Yikes! Ever Lost Urine During Exercise Class?

Has this ever happened to you? You’re at your Zumba (or any other exercise class) and all of a sudden you feel dampness on your underwear. Wait- this wasn’t supposed to happen. You emptied your bladder just 10 minutes ago. Your face becomes flushed from embarrassment and you’re not sure what to do.  Luckily, it’s only a little bit so you decide to continue with the class and check out what has happened once you hit the restroom.

Well, you’re not alone! It has happened to many women before you.  


Why did this happen?

Let’s first explain what this is. It’s called Stress Urinary Incontinence (SUI)– the involuntary loss of urine with any physical activity or movement – such as sneezing, coughing, laughing, jumping, running or doing a downward dog in yoga – that puts pressure on your bladder. This is due to a weakening of the pelvic floor muscles that support the bladder, uterus and rectum. Women are twice as likely than men to experience SUI and it increases with age occurring in more than 40% of women over the age of 65.  Many younger women also experience SUI due to pregnancy, vaginal childbirth and/or hormonal changes associated with menopause. In addition, as women, our urethra – the tube that transports urine from the bladder to outside the body – is shorter than in men, which makes SUI more common.  

The best way to understand this is to imagine your pelvic floor like a hammock cradling your pelvic organs and surrounding your urethra and rectum. As these muscles weaken, as well as the sphincters around the urethra and rectum, the bladder can drop down into a position that prevents the urethra sphincter from closing completely allowing urine to leak out.

What activities commonly contribute to SUI? 

You may experience urine leakage when you:​

  • Cough

  • Sneeze

  • Laugh

  • Stand up

  • Lift something heavy

  • Get out of a car

  • Exercise

  • Have sex

​What can we do to decrease the chances of having SUI?  

If you have SUI, it doesn’t mean you’re doomed to have it your whole life. Sometimes, SUI is short-lived and follows childbirth and decreases once you resume your normal menstrual cycles after breast-feeding. For other women, SUI may cause embarrassment, isolation, limits on your work and social life and impact your daily functions. This is when you may want to visit your gynecologist for evaluation for possible pessary (a device that holds up your bladder), surgical intervention (collagen injections around the urethra) or a sling procedure (an out-patient surgery to make a sling to elevate your urethra). 

As Amazing Over 40 women, we want to be proactive and prevent SUI from occurring, or at least, minimize it from happening.

What can Amazing over 40 women do to decrease their risk of SUI?

1. Do Kegel exercises. These exercises help strengthen the pelvic floor muscles, making it less likely for the bladder to drop and cause increased pressure. To do Kegel exercises, identify the muscles which need to be tightened. Initially, this can be done by trying to stop the flow of urine when you’re going to the bathroom.  

But beware! Don’t do this in the bathroom all the time – this confuses the bladder. You want to do this only to identify the muscles you want to improve.

Hold for 2-3 seconds, then release for 5 seconds. Hold again for 2-3 seconds then release. Do this a total of 10 times a day, 10 repetitions at a time. 

Photo via honestlyalexandra.com 

Another caution:

This won’t happen overnight! Like any other muscle in your body, it needs to be strengthened over time and done consistently to maintain this strength.

2. Lose weight. If you’re overweight, even losing 5-10 lbs can reduce SUI. Consult with your doctor to check what your ideal weight is.

Lastly, the cool thing about Kegel exercises – no one needs to know you’re doing them! I tell my patients to do Kegels all day long – at stoplights, waiting at the elevator or at line in the grocery store, or during exercise class. Be creative – you can also do them while having sex!

In health and happiness- 

Dr. Diana

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