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Is Your Bladder Getting in the Way in the Bedroom?

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The title is a little different, but the theme is the same. This is nearly the same article that I recently published in the April 2009 edition of Perfectify:

Women’s bodies are very resilient, but many women notice changes to their bodies below the belt after major life events. Because women are living healthier and longer lives, the chances of having a problem with your bladder, and how it affects the activities in your life is expected to only become more bothersome over time.

Problems with bladder control are quite common in women of all ages, but starting in the 30s and 40s, many women notice that going to the bathroom or accidental urine loss becomes embarrassing and restricting. Despite being healthy or physical fit, the muscles and connective tissue supporting the bladder, vagina, uterus and rectum can become weak or stretched and declare itself in a variety of ways.

Urinary incontinence (UI) is the involuntary loss of urine in any situation. It can be stress-induced, meaning, urine loss during exercise, running, jumping, laughing coughing and even sex. This is known as Stress Urinary Incontinence (SUI). Very often, the sense of needing to go to the bathroom never goes away and you may feel like you have to know where every bathroom is no matter where you go, otherwise there will be trouble. The constant sense of urge, frequency and leaking before you can even pull your pants down is known as Overactive Bladder (OAB), and can coexist with SUI in many women.

Giving birth is an exciting life-changing event, yet even one vaginal childbirth increases a woman’s risk of bladder and other pelvic floor problems. Having a C-section does not seem to be protective over time. The aging process, menopause, repetitive straining such as with a chronic cough, constipation, obesity, and surgery such as a hysterectomy, are other common predisposing factors. In fact, the lifetime risk for an American woman to need surgery for problems related to pelvic floor weakness is 11%. Urinary incontinence affects 13 million adults in the US, 85% of them being women.

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EmpowHER Guest

I hope, in addition to kegels, you consider recommending a more comprehensive physical therapy regimen for strengthening pelvic floor muscles. Kegels are one action of the muscle -- women should also perform pelvic floor elevations (the second action) as well as exercises to strengthen the coordinating muscles (abs, glutes, low back, deep hip rotators, etc.). In the physical therapy world, only do kegels is akin to trying to rehab a knee by only doing quad sets.

Physical therapy won't be the solution for every woman, but it is a good starting point for most. There is a relatively new and growing area within the American Physical Therapy Assocation devoted to Women's Health (http://www.womenshealthapta.org/plp/index.cfm)

You can also find a comprehensive description of the exercises I recommend at www.hab-it.com.

Tasha Mulligan MPT, ATC, CSCS
Creator of the Hab It: Pelvic Floor DVD

May 1, 2009 - 8:36am
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