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Stress incontinence has an annoying way of showing up at the most inopportune times.
You're jogging along, feeling great -- and then you realize your running shorts are damp with urine. Later that night, during a romantic rendezvous with your partner, a trickle of urine appears again, definitely spoiling the moment.
Lest you think stress incontinence is a problem only of middle-aged or elderly women, think again. Surprisingly, young women actually have more stress incontinence during sex than older women, according to Amy Rosenman, MD, a gynecologist at Santa Monica -- UCLA Medical Center, Santa Monica, Calif., and co-author of The Incontinence Solution.
While only 3% of women over age 65 reported incontinence during sexual activity, 29% of women under age 60 did, Rosenman reports in her book, citing an Israeli study that polled 100 women and was published in the International Urogynecology Journal in 1999. When incontinence occurs during intimate moments, women feel anxious, Rosenman says, even if they are in stable marriages.
The same anxiety can occur, of course, during a workout, where you may end up with an embarrassing wet spot on your pants for the world to see.
The problem, whether the stress incontinence occurs during exercise or sex, has a common denominator, says Beverly Whipple, PhD, RN, professor emerita at Rutgers, The State University of New Jersey, and a sexuality researcher.
"Stress incontinence is related to the strength of the pelvic floor muscles," Whipple says. The weaker those muscles are, the more likely you are to have symptoms of stress incontinence -- leaking urine during physical activity, such as exercise, sex, sneezing, laughing or jumping.
While many women experience minor leakage from time to time, at any age, if it becomes more frequent or interferes with your normal routine, you should tell your doctor. There is an array of very effective treatments for stress incontinence.
If you have had several pregnancies and childbirths, your pelvic muscles and tissues may have gotten stretched and damaged. With age, the muscles can weaken, too, although stress incontinence is not an inevitable part of aging. Excess weight can also weaken pelvic floor muscles and cause stress incontinence.
Strengthening the muscles of the pelvic floor is crucial, experts agree.
One recommended way to do that is through Kegel exercises, according to the American Academy of Family Physicians (AAFP).
First, some anatomy: at the bottom of the pelvis, many muscle layers stretch between your legs, attaching to the pelvic bones at the front, back and sides. If you think of the muscles you would use to stop the flow of urine, those are the ones you will be targeting when doing your Kegels.
The how-to's: Pull in or squeeze the muscles, pretending you are trying to stop urine flow. You should hold that squeeze for about 10 seconds. Follow that by a 10-second rest. How many? Try three to four sets of 10 squeezes a day, recommends the AAFP.
The beauty of Kegels, most experts find, is that they can be done anytime and just about anywhere -- sitting in your car or at your desk or watching television or while talking on the phone. No one will know what you are doing unless you tell them. But to ensure proper form, ask your doctor or nurse to describe to you exactly how to do them correctly.
If you do Kegels correctly and often, you can expect to leak less, Rosenman says.
Typically, bladder control improves after 6 to 12 weeks of daily Kegels, according to the AAFP. But you may notice improvement in stress incontinence after just a few weeks.
Another way to prevent stress incontinence is to use vaginal weights. Vaginal weights can help you to isolate the pelvic floor muscles while doing your Kegel exercises. They come in various sizes and are inserted into the vagina using a cone. As you progress, you insert heavier weights.
Vaginal weight kits are sold online and over the counter.