Help for athletes’ incontinence

Q: I have been running for six months. I have done some 5K runs, and I do pretty well on time. The problem is I have trouble with incontinence just during races. I have been able to cover it up, but it is very uncomfortable. I do use the bathroom right before I run. Any suggestions?

A:  Keep up the good work, and keep running. Loss of urine is a very common problem for many active women. There are two common types of urinary loss. Do you leak when you cough, or sneeze, or bounce? If so, that is probably stress incontinence, which is an anatomy problem — your bladder and urethra are probably hanging down, and need some help to hold them up. Vaginal squeezing exercises known as Kegels will usually help. When women ask me how many to do, I reiterate the old adage about being too rich – you can never do too many Kegels – the more, the better.

Another simple anatomy remedy is to place a tampon in the vagina before running – sometimes that will be sufficient to hold things up. However, if these simple remedies don’t do the job, consult your gynecologist. She may be able to fit you for a rubber gadget called a pessary, which can be placed into the vagina to hold up the bladder. And if the situation is really bad, you may qualify for a surgical operation to actually suspend the bladder. One of the my friends had one of these at the age of 60 to improve her marathoning – she sends me now postcards from all over the world, as testimonials to her now dry running.

Some women, though, are more victims of an unstable bladder, or have urge incontinence (its fancy name is detrusor dyssynergia). When their bladders fill only slightly, they have the urge to urinate, and even sometimes lose their urine. Surgery may actually make these women worse. These women do well with medication that quiets down their overactive bladders. A new medication called Detrol works well for these women, and if they take it twice a day, they will have drier running.

Incontinence is a very common problem, and nothing to be embarrassed about. So do speak with your care giver, so that she can help you keep yourself healthy.

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