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Get to know one of the hardest-working systems in your body
BY LAUREN FERRANTI-BALLEM
 e learn early on to wipe front to back, always go when you feel the urge and that cotton underwear ‘breathes’. But we take our hard-working bladder for granted until something goes wrong. Treat your bladder kindly, says Dr. Natasha Turner ND, author of The Hormone Diet: “Avoid or limit irritating foods, like caffeine, sugar, artificial sweeteners and spicy foods, which have the potential to aggravate the bladder,” she says. “Drink plenty of water, void when you need to, and regularly tone your pelvic floor muscles.”
Anatomy, age and fluctuating hormones can trigger occasional issues for women. Recognize the three most common bladder concerns, the steps you can take to prevent them, and traditional and alternative treatments for each.
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The concern:
Urinary tract infections (UTIs)
Generally, urine is free of bacteria and viruses. Infection occurs when bacteria that lives normally in the vagina and in the colon (most often E. coli), enter the urethra and multiply. An infection in the urethra only is called urethritis. Left untreated, the infection will travel, says Dr. Scott Farrell, past president of the Society of Obstetricians and Gynaecologists of Canada and a urogynaecologist based in Halifax. “The bacteria are apt to ascend in the urinary tract,” he says. When it moves to the bladder, it’s known as cystitis. Infection in the kidneys is called pyelonephritis, resulting in fever and extreme back pain. Symptoms include an urgency to urinate and burning and pain during urination. Despite the desperate urge to pee, you may only pass a trickle; urine may look milky, cloudy, or show blood traces.
When and why: Women, during their reproductive years, are more likely to suffer UTIs than men. “The main reason is the female anatomy, too many openings, too close together,” says Dr. Harold Drutz, Professor and Head of Urogynaecology at Toronto’s Mount Sinai Hospital.
In pregnant women, the urethra’s position can change, making an easier passage to the bladder, while the hormonal shift of menopause can cause thinning of the vaginal lining (which includes good bacteria), often allowing harmful bacteria to take their place.
One UTI increases the odds for
recurrence, says Dr. Lesley Carr, a
urologist at Toronto’s Sunnybrook Hospital and spokeswoman for the Canadian Urological Association. |
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Prevention: Keep well hydrated and urinate regularly, especially after sex. “Because E. coli may colonize the vagina, there is a chance the bacteria could be introduced along the urethra and into the bladder during sex,” Carr warns. “Spermicide on condoms may kill good bacteria. Always urinate afterward to help flush out potential problems.” Recurrent UTI sufferers can also take a one-dose antibiotic before intercourse, says Carr. Keep the bowel regular. “Constipation leaves more stool in the rectum, meaning more bacteria in the area.” Avoid harsh soap, detergents, perfumes and wipes, which can strip away good bacteria.
 Drink pure, unsweetened cranberry juice to prevent bacteria from adhering to the urinary tract and bladder wall, Turner says. “Mix 1/4 cup in your daily smoothie, or take cranberry extract capsules.” Cranberry products can reduce recurrence of cystitis, while certain probiotics may bolster good bacteria in the vagina. “That's still debatable,” Farrell says, “it doesn't hurt to take them; capsules can even be inserted vaginally.”
Treatment: When symptoms start, see your doctor immediately for a urine test; infection can worsen quickly. Single dose to a three-day antibiotics treatment typically clears symptoms within a day or two; infections take slightly longer. Alternately, Turner suggests D-mannose, a natural sugar that maintains healthy bacteria in the bladder. “At the first sign of symptoms, use every few hours for the first 24 hours, and before and after sex,” she says. “Uva ursi, corn silk and goldenseal are common herbs for treating UTIs, and echinacea can boost the immune system to fight infection.”
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The concern: Stress incontinence
It occurs when the muscles and tissues supporting the urethra (the tube at the base of the bladder that passes urine out of the body), don’t squeeze hard enough to keep urine in. Leaking is more common during strenuous physical activities, coughing, sneezing and laughing.
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When and why: The most common type of incontinence spans age groups: young athletes like gymnasts (though rare); following vaginal birth; the overweight and obese; smokers with a persistent cough; and an aging, weakened pelvic floor.
Prevention: Carr stresses starting preventive pelvic floor strengthening, long before childbirth. “Like any muscle, pelvic muscles need exercise to stay strong.” Quit smoking (to stop the cough) and maintain a moderate, healthy weight. If you’re expecting, be diligent about Kegel exercises.
Treatment: If Kegel exercises are not effective, the inclusion of acupuncture and physiotherapy may help, in addition to mild electric stimulation. Carr reassures, “It is a painless low current that stimulates the vaginal muscles.” In advanced cases, vaginal cones and incontinence pessaries may strengthen and support pelvic floor and bladder muscles. Surgery is also an option, though not as effective as once thought, Farrell says. |
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The concern: Urge incontinence
Overactive bladder muscles and decreased bladder capacity cause frequent urination, feelings of urgency and leakage.
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When and why: Overactive bladder peaks in the mid 60s to 80s. About 55% of incontinence is a mix of stress and urge, while about 15% of people experience pure urge incontinence.
Prevention: Conditioned reflex or mental triggers, are a major factor. Often called ‘garage door syndrome’, the desperate urge to pee tends to occur on arrival home – when the garage door opens or the key turns in the lock. |
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Treatment: Caffeine reduction or elimination is effective at stopping symptoms. Try bladder training or urge suppression as an alternative to drugs. Set time intervals for urination, Farrell suggests. Begin by urinating every half hour during the day and, after two to three days, gradually extend the time between voids, resisting the urge between
intervals. The next approach would be a prescription medication, says Carr, that would relax the abnormal contractions of the bladder and regain control. H&L
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