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How do you treat stress incontinence naturally

For many people with urinary incontinence, the following self-help tips and lifestyle changes are enough to relieve symptoms.

Do daily pelvic floor exercises

Pelvic floor exercises can be effective at reducing leaks, but it’s important to do them properly. Find out how to do pelvic floor exercises.

You may have to do pelvic floor exercises for 3 months before you see any benefits.

Stop smoking

If you smoke, you put yourself at risk of incontinence, because coughing puts strain on your pelvic floor muscles.

Find out about NHS Smokefree support services, or call the Smokefree National Helpline to speak to a trained adviser on 0300 123 1044 from Monday to Friday 9am to 8pm and Saturday and Sunday 11am to 4pm.

Find out more about how to stop smoking.

Do the right exercises

High-impact exercise and sit-ups put pressure on your pelvic floor muscles and can increase leaks.

To strengthen your pelvic floor to relieve symptoms, replace high-impact exercise, such as jogging and aerobics, with strengthening exercise, such as pilates.

Pilates strengthens your core muscles, which is beneficial for stress incontinence.

Avoid lifting

Lifting puts strain on your pelvic floor muscles, so avoid it whenever you can.

When you do need to lift something, such as picking up children or shopping bags, tighten your pelvic floor muscles before and during the lift.

Lose excess weight

Being overweight can weaken your pelvic floor muscles and cause incontinence because of the pressure of fatty tissue on your bladder.

Your symptoms may improve, and could go away completely, if you lose any excess weight.

Use the healthy weight calculator to check you’re a healthy weight for your height.

Find out more about how to lose weight.

Treat constipation promptly

Straining to poo weakens your pelvic floor muscles and makes urinary incontinence worse.

Never ignore the urge to poo. If you have constipation, it may help to change your diet and lifestyle.

Eating more fibre and exercising more can help. It may also help if you change the way you sit and use your muscles to empty your bowels. A specialist physiotherapist can advise you on this.

Find out more about how to have a healthy diet.

Cut down on caffeine

Caffeine irritates the bladder and can make incontinence worse.

Coffee has the biggest effect, so stop drinking it or switch to decaffeinated coffee.

Fizzy drinks, tea, green tea, energy drinks and hot chocolate also contain caffeine, so cut down on these too and replace them with water and herbal or fruit teas.

Cut down on alcohol

Alcohol is a diuretic, which makes you urinate more often. Cutting down may help incontinence symptoms.

Find out more about how to cut down on alcohol.

Drink plenty of water

Drink 6 to 8 glasses of fluid a day (but no more) unless your doctor advises you otherwise.

Many people with urinary incontinence avoid drinking fluids, as they feel it causes more problems. However, limiting your fluid intake makes incontinence worse, because it reduces your bladder’s capacity.

Not drinking enough fluid can also cause constipation or make it worse.

Find out which are the healthiest drinks.

Eat the right foods

Avoid spicy and acidic foods, such as curries and citrus fruits, as they can irritate the bladder and make leaks and other incontinence symptoms worse.

Page last reviewed: 07 November 2019
Next review due: 07 November 2022

Research has found that at least half of people with urinary incontinence don’t discuss the condition with a health care provider. But there’s no need to feel embarrassed. If you have a leaky bladder, you’re definitely not alone. Bladder leakage, or urinary incontinence, affects women and men of all ages, though it becomes more common later in life.

And it’s definitely worth discussing, because of the many ways it can interfere with enjoying daily life—from exercise and travel to social outings and romance, says E. James Wright, M.D., director of urology at Johns Hopkins Bayview Medical Center.

What Causes Bladder Leaks?

There are two main types of urinary incontinence:

Stress incontinence 

If you have this type, activities that raise the pressure inside your abdomen cause urine to leak through the ring of muscle in your bladder that normally holds it in. Coughing, sneezing, jumping and lifting heavy objects could lead to a leak.

Going through childbirth, smoking or being overweight can raise the risk of stress incontinence for women, Wright says. Stress incontinence in men is rare, and when it arises, it’s often due to prostate cancer treatment, such as radiation or surgery.

Urge incontinence 

With this type, your brain, spinal cord and bladder don’t work together properly to allow you to hold and release urine at the right time. Your bladder may suddenly empty itself without warning. Or you may feel like you need to urinate frequently, a problem called overactive bladder.

Some diseases that affect the nervous system, such as multiple sclerosis or stroke, can cause this kind of incontinence, says Wright. In men, an enlarged prostate may be the culprit. But in many cases, doctors don’t know what causes urge incontinence.

It is possible to have both types of incontinence at the same time.

Diagnosis

During your visit, your health care provider looks for clues that may indicate contributing factors. Your appointment will likely include a:

  • Medical history
  • Physical exam, which may include a rectal exam and a pelvic exam in women
  • Urine sample to test for infection, traces of blood or other abnormalities
  • Brief neurological exam to identify any pelvic nerve problems
  • Urinary stress test, in which the provider observes urine loss when you cough or bear down

Tests of bladder function

Common cases of urinary incontinence usually don’t require additional tests. However, in some cases, your provider might order tests to assess how well your bladder, urethra and sphincter are functioning (urodynamic tests).

Bladder function tests may include:

  • Measurements of post-void residual urine. Your provider may recommend this test if there’s concern about your ability to empty your bladder completely, particularly if you are older, have had prior bladder surgery or have diabetes. This test can tell how well your bladder is functioning.

    A specialist uses an ultrasound scan, which translates sound waves into an image, to view how much urine is left in your bladder after you urinate. In some cases, a thin tube (catheter) is passed through the urethra and into your bladder. The catheter drains the remaining urine, which can then be measured.

  • Measuring bladder pressures. Cystometry is a test that measures pressure in your bladder and in the surrounding region as your bladder fills. Your provider may recommend this test to check for stress incontinence if you have had a neurologic disease of the spinal cord.

    A catheter is used to fill your bladder slowly with warm fluid. As your bladder fills, you may be asked to cough or bear down to test for leaks. This procedure may be combined with a pressure-flow study, which tells how much pressure your bladder has to exert in order to empty completely.

  • Creating images of the bladder as it functions. Video urodynamics is a test that uses imaging to create pictures of your bladder as it’s filling and emptying. Warm fluid mixed with a dye that shows up on X-rays is gradually instilled in your bladder by a catheter while the images are recorded. When your bladder is full, the imaging continues as you urinate to empty your bladder.
  • Cystoscopy. This test uses a scope that is inserted into the bladder to look for blockages or any abnormalities in the bladder and urethra. This procedure is usually completed in the office.

You and your provider should discuss the results of any tests and decide how they impact your treatment strategy.

Care at Mayo Clinic

Our caring team of Mayo Clinic experts can help you with your stress incontinence-related health concerns Start Here

Treatment

Your health care provider may recommend a combination of strategies to treat incontinence. If an underlying cause or contributing factor, such as a urinary tract infection, is identified, you’ll also receive treatment for the condition.

Behavior therapies

Behavior therapies may help you eliminate or lessen episodes of stress incontinence. The treatments your doctor recommends may include:

  • Pelvic floor muscle exercises. Your provider or physical therapist can help you learn how to do Kegel exercises to strengthen your pelvic floor muscles and urinary sphincter. Just like any other exercise routine, how well Kegel exercises work for you depends on whether you perform them regularly.

    A technique called biofeedback can be used along with Kegel exercises to make them more effective. Biofeedback involves the use of pressure sensors or electrical stimulation to reinforce the proper muscle contractions.

  • Fluid consumption. Your provider may recommend how much and when you should consume fluids during the day and evening. However, don’t limit what you drink so much that you become dehydrated.

    Your provider may also suggest that you avoid caffeinated, carbonated and alcoholic beverages, which may irritate and affect bladder function in some people. If you find that using fluid schedules and avoiding certain beverages significantly improve leakage, you’ll have to decide whether making these changes in your diet are worth it.

  • Healthy lifestyle changes. Quitting smoking, losing excess weight or treating a chronic cough will lessen your risk of stress incontinence and improve your symptoms.
  • Bladder training. Your provider might recommend a schedule for toileting if you have mixed incontinence. More frequent voiding of the bladder may reduce the number or severity of urge incontinence episodes.

Medications

There are no approved medications to specifically treat stress incontinence in the United States. The antidepressant duloxetine (Cymbalta, Drizalma Sprinkle) is used for the treatment of stress incontinence in Europe, however.

Symptoms quickly return when the drug is stopped. Nausea is the most common side effect that makes people stop taking the medication.

Devices

Certain devices designed for women may help control stress incontinence, including:

  • Vaginal pessary. A specialized urinary incontinence pessary, shaped like a ring with two bumps that sit on each side of the urethra, is fitted and put into place by your provider. It helps support your bladder base to prevent urine leakage during activity, especially if your bladder has dropped (prolapsed).

    This is a good choice if you wish to avoid surgery. A pessary will require routine removal and cleaning. Pessaries are used mostly in people who also have pelvic organ prolapse.

  • Urethral inserts. This small tampon-like disposable device inserted into the urethra acts as a barrier to prevent leakage. It’s usually used to prevent incontinence during a specific activity, but it may be worn throughout the day.

    Urethral inserts can be worn for up to eight hours a day. Urethral inserts are generally used only for heavy activity, such as repeated lifting, running or playing tennis.

Surgery

Bladder neck suspension

Bladder neck suspension procedure

Bladder neck suspension

The Burch procedure, the most common suspension surgery, adds support to the bladder neck and urethra, reducing the risk of stress incontinence. In this version of the procedure, surgery involves placing sutures in vaginal tissue near the neck of the bladder — where the bladder and urethra meet — and attaching them to ligaments near the pubic bone.

Surgical interventions to treat stress incontinence are designed to improve closure of the sphincter or support the bladder neck. Surgical options include:

  • Sling procedure. This is the most common procedure performed in women with stress urinary incontinence. In this procedure, the surgeon uses the person’s own tissue, synthetic material (mesh), or animal or donor tissue to create a sling or hammock that supports the urethra.

    Slings are also used for men with mild stress incontinence. The technique may ease symptoms of stress incontinence in some men.

  • Injectable bulking agents. Synthetic polysaccharides or gels may be injected into tissues around the upper portion of the urethra. These materials bulk up the area around the urethra, improving the closing ability of the sphincter.
  • Retropubic colposuspension. This surgical procedure uses sutures attached to ligaments along the pubic bone to lift and support tissues near the bladder neck and upper portion of the urethra. This surgery can be done laparoscopically or by an incision in the abdomen.
  • Inflatable artificial sphincter. This surgically implanted device is used to treat men. A cuff, which fits around the upper portion of the urethra, replaces the function of the sphincter. Tubes connect the cuff to a pressure-regulating balloon in the pelvic region and a manually operated pump in the scrotum.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Lifestyle and home remedies

Healthy lifestyle practices can ease symptoms of stress incontinence. These include:

  • Shed extra weight. If you’re overweight — your body mass index (BMI) is 25 or higher — losing excess pounds can help reduce the overall pressure on your bladder and pelvic floor muscles. Moderate weight loss may markedly improve stress incontinence. Talk to your doctor for guidance on weight loss.
  • Add fiber to your diet. If chronic constipation contributes to your urinary incontinence, keeping bowel movements soft and regular reduces the strain placed on your pelvic floor muscles. Try eating high-fiber foods — whole grains, legumes, fruits and vegetables — to relieve and prevent constipation.
  • Avoid foods and beverages that can irritate your bladder. If eating chocolate or drinking coffee, tea (regular or decaf) or carbonated beverages seems to make you urinate and leak more frequently, try eliminating that drink, especially on days you really don’t want to be bothered by leakage.
  • Don’t smoke. Smoking can lead to a severe chronic cough, which can aggravate the symptoms of stress incontinence. Smoking is also a factor in many cases of bladder cancer.

Coping and support

Treatments for stress incontinence can often substantially reduce, and possibly eliminate, urine leakage. Some people will still have urine leakage every now and then. Being prepared may help you cope.

Going out and about

Maintaining your connection with family, friends and co-workers can prevent feelings of isolation and depression that can accompany incontinence. Being prepared may help you feel more comfortable when you’re out and about:

  • Stock up on supplies. Take along sufficient incontinence pads or protective undergarments and possibly a change of clothes. Incontinence products are discreet and can be stowed in a roomy purse or a small backpack. Extra supplies and spare clothes can be kept in the trunk of your car or a backpack for use when needed.
  • Scout out your destination. Familiarize yourself with the restrooms available at your destination. Choose seating that allows easy access to restrooms.
  • Take good care of your skin. Prolonged contact with wet clothing can cause skin irritation or sores. Keep your skin dry by changing your garments when they’re wet and applying a barrier cream if your skin is frequently wet.

Sexuality and incontinence

Leaking urine during sexual intercourse can be upsetting, but it doesn’t necessarily have to get in the way of intimacy and enjoyment:

  • Talk with your partner. As difficult as this may be initially, be upfront with your partner about your symptoms. A partner’s understanding and willingness to accommodate your needs can make your symptoms much easier to handle.
  • Empty your bladder beforehand. To reduce your chances of leakage, avoid drinking fluids for an hour or so before sex and empty your bladder before intimacy starts.
  • Try a different position. Altering positions may make leakage less likely for you. For women, being on top generally gives better control of the pelvic muscles.
  • Do your Kegel exercises. These exercises strengthen your pelvic floor muscles and reduce urine leakage.
  • Be prepared. Having towels handy or using disposable pads on your bed may ease your worry and contain any leakage.

Seek help

Incontinence is not a normal part of aging. Treatments are usually available to cure or significantly reduce the effects of stress incontinence on your life.

Find a health care provider who’s willing to work with you to determine the best way to treat your incontinence. Choosing the right treatments for you should be a partnership between you and your provider. Take time to discuss the pros and cons of the many treatment options with your provider.

Consider joining a support group. Support groups offer an opportunity to voice concerns and often provide motivation to maintain self-care strategies.

Organizations such as the National Association for Continence offer resources and information for people who have stress incontinence.

Preparing for your appointment

Your health care provider may have you fill out a questionnaire to make a preliminary assessment of your stress incontinence symptoms. You may also be asked to keep a bladder diary for a few days. In a bladder diary, you record when, how much and what kind of fluids you consume, as well as when and how much you urinate and when you experience incontinence episodes.

Your diary may reveal patterns that help your provider understand your symptoms and identify contributing factors. This may reduce the need for more invasive testing.

Specialized testing may require referral to a specialist in urinary disorders for men and women (urologist) or a specialist in urinary disorders in women (urogynecologist).

What you can do

To get the most from your visit to your health care provider, prepare in advance:

  • Make a list of any symptoms you’re experiencing. Include when urine leakage occurs.
  • Make a list of any medications, herbs or vitamin supplements you take. Some over-the-counter supplements can irritate the urinary tract. Include doses and how often you take the medication.
  • Have a family member or close friend accompany you. You may be given a lot of information at your visit, and it can be difficult to remember everything.
  • Prepare a list of questions to ask your provider. List your most important questions first to be sure you cover those points.

For urinary incontinence, some basic questions to ask your provider include:

  • Will my urinary incontinence get worse?
  • Could pelvic floor exercises help me? How do I do them?
  • How does my weight affect my condition?
  • Could the medicines I take be aggravating my condition?
  • What tests might I need to determine the cause of my incontinence?
  • Will I need surgery?

Don’t hesitate to ask other questions as they occur to you during your appointment.

What to expect from your doctor

Be prepared to answer questions from your provider. Questions your provider might ask include:

  • How often do you leak urine?
  • When you leak urine, is it a few drops or are your clothes soaked?
  • Are there times when you know that you will leak?
  • Do you leak urine when you exercise?
  • Do you wake up during the night to urinate? How often?
  • What’s your typical daily fluid intake?
  • Does anything seem to make your incontinence better? How about worse?
  • What bothers you most about your urinary incontinence?
  • Do you also have bowel leakage? How often? Does this cause you to restrict your activities?
  • Does it seem as if there’s something “falling out” of your pelvis or vagina?
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