OAB Questions & Answers
Q: Sometimes when I laugh, sneeze or cough, I urinate just a little. Is this something to be concerned about or does it happen to everyone?
A: "Accidentally releasing a drop of urine three to six times a year is not really that unusual," says Jill Maura Rabin, M.D., head of urogynecology at the Long Island Jewish Medical Center, North Shore-LIJ Health System in New Hyde Park, NY. This is a form of mild stress incontinence, which occurs when movements or activities (such as sneezing) increase pressure on the bladder, causing leaks.
"While not severe, if you find the problem worrisome or it's occupying a significant portion of your thoughts, it's something to discuss with your doctor," Dr. Rabin says. Most leakage issues can be helped.
Q: After I exercise hard, my underwear is damp and has an acidic smell. How can I tell if this is sweat or if this means I'm leaking urine when I work out?
A: You can actually do a little experiment to tell for sure: Half an hour before you exercise, take a pyridium tablet (100 mg). It's an over-the-counter medication for urinary tract infection pain, but it also turns your urine orange. Next, temporarily place a sanitary napkin in your underwear. Examine it after your workout, advises Dee Fenner, M.D., Furlong professor of obstetrics and gynecology and director of gynecology at the University of Michigan in Ann Arbor. "If it's damp and orange, you probably leaked urine."
Q: What can I do to control urine odor?
A: Shower twice a day and change your underwear even more frequently if necessary. "And make sure your underwear is 100 percent cotton. This allows the skin to breathe and helps keep it dry, which may prevent rashes and yeast infections," Dr. Fenner says.
You can also use alcohol-free moist wipes to freshen up "down there." What you don't want to do is use deodorant sprays or feminine hygiene products. "These can throw off the vaginal pH balance and lead to irritation," Dr. Rabin says.
Q: I have trouble making it through the night without changing my pad. Which products are the most absorbent?
A: A special kind of underwear might be best for you. One brand of absorbent products that Dr. Rabin recommends is called Stride (www.strideeveryday.com)they can hold up to an ounce of liquid and wick moisture away from the skin to prevent irritation. (Pads, on the other hand, trap moisture and, when worn overnight, can cause inflammation similar to diaper rash.)
After wearing the underwear, you can toss it in the washing machine, let the underwear air dry, then wear it again. These start at about $13 a pair.
To help minimize your middle-of-the-night need to urinate, try propping your legs up for about 20 minutes, one to two hours before bedtime. If you are retaining any fluid in your feet and legs, this will help move the liquid to the kidneys more quicklyallowing you to excrete it before you go to sleep for the night.
Q: Lately, the color of my urine has changed. What could this mean?
A: A change in the color or smell of urine could be due to something you ate. For instance, eating beets can cause urine to develop a temporary reddish tinge, while asparagus gives urine a distinctive odor. Some vitamin supplements can alter the color of your urine as well. And when urine is highly concentrated (looks dark yellow and/or smells acidic) it could mean you're not drinking enough fluids, Dr. Rabin says.
If the change persists or you suspect a red or orange hue may be due to blood in your urine, bring this to your doctor's attention immediately.
Q: Sometimes I leak urine during sex. What can I do to guard against this? A: For starters, always try to empty your bladder before you slip between the sheets. And opt for sexual positionssuch as being on topthat may reduce the likelihood of accidents. "If leakage occurs with orgasm, short-term use of a medication for overactive bladder may help," Dr. Fenner says. "You'll need to take it one to two hours before sex, so plan ahead."
Q: Why does my underwear sometimes get wet when I go from a sitting to a standing position?
A: Usually, this kind of leak is due to a weak sphincter muscle that allows a bit of urine to slip out of the bladder when you change positions. Do Kegels religiously to prevent this from happening. Once you get good at them, you can do a Kegel-like move called a perineal lock every time you stand. "This is when you really clamp down on the muscles that are used in Kegel exercises to prevent such leakages as you switch positions," explains Craig Comiter, M.D., director of the Female Pelvic Medicine and Reconstructive Surgery Fellowship at the Stanford University School of Medicine.
Q: Why do I leak urine more easily before my period?
A: Right before your period, your uterus may be slightly enlarged, which can put pressure on your bladder, spurring leaks. But the problem could also be attributed to hormonal changes: A shift in progesterone and estrogen levels can relax the urethra, Dr. Comiter says. And fluctuations in the levels of prostaglandins (fatty acid compounds) can cause your uterus and bladder to contract, which can give you overactive bladder symptoms or leakage problems.
"If you're prone to menstrual cramps, taking a nonsteroidal anti-inflammatory drug (NSAID) just before you expect your period will block prostaglandins and reduce bladder and uterine spasms," Dr. Rabin says. Ibuprofen or naproxen fit the bill. Your best bet is to follow the package directions for dosage and frequency.
The skin in my vaginal area gets red and raw from frequent contact with urine. What can I do about this?
A: Change your underwear regularly, shower twice a day and apply an ointment that contains zinc oxide, such as Desitin or Balmex, to the area. The zinc oxide in these products acts as a barrier to moisture and helps soothe (and prevent) irritation, Dr. Rabin says.
"You can also use cornstarch powder, but be sure to avoid products containing talc," she notes, "as these can add to the irritation." If your skin burns or itches or if you have a vaginal discharge, see your doctor because you may have a yeast or other type of infection.
Q: I had a bed-wetting problem as a kidam I more susceptible to incontinence as an adult?
A: Most people can cross this item off the worry list. "There's no evidence linking night-time wetting as a child to future bladder problems," Dr. Comiter says.