Strengthen your pelvic floor

Your pelvic floor muscles and urinary sphincter help control urination. You can strengthen these muscles by regularly doing pelvic floor exercises, commonly referred to as Kegels.

The pelvic floor muscles open and close the tube that carries urine from the bladder to outside your body (urethra). These muscles also support the bladder during everyday activities such as walking, standing, lifting and sneezing.

  • Practice Kegel exercises. To perform, squeeze your pelvic floor muscles — as if you're trying to stop your stream of urine — for three seconds. Relax for a count of three and repeat several times. Your doctor might recommend that you do a set of these exercises three or four times a day, lying down, sitting and standing.

    To be sure you're doing them correctly, ask your doctor or nurse to help you or to refer you to a physical therapist knowledgeable about pelvic floor exercises.

  • Biofeedback. Biofeedback can help train pelvic floor muscles. Sensors placed near the muscles transmit exertion levels to a computer, which displays the levels on the screen. This immediate feedback may help you master Kegel exercises more quickly because you can see whether you're using the correct muscles. Biofeedback can be done with a professional or with a home device.
  • Vaginal weights. Cone-shaped weights are another option used to help with Kegel exercises. You place a weight in your vagina and contract your pelvic floor muscles to keep it from falling out. Many cones come in sets of varying weights, so you can build up to heavier weights as your pelvic floor muscles strengthen.

Control contributing factors

Certain medications, excess weight, smoking and physical inactivity can contribute to bladder control problems. If you address these factors, bladder-specific techniques — such as avoiding bladder irritants and bladder training — might be more successful.

  • Manage your medications. Drugs that might contribute to bladder control problems include high blood pressure drugs, heart medications, diuretics, muscle relaxants, antihistamines, sedatives and antidepressants. If you develop incontinence or difficulty urinating while taking these drugs, talk to your doctor.
  • Maintain a healthy weight. Being overweight can contribute to bladder control problems, particularly stress incontinence. Excessive body weight puts pressure on your abdomen and bladder, sometimes resulting in leakage. Losing weight might help.
  • Stop smoking. Smokers are more likely to have bladder control problems and to have more-severe symptoms. Heavy smokers also tend to develop a chronic cough, which can place added pressure on the bladder and aggravate urinary incontinence.
  • Be active. Some studies indicate that regular physical activity improves bladder control. Try for at least 30 minutes of low-impact moderate activity — such as walking briskly, biking or swimming — most days of the week.
  • Minimize constipation. Straining during bowel movements can damage the pelvic floor. Unfortunately, some medications used to treat bladder control problems can worsen constipation. Exercising, drinking enough water and eating high-fiber foods, such as lentils, beans, and fresh vegetables and fruit, might help improve constipation.
  • Manage chronic cough. Your cough could be making your bladder problem worse. See your doctor about treatment options.

Your role in treatment

Behavior therapies, which take time and practice, can improve bladder control. If you stick with the program, you'll likely see improvement in your symptoms. And if one of these approaches doesn't work, talk with your doctor about trying another strategy.

July 18, 2017 See more In-depth