. The flight attendant can alert you before they turn on seat belt sign making it possible for you to use the restroom. The attendant can help you get off plane for connecting flight if you are at the back the plane.
3. Be aware that you cannot use the bathroom during ascent (short) and descent (long)
4. Wear adult diaper or protective underwear for the trip. You should have a carry-on duffel bag with extra undergarments, pads, antibacterial soap, and an empty plastic bag for soiled clothing.
5. Be mindful of your fluids. It is not a good idea to dehydrate yourself for long periods before departure. To do so will lead to a concentrated urine which is irritating to the bladder and may promote bladder contractions. Drink 6 cups of fluid per day but time it appropriately to your flight departure.
6. Avoid bladder irritants (coffee, alcohol, carbonate drinks, artificial sweeteners, citrus)
7. Suppress the urge by doing Turbo Kegels, which I will describe in the next blog.
8. Voiding by the clock. Don’t wait for your bladder to become full or over distended. Urinate every 2-3 hours especially on long flights.
9. Take your medications prescribed by your doctor. I suggest that you make sure to take at least for 2 weeks before travel
10. Use a waterproof skin barrier ointment (zinc oxide) to protect skin if you do have frequent accidents

Bottom Line: If you have urinary incontinence, you may have problems with airline travel. Applying a few of these principles may just make that flight more enjoyable and less stressful.

For more information on urinary incontinence, I recommend my new book,
The Complete Guide To Women’s Pelvic Health which is available at Amazon.com

New book on women’s health

Wearing Diapers? Check Your Medications Which May Be The Culprit

Urinary incontinence affects millions of American men and women.  There are dozens of medications that can be contributing to the cause of incontinence.  Often times stopping these medications, with physician’s approval, or changing to another drug, also with physician approval, may help control the urine process. 

There are many types of urinary incontinence, the most prevalent being “urge incontinence” — an urge to urinate so sudden and strong that you often can’t get to a bathroom in time. When this type of incontinence has no identifiable cause, it’s called “overactive bladder.”

The drugs typically used to treat this condition include darifenacin (Enablex), fesoterodine (Toviaz); oxybutynin (Ditropan), solifenacin (Vesicare), tolterodine (Detrol) and trospium (Sanctura). These are all anticholinergics — drugs that block the effects of acetylcholine, a neurotransmitter associated with muscle activation, learning and memory.

Many commonly prescribed drugs can also cause incontinence or make it worse. Among them:

• heart medications
• blood-pressure medications      (amlodipine, furosemide, hydrochlorothiazide, lisinopril and furosemide,      for example)
• antidepressants
• muscle relaxants
• diuretics
• sleeping pills

I’d recommend that you work closely with your physician to determine; if at all possible, what might be causing her incontinence. Smoking or being overweight can be contributing factors, for example.

While it’s not always possible to pinpoint a cause, I find that adjusting a patient’s medications often resolves or, at least, substantially lessens the problem. Some simple behavioral techniques — including bladder training and scheduled toilet trips — can help, too.

Bottom Line:  Incontinence is a common problem.  Make sure your medications aren’t causing the problem or making it worse.  Check with your doctor.

 

Put Away Your Depends-Treatment Options Without Medication or Surgery

Losing urine that requires a woman to wear Depends is a very depressing situation.  It is very embarrassing for women to go to the pharmacy or grocery store and her box of Depends in her cart is very discouraging and a source of great anxiety.  There are nearly 13 million women who have incontinence and many of them have not talked to their doctor about the problem and suffer in silence.

 

Stress incontinence, which is more common in women, causes urine to leak when you laugh or cough. Overactive bladder, also called urge incontinence, is caused by urinary muscle spasms that cause an urgency to urinate. If you leak urine when you cough, laugh, sneeze, or exercise, you have stress incontinence. Mental stress does not cause stress incontinence. The “stress” is pressure on the bladder. When your pelvic and sphincter muscles are strong, they can handle the extra pressure from a cough, sneeze, exercise, or laugh. But when those muscles are weak, that sudden pressure can push urine out of the bladder.

In stress incontinence, weak pelvic muscles can let urine escape when a cough or other action puts pressure on the bladder.

 

Some treatments are as simple as changing some daily habits.

I recommend that women try the simplest treatment choices first. Kegel exercises strengthen the pelvic muscles and don’t require any equipment. The trick is finding the right muscles to squeeze. It is the same muscles that you contract to stop your urine stream or to prevent you from passing gas from your rectum.  After about 6 to 8 weeks, you should notice that you have fewer leaks and more bladder control. Use the pelvic muscle exercise log included with the Kegel Exercise Tips sheet  to keep track of your progress.




Timed voiding. By keeping track of the times you leak urine, you may notice certain times of day when you are most likely to have an accident. You can use that information to make planned trips to the bathroom ahead of time to avoid the accident. Once you have established a safe pattern, you can build your bladder control by stretching out the time between trips to the bathroom. By forcing your pelvic muscles to hold on longer, you make those muscles stronger.

 

Diet changes. You may notice that certain foods and drinks cause you to urinate more often. You may find that avoiding caffeinated drinks like coffee, tea, or cola helps your bladder control. You can choose the decaf version of your favorite drink. Make sure you are not drinking too much fluid because that will cause you to make a large amount of urine. If you are bothered by nighttime urination, drink most of your fluids during the day and limit your drinking after dinner. You should not, however, avoid drinking fluids for fear of having an accident. Some foods may irritate your bladder and cause urgency. Talk with your doctor about diet changes that might affect your bladder.

 

Weight loss. Extra body weight puts extra pressure on your bladder. By losing weight, you may be able to relieve some of that pressure and regain your bladder control.

 

Bottom Line: Incontinence doesn’t kill a woman but it does steal her quality of life.  Often times these simple techniques will help reduce urinary incontinence.  If you have any questions.  See your doctor

 

I have also written a book, What’s Going On Down There-The Complete Guide To Women’s Pelvic Health, and there is an entire chapter on urinary incontinence.  The book is available from Amazon.com

 

 

New book on women’s health

A Kegel A Day Keeps the Depends (TM) Away

Urinary incontinence is a devastating problem affecting millions of American women. For women with mild to moderate loss of urine with coughing and sneezing, Kegel exercises can M)improve urinary control and decrease the use of absorbent pads and even the use of Depends.

Kegel exercises strengthen the pelvic floor muscles, which support the uterus, bladder and bowel. You can do Kegel exercises discreetly just about anytime, whether you’re driving in your car, sitting at your desk or relaxing on the couch.
Many factors can weaken your pelvic floor muscles, from pregnancy and childbirth to aging, which is associated with estrogen deficiency and being overweight. This may allow your pelvic organs to descend and bulge into your vagina — a condition known as pelvic organ prolapse. Kegel exercises can help delay or even prevent pelvic organ prolapse and the related symptoms.
Another huge benefit of Kegel exercises includes assistance for women who have persistent problems reaching orgasm. I am not sure how this works but I have heard so many anecdotal success stories that I am convinced that Kegel exercises are effective.

I have recommended a device, the Laselle by Intimina (http://www.intimina.com/en/kegel-exercisers-laselle.php), for women with incontinence issues.

Laselle Spheres For Kegel Exercises

There is documented evidence that has concluded that pelvic exercises should be included in first-line conservative management programs for women with urinary incontinence. The Laselle Kegel exercisers are elegantly crafted spheres with an attached string for easy insertion and removal that helps women gain objective evidence that they are doing the exercises correctly.

These weighted spheres, which if worn discreetly inside the vagina during daily activities, give women the most complete intimate workout, helping women to locate their pelvic floor muscles and providing a solid object for women to flex around for more effective strengthening. Within each sphere is a weighted ball that responds to your body’s movements, causing gentle kinetic vibrations to help prompt your pelvic floor muscles to contract and relax as you walk around.

Laselle Kegel exercisers are available in three different weights. These three different weights provide different levels of resistance and can be combined and adapted to your routine as your pelvic floor becomes stronger, helping you to unlock the full potential that this muscle set offers.

Correct performance of Kegel exercises
1. Contract your pelvic floor muscles, lift the exerciser(s) upwards
2. Hold the contraction for 2-10 seconds, while taking deep breaths
3. Release the contraction
4. Rest & relax for a minimum of your hold time, or for as long as you need before repeating the exercise
Repeat 10 times for a Kegel set, if this is challenging, reduce your repetitions to an amount that is comfortable for you.
For an efficient workout, perform a Kegel set 3 times a week on alternative weekdays
Correct Kegels do not involve tensing the abdomen, squeezing the buttocks, or straining and pushing down when contracting.

Performing Kegel Exercises Correctly

Bottom Line: Incontinence is a common problem affecting millions of American women. Kegel exercises are an effective method of solving the problem. Laselle spheres by Intimina are an easy way to get started.

Your Morning Cup of Jo Won’t Make You Go (Urinate)

Go ahead and have a sip, it won’t affect your bladder

For years the standard advice doctors gave patients was that coffee\caffeine contributed to urinary incontinence. Now we know that women with urinary incontinence who also enjoy their regular cup of coffee or tea don’t have to worry about the extra caffeine making their condition worse.
The new research stands in contrast to the common recommendation that women with incontinence avoid caffeinated foods and beverages.

A recent study from Harvard showed that women with moderate incontinence shouldn’t be concerned about their caffeine consumption. All women, even those without incontinence, need to know that caffeine increases the production of urine and may give some the urge to urinate.

The researchers looked at data on roughly 21,500 women enrolled in two large studies, each of which tracked the long-term health of U.S. nurses through surveys starting in the 1970s or 1980s. The study included women with moderate incontinence — defined as leaking urine one to three times per month — from participants who were asked about incontinence and caffeine consumption in 2002 or 2003.

The women were questioned about how much caffeine they consumed in the form of coffee, tea, soda or chocolate. Two years later, when they were again surveyed about incontinence, about 20% said their symptoms had gotten worse and they now leaked urine at least once per week.
The percentage of women with urinary incontinence progression was similar across categories of baseline level of caffeine intake. Similarly, they were unable to find a link between increased caffeine consumption and worsening urinary symptoms — either for general incontinence or for overactive bladder in particular.

Bottom Line: If you are a woman with mild to moderate urinary incontinence, caffeine in moderation will probably not worsen your urinary symptoms
SOURCE: http://bit.ly/IJ1RzF (April 23, 2012 in Journal of Obstetrics & Gynecology)

Don’t Let Your Bladder Drain Your Travel Plans

Travel today can make anyone anxious and nervous. But traveling and worrying about urinary incontinence can make even the most seasoned traveler think twice about making plans for a trip. This article will provide ideas that can help allay those apprehensions about traveling if you have urinary incontinence.

First, if fears about having an incontinence episode are causing you to consider skipping your trip entirely, check in with your doctor. There are medications that can be taken once a day that will help with bladder frequency, urgency of urination and urinary incontinence. You may need to start taking medications a few days or a week in advance of traveling for them to work most effectively, so don’t delay.
Here are other things to discuss with your doctor:

A Kegel a day may keep you dry and comfortable. Kegel exercises are used to strengthen the muscles in the pelvis. However, it may take weeks or months to train these muscles to help control your urination. You can do the exercises at any time even while reading this article or while waiting for the lavatory sign to read “vacant.”

Some medications have side effects that can contribute to urinary incontinence. Check to make sure other drugs you take aren’t undermining bladder control. For example, people who take diuretics to manage blood pressure or swelling might need to switch medications to fight incontinence .
Creating Your Flight Plan

Here’s how to plan for flying or driving “dry”:
Book tickets carefully. If you’re flying, try to get an aisle seat and, if possible, one close to the toilet. Many booking sites let you choose the seat you want on a map of the plane.

Plan your route. If you’re driving, take a careful look at your map and consider stopping for bathroom breaks every 90 minutes or so (based on your typical time between urges or leaks).

Buy supplies. Even with good planning, you could experience a leak. Adult absorbent pads can help you feel more confident. For long trips, talk with your doctor about urethral plugs or portable catheters. Some patients may have a catheter or tube inserted into the bladder before a trip which will drain urine from the bladder to a leg bag which can be easily concealed under your clothing. The catheter can then be removed when you reach your destination. And if you’re flying, check ahead with your airline to find out what you can take in a carry-on. Generally, all prescription assistive products can go on the plane with you.

Learn foreign customs. If you’re traveling internationally, learn how to ask for a bathroom in the local language. Also check in advance to find out whether you will need change for public restrooms and tips for attendants.
Bladder Control While on Your Trip

Choose beverages carefully. Caffeine, soda, beer, and wine are all diuretics and increase the production of urine and can aggravate an already overactive bladder. You should skip these while flying or driving. Sip on water if you’re thirsty.

Ask for privacy. Should you find yourself in the awkward situation of needing a pat-down or other security screening, and you’re feeling embarrassed about your incontinence or related supplies, know that you can ask security officers for privacy. You may want to ask your doctor in advance for a note to confirm your situation.

Avoid constipation as constipation actually makes bladder control more difficult, so make sure you eat a varied diet and have regular bowel movements.

Void early and often. Instead of waiting for a leak, be proactive and seize your opportunities. Make sure you go to the bathroom before you get on the plane, during a layover, and when you have opportunities between meal and beverage cart service times. When driving, stick to your planned stops, even if you don’t feel the urge to go.

Pack a change of clothes. You want to travel light, but you should have easy access to a spare set (or two) of underwear and easy-to-wash travel pants.

Pack toilet supplies. Because you never know how well bathrooms will be maintained, you may want to carry your own flushable wipes, spare toilet tissue, sanitizing hand gel, plastic bags for disposing of trash or for storing soiled clothes, and any other supplies you think you might need.

Plan for special events. You may occasionally have to attend a gala dinner or other social engagement that could require sitting for hours while people speak or make presentations. Try to find out whether these will be on your itinerary and whether you can be seated close to a door.

Bottom Line: With proactive incontinence management, your trip should be as pleasurable and comfortable as you want and you won’t have to depend on Depends!

Article modified from Taking Incontinence on the Road, By Madeline Vann, MPHMedically reviewed by Farrokh Sohrabi, MD

Ladies, When You Gotta Go –It May Just Affect Your Sex Life

Overactive bladder (OAB) can rain havoc on your sex life. OAB is marked by the near constant urge to urinate, which can lead to urinary incontinence or leakage. This occurs because your bladder involuntarily contracts when it isn’t full. From medication side effects and neurological conditions to urinary tract infections and pregnancy, the potential causes of OAB in women vary.
If you are a woman with OAB, sexual intimacy may worsen the symptoms of OAB. Some women are apprehensive about the loss of urine during sexual intimacy and will avoid intimacy to avoid embarrassment. OAB or urinary incontinence can cause physical symptoms as well as fear, anxiety, and shame about sex and intimacy. Most women find it very difficult to discuss their OAB symptoms with men especially if those urinary symptoms occur at the time of sexual intimacy.
Most women with OAB can be helped with medication. Also, sometimes simple actions like using the restroom before sexual intimacy may alleviate the problem. There are dietary modifications such as omitting caffeine and alcohol several hours before you anticipate you are going to be sexually active can reduce the symptoms of OAB. Also there are medications that cause OAB and it may be something as simple as speaking with your doctor and changing your current medication regimen to one that doesn’t cause OAB symptoms. Most patients can be helped with medication and behavior changes to decrease the bladder irritation that results in OAB symptoms.
Unfortunately, many women with OAB will just avoid sex altogether. They think it’s bad for their bladder and that it will make it worse, so they stay away from that whole area. Unless you have a prolapsed bladder or a protrusion from your vagina intercourse is not dangerous and will not damage your bladder.
Sometimes being forthright and honest with your partner is best course of action. Once you are open with your partner, you can face the situation together. If there is urine incontinence during sex or orgasm, you may need a towel. This is something that should be done before you hit the bedroom sheets. Sex experts advise bringing up OAB and sex fears long before intimacy occurs.
Bottom Line: Overactive bladder doesn’t kill you; it just ruins your life. It doesn’t have to be that way. Speak to your partner and your doctor and, this too, shall pass.

This blog was modified from an article on WebMD: OAB: How it Affects Sex and Intimacy, WebMD Feature, By Denise Mann