Urinary Incontinence is No Joking Matter

Have you ever heard someone say after telling a joke, “I laughed so hard, I peed my pants”? If it is indeed true, then it is no laughing matter. Incontinence affects millions of American men and women. It is more common as men and women age but can occur at any time and may impact a man or woman’s quality of life because of embarrassing leakage. It can affect a man or woman’s self-image and confidence.

There are two categories of urinary incontinence: stress incontinence and urge incontinence. Stress incontinence is due to laughing or sneezing. Basically, small amount of leakage occurs when the pressure in the belly is more than what the urethra – the urine tube leading out of the bladder – can stand. This is what happens when you laugh or sneeze and leak.

Urge incontinence occurs when the bladder contracts and forces usually large volume of urine out. People may describe a sudden urge to urinate, and they simply cannot make it in time to the bathroom. Sometimes both types of incontinence may be present and is referred to mixed incontinence.

Women are more likely to experience urinary incontinence because their anatomy predisposes them to leakage of urine. Also, hormonal changes occurring at the time of menopause with a decrease in estrogen levels, childbirth and aging make leakage more common for women. If the incontinence affects a woman’s day-to-day life and it keeps them from taking part in their daily activities, then they should take the initiative and obtain the assistance of the physicians.
Men with incontinence, on the other hand, should see their doctor as it may represent a more serious problem with their prostate gland.
The good news is that urinary incontinence can be treated. It may be as simple as behavioral changes quit, special exercises and medicines. In some cases it may involve surgery.

Bottom Line: Urinary incontinence affects millions of American men and women. It is not a condition that kills those who suffer but it does affect their quality of life. Help is available and most men and women who suffer from urinary incontinence can be helped. Remember you don’t have to depend on Depends!

FAQ From My Patients

I am frequently asked questions by my patients and the answers may be of interest to you. If you have any questions that you would like me to answer, please write me at nbaum@neilbaum.com. to your good health.

I am a 60 yr. woman with recurrent urinary tract infections. I was told to drink cranberry juice. Is that effective?
Studies have documented that within eight hours of drinking cranberry juice, the juice could help prevent bacteria from developing into an infection in the urinary tract. Previous studies have suggested that the active compounds in cranberry juice work to fight against bacteria, including E. coli. Naturopaths believe in the medicinal value of cranberries. My own experience with hundreds of patients is that cranberry juice helps but you must drink 4-6 glasses a day, which is also a lot of sugar. So I suggest the cranberry juice pills. Anyone who suspects they have an infection should see a doctor, but drinking cranberry juice may be an easy, inexpensive way to help keep E. coli at bay.
I have chronic prostatitis. Is zinc helpful for this condition?
Zinc plays an important role in maintaining and improving prostate health. While zinc is found in every organ, tissue and cell in the human body, in males, the prostate has more zinc than any other tissue except bone.
As men get older, they tend to exercise less and their diets change as well, often causing them to fall short of the recommended daily allowance of zinc. Men who don’t have significant levels of zinc in their diets tend to have higher instances prostatitis. They also have higher prostate cancer rates.
The recommended daily allowance for men is 11 milligrams. Zinc is found in many popular foods, including meat and poultry, as well as oysters, beans, nuts, crab, lobster, whole grains, fortified breakfast cereals and dairy products.

My urologist told me that I have a varicocele. Will this cause me to have a problem with infertility?

Yes it may. Varicoceles are enlarged varicose veins that occur in the scrotum. They are fairly common, affecting 15 out of 100 men overall and one of the most common causes of male infertility because the heat from the dilated veins affect sperm production. Varicoceles occur most often in the left testicle. A varicocele repair is done to improve male fertility and is accomplished on an outpatient basis with improvement in the sperm producing in 3-4 months after the procedure.

I had radiation therapy for prostate cancer and now have a loss of my sex drive. What is the cause?
Men who receive radiation therapy for prostate cancer often receive injections to lower the testosterone level to decrease the growth of the cancer. Testosterone is responsible for the sex drive or libido. Often the testosterone level will return to normal after the medication is discontinued after the radiation therapy. In some instances men can receive testosterone one year after radiation if the PSA level stays at a low level. I suggest you have a discussion with your urologist about the use of testosterone in men with prostate cancer.

Caution On Use of Testosterone-Don’t Let Partner and Children Touch The Application Site

Testosterone is recommended for millions of American men with low T. These men report significant improvement in their symptoms of low T such as improved energy level, improvement in libido and erections, improved bone mineral density thus preventing osteoporosis in men. However, there are some precautions regarding the use of testosterone topical gels, which is the most used method of testosterone replacement. Testosterone left on the skin that is not absorbed can be transferred to your partner or your children if they come in contact with the application site.

If you are using topical testosterone gels, you should avoid contact between the applications sites and the skin of your partner and children.

To minimize the risk of testosterone gel transfer, men should wash the exposed area thoroughly before allowing direct, skin-to-skin contact. I also suggest than men wash their hands with soap and water immediately AFTER application of the gel. However, subsequent skin-to-skin exposure to the application site can still lead to transfer of testosterone from the man using the topical gel to others.

I also suggest that men be instructed to wear a T-shirt over the application site if the gel is applied to the abdomen and\or upper shoulders to prevent inadvertent testosterone transfer.

Men using topical gels should watch carefully for signs of testosterone transfer to partners and children.

Signs of testosterone in little boys include increased public hair, penile enlargement and accelerated bone growth. Other symptoms in both boys and girls include deepening of the voice, overactive oil gland in the skin leading to acne, increased body odor, increased muscle mass, frequent erections and masturbation, as well as behavioral changes.

In women the signs of testosterone transfer toxicity may include growth of hair on the face, male pattern baldness, irregular menses, enlargement of the clitoris, and deepening of the voice.

Bottom Line: Testosterone from accidental exposure from the topical gel from the man to his partner or children places the women or children to the deleterious effects of testosterone in women and\or children. The best advice for protection of partners and children is for the man to wash his hands after applying the gel and covering the application sites with a T-shirt or underclothing.

Sexual Wellness Program on Angela WWL, April 9, 2014

Angela Hill

Email: angela@wwl.com
Twitter: @AHillWWL

Angela: Help with sexual wellness is available, you just have to speak up!

by Angela Hill posted Apr 9 2014 4:22PM
Dr. Neil Baum has been a friend of “An Open Mind” ever since we started last fall, helping us understand medical issues that can affect our sex lives.

He spent a whole hour talking to WWL listeners today and pointed out that oftentimes, when it comes to sexual problems, women are suffering in silence, even though sexual dysfunction is more common in women than it is in men.

So what are the problems women are facing, and why can’t we speak out about it? It seems like every time you turn on the television or radio you hear an ad for a product that helps men with erectile dysfunction. Where is the help for women? Products to help women are just now starting to crack through, but haven’t gone mainstream yet.

So many men are having an open and honest dialogue with each other and their doctors, it is easy for them to speak out on these topics, but the lack of dialogue concercing female sexual dysfunction is holding women back. But it doesn’t have to be that way!

“Women who have problems with enjoyment, who have problems with dryness, who have problems with decreased libido are afraid to bring it up with their physicians. There are things that can be done for these women, and they should be encouraged to talk to their doctors,” Dr. Baum said. “Women have to understand that help is available for them, and they don’t have to suffer in silence.”

Is there Viagra for women?

“Right now, there is not. But there are things that can be done for decrease in drive for women, those whose interest is waning. It is primarily hormone-driven.”

Could hormone replacement therapy help your sex life? It’s not for everyone, but no matter what stage of life you are in, it’s imperative that you talk to your doctor, because there are options that can help you restore your love life.

One woman calls in to talk about her experience at “The Vagina Clinic,” where she found good medical advice from professionals tailored to her needs. Another man calls in with a question about testicular pain, and another with a question about fertility treatments

Everyone should take a moment to listen to the full interview – hear from men and women who have problems that may mirror those in your own life, or in the lives of your loved ones.

Bottom line? Talk to your Doctor!

FULL AUDIO: Angela talks to Dr. Neil Baum about sexual dysfunction and wellness

Low T, To Treat Or Not To Treat?

There’s controversy on the use of testosterone in men who suffer from low T. In this blog I would like to share the benefits of treating low T
from several thousand men who had symptoms of decreased testosterone.

About 40% of men older than 40 have low T. If you have low T, with symptoms that are decreasing your enjoyment of life, you need to weigh the risks and benefits of treatment. There could be a big upside to treatment.

Once you start low T treatment, you need to continue it or your testosterone level will drop back down.

The U.S. Food and Drug Administration has approved testosterone treatment for men with low testosterone and symptoms of low T, such as:
• Lack of sex drive
• Fatigue
• Weak bones
• Depressed mood
• Loss of muscle
• Erectile dysfunction (ED)

The Benefits of Treating Low T
If you meet the guidelines for treatment and you and your health care provider decide the benefits outweigh the risks for you, there are good reasons to treat low T.
Possible benefits you may experience include:
• Reduced weakness
• Less chance of falls and fractures
• Improved mental ability
• Improved sexual desire
• More energy
• Better quality of life
According to the American Urological Association, you may also experience:
• Better sleep
• Better erections
• Decreased body fat
• Increased muscle mass
• Stronger bones

Current Guidelines
The most up-to-date guidelines for when to treat low T are from the Endocrine Society. The guidelines say that low T should be treated if you have an early morning blood test that shows low testosterone and you have symptoms of low T.
The guidelines also list other medical conditions where the risks of low T therapy outweigh the benefits. The conditions include prostate cancer, sleep apnea, and heart disease.

Bottom Line: Millions of American men suffer from low T. Low testosterone on a blood test is not enough reason to treat low T. If you meet have symptoms of low T and have a blood test that confirms low T, the benefits can make treatment worthwhile.
If you have any questions about the management of low T, speak to your doctor.

A Hop, Skip and a Jump May Just Help Women With Urinary Incontinence

Urinary incontinence affects millions of American women. It is a quality of life condition that can lead to embarrassment, anxiety, and even depression. Conventional treatment is medication, exercises, and surgery. Now a new study from Canada has shown that dancing may strengthen the muscles in the pelvis and help control urinary incontinence.

Women were provided a series of dance exercises via a video game console in addition to a program for pelvic floor muscles exercises. The results revealed a greater decrease in daily urine leakage than for the usual program (improvement in effectiveness) as well as no dropouts from the program and a higher weekly participation rate (increase in compliance).

According to the researchers, fun is a recipe for success. The researches suggested that the more you practice, the more you strengthen the pelvic floor muscles. The investigators quickly learned that the dance component was the part that the women found most fun and didn’t want to miss.

The dance period also served as a concrete way for women to apply pelvic floor muscle exercises that are traditionally weak an ineffective to help hold the urine in the bladder until it is convenient to empty the bladder in a toilet. Dancing gives women confidence, as they have to move their legs quickly to keep up with the choreography in the video game while controlling their urine. They now know they can contract their pelvic floor muscles when they perform any daily activity to prevent urine leakage. These exercises are therefore more functional.

This is the first time that it has been used to treat urinary incontinence.

Bottom Line: Dancing may be effective in helping women with a problem of urinary incontinence. If this is a problem that is affecting your life style, contact your physician. Help is available. You don’t have to depend on Depends!