Trouble Down Below

Pelvic-floor problems like incontinence and prolapse are common but not often discussed. Here are some nonsurgical solutions.

Trouble Down Below
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When the urge is really urgent
If you have urge incontinence, also known as an overactive bladder, you get the urge to go even though your bladder is barely filled, and you leak en route to the restroom. (Having frequent urges without the leakage is called urinary frequency and often has the same causes.) Urge incontinence is heavily influenced by dwindling estrogen levels after menopause, and the more babies you’ve delivered, whether vaginally or via Cesarean section, the higher your risk.

A huge percentage of women have mixed incontinence—both stress and urge—and the only reliable way to distinguish between the two is to undergo urodynamic testing at a urology clinic. (It’s also important to rule out other causes, such as urinary tract infections.) Bladder retraining exercises help for urge incontinence, and there are also several drugs available, but their results and side effects vary widely, so it pays to explore other options first. Because urge incontinence is often triggered by bladder irritation or inflammation, the following approaches can be helpful:

DIETARY CHANGES Bladder inflammation is often caused or aggravated by certain beverages such as coffee, black tea and alcohol as well as spicy and acidic foods, wheat and dairy. “Identifying food sensitivities can make a big difference,” says Quinn. A blood test as well as an elimination diet can help you identify which ones to cut out.

AMINO ACIDS “The two key ones are L-glutamine and N-acetyl glucosamine,” Quinn says. She also uses the herbs Zea mays (cornsilk), uva-ursi and marshmallow root. “They are protective of all the mucous membranes in the body and have a particular affinity for irritation and inflammation of the bladder,” she explains. These products and the toning herbs below should be prescribed by a qualified practitioner, such as a naturopathic physician (N.D.) or an osteopathic physician (D.O.), who can diagnose your specific problem.

TONING HERBS Herbs such as passionflower and chamaelirium can help tone the pelvic tissue, says Pina LoGiudice, N.D., L.Ac., a naturopathic physician at InnerSource Natural Health in Huntington, N.Y. “Also, an herb called equisetum strengthens the whole pelvic floor and helps with nighttime urinary frequency.”

ACUPUNCTURE “Traditional Chinese medicine looks at imbalances in the body, and incontinence is an energy-deficiency problem,” says LoGiudice, who is also a licensed acupuncturist. “By stimulating various points you can strengthen a patient’s qi, or energy, so the bladder regains its strength and doesn’t spasm.” LoGiudice recommends weekly treatments for eight to 10 weeks.

PERCUTANEOUS TIBIAL NERVE STIMULATION (PTNS) Among the most promising treatments for urinary urgency and frequency is this technique in which an acupuncture needle transmits a mild electrical current at the ankle. “We’ve seen surprisingly good results, mainly among women who couldn’t tolerate overactive-bladder medication or didn’t respond to it,” says Roger Goldberg, M.D., director of urogynecology research at the University of Chicago NorthShore University HealthSystem. “The main downside is that the results aren’t permanent,” he adds.

My grandma dealt with her urinary problems by staying close to the restroom at all times, even if that meant, at age 92, seeing movies like The Matrix Reloaded. Fortunately, better options are available. If you have any degree of bladder or other pelvic-area problems, says Quinn, “first consult with your holistic health provider, then get a referral to a physical therapist and a urologist with a big-picture attitude.”