Some of my female patients – both younger and older – are often embarrassed by what I refer to as “The Laugh and Leak” Syndrome. More accurately, it’s often the laugh, sneeze, cough, exercise – and sometimes sex and many other things – leak syndrome. No matter what the activity may be that triggers it, “leak syndrome” involves the involuntary “spritz” of urine, and sometimes feces.
It’s caused by weak pelvic floor muscles and affects about 50 million women worldwide – about 17 million in the U.S. alone. So, I’d like to tell you about some specific exercises, as well as some pelvic floor training devices on the market, that are showing good results in treating this condition.
Stop “The Leak” with Pelvic Floor Training
Stress urinary incontinence can occur in women of all ages. It typically starts to occur in younger women who have had several childbirths, or who have significant abdominal obesity. The ligaments that support the uterus become stretched out, or “lax”. As a result the uterus changes its position, going more forward, or down, putting pressure on the bladder which also displaces it and the urethra. This laxity can also displace the lower part of the intestine, the rectum, and cause leakage there as well.
Stress incontinence can also occur in older, menopausal women from hormonal changes in tissues. Left untreated, these changes cause the uterus and vaginal walls to atrophy, or shrink, which can change the position of the urinary urethra.
In stress incontinence, women experience the sudden release of urine, and/or sometimes feces, with sudden stressors that occur when you sneeze, cough, and laugh. But it can also start to occur when extra “bearing down” pressure is put on the pelvic floor such as lifting a heavy object, or with impact pressure that occurs with certain types of exercise like running, jumping. It can also occur during sex which can make her shy away from intimate relations.
For years, gynecologists and internists have recommended women to do Kegel exercises. These are exercises that isolate the weakened pelvic floor muscles that support the uterus and bladder. Although Kegel exercises have been proven to work to strengthen these muscles, they have to be done correctly to be effective.
Many women either don’t do them correctly or don’t do them enough to make a real difference. So, I’d like to tell you about some other options you have – 2 other exercises, that target the same pelvic floor muscles, as well as some new devices that pretty much do the exercises for you. They’ve been shown to have great success in eliminating, or greatly decreasing, the leakage of urine.
Hip Lift and Squeeze. Sit on your knees on a gym mat, or rug. Widen your knees as far as you comfortably can. Now, lean your torso back so you’re sitting on your feet. Support yourself with your arms. In this position, lift your hips forward, upward.
Now, squeeze your pelvic muscles, as if you were holding back urine (like in a typical Kegel). Squeeze as hard as you can and hold for 10 seconds. Repeat the sit, lift hips, and squeeze sequence 10 times. Try to do this exercise at least once a day.
Pelvic Lift. Sit on your mat or rug, your legs out in front of you spread about 1 foot apart, your arms supporting behind you, your hands facing flat, and outward.
Now, placing your feet flat on the floor, lift your hips up so that you’re middle is “planking”. Perform the same pelvic muscle squeezes as you did in #1, hold for 5-10 seconds, or as long as you can if you feel shaky.
In addition, I’d like to tell you about some new devices – pelvic floor “exercisers” – that pretty much perform the exercise for you.
Pelvic Floor Training Devices
There are several pelvic floor training devices on the market that have been effective in strengthening pelvic floor muscles and decreasing urinary leakage. Here are a few you may want to look into:
Super Kegel Exerciser. This simple device is held between the tops of the thighs. You squeeze the paddles together and hold for 10 seconds, then release, repeat. It also has the added benefit of strengthening the thighs, buttocks and lower abdominal muscles.
In-Tone Pelvic Floor Trainer. This is a relatively new medical device that is now available for women to use. It is a gentle, painless, electrical stimulation unit that “exercises” the specific pelvic floor muscles once it is inserted into the vaginal cavity. Your doctor calibrates the level of stimulation and comfort for you. You purchase it to use at home in a program outlined by your doctor. Regular checkups are necessary to measure your progress.
As In-Tone is a medical device designed to treat a specific medical condition, your insurance company should reimburse you for the cost. Ask your doctor about In-Tone, or find a specialist trained in its use by visiting their website (see References below).
Stress incontinence may eventually worsen into complete incontinence where you can’t control the flow of urine at all. It’s one of the reasons that older women wind up in nursing homes. So, working on strengthening the pelvic floor muscles can only help you as you get older. It can also help prevent bladder infections. Keeping a normal weight as increased abdominal fat puts pressure on the bladder, emptying your bladder before exercise, or other activities, and wearing pads, can help decrease the chance of “leaks” at inopportune moments.
Mark Rosenberg, M.D.