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Urinary Incontinence Alternatives

April 3, 2011 Written by JP       [Font too small?]

Many of the decisions we make in life are based on estimates and statistical probability. In health care, this means factoring in hereditary influences and general population figures to “guesstimate” the odds of developing virtually any conceivable medical condition or disease. Age must also be introduced into the equation. As we grow older, the incidence of various conditions such as arthritis, prostatic enlargement and urinary incontinence increase substantially. In previous columns, I’ve addressed several natural strategies that may minimize the risk and reduce the symptoms of arthritis and an enlarged prostate. Today’s focus is on three little-known techniques that may discourage the likelihood of age-related incontinence and limit the symptomatic impact of incontinence if it’s already established.

If you’re over 60 years old, chances are that you or someone you know are affected by urinary incontinence (UI). US Government statistics estimate that almost 40% of women over the age of 60 and about 20% of men in that same age bracket are living with UI. The severity of this condition can vary widely from mild leakage provoked by coughing or laughing to significant, involuntary wetting. The cause of UI most frequently has to do with weakness in the pelvic muscles. However, other age-related changes in both men (prostate enlargement) and women (thinning of tissues in the urethra and vagina); medication side-effects; nerve damage; obesity and urinary tract infections can also play a role in select cases of UI. (1,2,3)

Far and away, the most popular natural remedy for UI is a specific form of physical training known as Kegel exercises. This practice was developed by a gynecologist named Arnold Kegel in the late 1940′s as a means of supporting normal pelvic floor function, which in turn, can reduce urinary incontinence. In subsequent years, pelvic floor muscle training has been combined with other natural modalities including biofeedback in an attempt to further improve treatment outcomes. Some additional background information and a how-to guide on performing Kegel exercises can be accessed by clicking on the citations at the end of this paragraph. (4,5,6)

The current edition of the journal Neurourology Urodynamics is the first scientific publication to report that green tea consumption may be of value in the prevention of urinary incontinence. Previous inquiries that have investigated other beverages containing caffeine have yielded mixed results. In some instances, overall tea consumption has been implicated with a greater likelihood of UI prevalence and symptom severity. Surprisingly, coffee intake is unlikely to play a detrimental role in developing UI. In fact, some data indicates that coffee use may actually reduce the risk in some populations. But, the specific study of green tea in relation to UI hadn’t been investigated until recently. Here are the findings of the one and only intervention pertaining to this matter: (7,8,9,10,11)

  • The examination in question followed 300 women with ages ranging from 40 to 75.
  • The researchers evaluated UI incidence and “habitual tea and coffee consumption”
  • Women who drank 4 or more cups of green tea/day were 66% less likely to have incontinence.
  • No similar benefits were found in association with black tea, coffee or oolong tea intake.

It’s not uncommon for older men and women to be deficient in Vitamin D. This reality has lead some scientists to the conclusion that many age-related medical issues may be influenced by inadequate levels of the essential hormone/nutrient. Several studies of late reveal that women with higher levels of Vitamin D (above 30 ng/mL) are afforded some degree of protection from pelvic floor disorders. What’s more, supplementing with Vitamin D alone or in conjunction with other nutrients may improve incontinence. The upside of bringing Vitamin D levels up to an optimal level is that other “side benefits” will likely appear. A trial from June 2010, which utilized a supplement containing astaxanthin, calcium, citrus bioflavonoids, lycopene and Vitamin D resulted in a 45% improvement in overall menopausal symptoms, including incontinence, in a group of 65 older women. (12,13,14,15,16)

Diabetes & Metabolic Syndrome May Increase the Risk of Developing Incontinence

Source: Rev Urol. 2010 Fall; 12(4): e157–e180. (link)

Another unconventional therapy to consider is acupuncture. Numerous studies in animal and human models of urinary incontinence indicate that this Eastern healing practice is an effective means of addressing various forms of UI. A double-blind, randomized, pilot study from December 2009 found that twice-weekly acupuncture for 6 weeks provided a 67% reduction in “daytime accidents”. Those receiving the placebo treatment or “sham acupuncture” only demonstrated a 17% decline in UI symptoms. Also of note, the benefits extended for at least 4 weeks beyond the end of treatment. Other successful acupuncture trials have involved the use of hand acupuncture for “female stress urinary incontinence” and “bladder-specific acupuncture” for “overactive bladder with urge incontinence”. These findings aren’t surprising when you consider that acupuncture has also been shown to improve related bladder control conditions such as diabetic bladder dysfunction. (17,18,19,20,21)

There’s so much that we take for granted in our youth. Anyone who’s fortunate enough to grow old tends to find this out the hard way. I know I’m already in the midst of that learning process. But the good news is that many of the expected changes that accompany age can be forestalled and possibly even avoided if we stay informed about natural options that are available to us all. If you look over the remedies highlighted today you’ll see that at least two of the three can be very easily and inexpensively incorporated into almost every health care program. Drinking green tea instead of fruit juice or soda would be a great start. Having Vitamin D levels tested and supplementing with D when warranted could conceivably counteract many of the expected changes associated with growing old as well. Now, I’ll admit that acupuncture probably isn’t going to be the preventive measure of choice for most people. But that’s perfectly okay. Some alternative and complementary options can be used on an “as needed” basis. That’s why they exist! And that’s the key to genuine health care success: understanding your options and employing them judiciously.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Be well!

JP

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7 Comments & Updates to “Urinary Incontinence Alternatives”

  1. susiet Says:

    Hi Harry,

    Long time no talk! You probably know me as “Pooti,” but it’s been quite a long time since we last talked. I took a hiatus when my mom was dx’d with lung cancer. I’m now back with a food and cooking blog and re-discovered your very informative blog!!!

    I really appreciated this post. I know as a T2 person, my urinary incontinance that began as a result of enlarged femal organs (pre-historectomy), gets worse depending on how low or high my blood sugars are on any day!

    So I have a new blog…www.fluffychixcook.blogspot.com. Hope to see you soon!

    All the best!

    SusieT.

  2. JP Says:

    Thank you, Susie. I appreciate you sharing your experience. It’s valuable information for people to know! I’m also glad that you’re back to writing. Excellent.

    Be well!

    JP

  3. Ted Hutchinson Says:

    This http://tinyurl.com/3um5eg8 pubmed search for Melatonin Nocturia shows that melatonin use allows the bladder to expand, increase capacity, as you sleep thus avoiding disturbing sleep.
    I find this beneficial as I have to self catheterize and it’s simpler not to do so during the night.

    Perhaps other readers may also like to read
    “Antimicrobial peptides, innate immunity, and the normally sterile urinary tract.” Zasloff M. PMID: 17942949 full text free at pubmed.
    Having to self-catheterize 5 x daily increased UTI incidence. Improving vitamin D status reduced Urinary Tract Infections.
    Most UTI’s are from intestinal bacteria. Cleaning up pathogenic gut flora is helpful in reducing UTI’s.
    Green tea and Curcumin both have the ability to inhibit e coli (common cause of UTI) so I’ve now gone over a year without a UTI by keeping Vitamin D status high, drinking green tea as my main beverage and taking Curcumin regularly.
    It’s much better preventing UTI than having to use prescribed antibiotics to control repeat infections.

  4. JP Says:

    Excellent information. Thank you for sharing it, Ted. Much appreciated!

    Be well!

    JP

  5. JP Says:

    Update: Pilates supports urinary continence after prostate surgery …

    http://www.ncbi.nlm.nih.gov/pubmed/25809925

    Neurourol Urodyn. 2015 Mar 21.

    Is pilates as effective as conventional pelvic floor muscle exercises in the conservative treatment of post-prostatectomy urinary incontinence? A randomised controlled trial.

    AIMS: To verify the efficacy of a Pilates exercise program compared to conventional pelvic floor muscle exercise (PFME) protocol in the conservative treatment of post-prostatectomy urinary incontinence (PPUI).

    METHODS: Baseline assessment was performed four weeks postoperatively and included 24 hr pad test, bladder diary, and the ICIQ-SF. Patients were randomised into three groups: Pilates (G1), PFME combined with anal electrical stimulation (G2), and a control group (G3). Both treatment groups had to perform 10 weekly treatment sessions. Primary outcomes were mean reduction of daily pads and mean reduction of ICIQ-SF score four months after surgery. The significance level was set at P <  0.05.

    RESULTS: 85 patients completed the study. Differences between treatment groups (G1 and G2) in terms of mean reduction in daily pad usage, 24 hr pad test, and ICIQ-SF scores were not statistically significant (P > 0.05). The control group differed from G1 in daily pad usage (P = 0.01) and ICIQ-SF score (P = 0.0073). Intergroup comparisons revealed that 57.7% of the volunteers in G1 and 50% of the individuals from G2 no longer used pads by the end of the treatment period (P = 0.57). In the control group, 22.6% were not using pads four months after surgery, with statistical difference compared to G1 (P < 0.05).

    CONCLUSIONS: The Pilates exercise program proved to be as effective as conventional PFME to speed up continence recovery in PPUI. It also achieved a higher rate of fully continent patients when compared to the control group in the short-term.

    Be well!

    JP

  6. JP Says:

    Updated 08/03/15:

    http://www.goldjournal.net/article/S0090-4295(15)00705-0/abstract

    Urology. 2015 Jul 29.

    Urinary Lignans are Associated with Decreased Incontinence in Postmenopausal Women.

    OBJECTIVE: To examine the association between urinary phytoestrogens and self-reported urinary incontinence in post-menopausal women in the United States using a large, cross-sectional, population based cohort survey.

    METHODS: Data were analyzed for 1,789 post-menopausal women 50 years of age or older who participated in one of the 2001 to 2010 cycles of National Health and Nutrition Examination Survey and underwent measurement of four isoflavone (soy-derived) and two lignan (flax-derived) phytoestrogens in their urine. Incontinence was defined as self-reported stress, urge, other or mixed incontinence. Urine phytoestrogen concentrations were examined in weighted, multivariate logistic regression models for association with each of the lower urinary tract symptoms. All models were adjusted for age, body mass index, diabetes, race, smoking and parity.

    RESULTS: Increasing urine concentrations of the lignan phytoestrogen enterodiol was associated with decreased likelihood of urge (OR 0.92, 95% CI 0.85-0.99), mixed (OR 0.90, 95% CI 0.82-0.98) and other (OR 0.90, 95% CI 0.81-0.99) incontinence, while increasing urine concentrations of the lignan phytoestrogen enterolactone was associated with decreased likelihood of urge (OR 0.92, 95% 0.86-0.99) and mixed (OR 0.91, 95% CI 0.84-0.99) incontinence. No association was observed between any isoflavone phytoestrogens and types of incontinence.

    CONCLUSIONS: This study demonstrates that lignan phytoestrogens may have a protective effect against incontinence in post-menopausal women. Prospective clinical and laboratory studies are warranted to investigate the mechanism of this relationship.

    Be well!

    JP

  7. JP Says:

    Updated 10/15/16:

    http://bmcurol.biomedcentral.com/articles/10.1186/s12894-016-0178-y

    BMC Urol. 2016 Oct 6;16(1):61.

    Coffee and caffeine intake and risk of urinary incontinence: a meta-analysis of observational studies.

    BACKGROUND: Previous results from studies on the relationship between coffee/caffeine consumption and risk of urinary incontinence (UI) are inconclusive. We aim to assess this association using a meta-analysis of observational studies.

    METHODS: Pertinent studies were identified by searching electronic database (Embase, PubMed and Web of Science) and carefully reviewing the reference lists of pertinent articles until July 2015. Random-effects models were used to derive the summary ORs and corresponding 95 % CIs.

    RESULTS: Seven studies (one case-control, two cohort and four cross-sectional) were included in our meta-analysis. The summary ORs for any versus non-consumption were 0.75 (95 % CI 0.54-1.04) for coffee and 1.29 (95 % CI 0.94-1.76) for caffeine consumption. Compared with individuals who never drink coffee, the pooled OR of UI was 0.99 (95 % CI 0.83-1.18) for regular coffee/caffeine drinkers. Coffee/caffeine consumption was not associated with moderate to severe UI (OR 1.18, 95 % CI 0.88-1.58). In stratified analyses by gender, no significant association was found between UI risk and coffee/caffeine consumption in both men (OR 0.99, 95 % CI 0.42-2.32) and women (OR 0.92, 95 % CI 0.80-1.06). By subtype, the pooled ORs were 1.01 (95 % CI 0.86-1.19) for stress UI, 0.99 (95 % CI 0.84-1.16) for urge UI and 0.93 (95 % CI 0.79-1.10) for mixed UI.

    CONCLUSIONS: This meta-analysis found no evidence for an association between coffee/caffeine consumption and the risk of UI.

    Be well!

    JP

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