Bladder control problems in women: Lifestyle strategies for relief

You've been struggling with the embarrassment and discomfort of a bladder control problem for some time now. Maybe you hoped it would just go away on its own, but things aren't getting any better. In fact, they're gradually getting worse.

You're ready to make some changes, but what exactly can you do? There are some simple strategies you can try on your own that may just help improve your bladder control problem.

Doctors often call these strategies "behavior therapies." They're safe, easy, effective and inexpensive. These techniques can be used before resorting to other types of treatment, such as medications or surgery, or in combination with them. Sometimes behavior therapies may be the only treatment you need.

Try bladder training

When you have an overactive bladder, you can become accustomed to urinating frequently or at the slightest urge. Sometimes, you may go to the bathroom even if you don't have the urge but you want to avoid a possible accident. After a while, your bladder begins sending "full" messages to your brain even when it's not full, and you feel compelled to go.

Bladder training, or retraining, involves adjusting your bathroom habits. You go to the bathroom on a set schedule — even if you have no urge to urinate — gradually increasing the time between bathroom visits and emptying your bladder completely when you go. This allows your bladder to fill more fully and gives you more control over the urge to urinate.

A bladder-training program usually follows these basic steps:

• Find out your pattern. For a few days, keep a diary in which you note every time you urinate. Your doctor can use this diary to help you establish a schedule for your bladder training.
• Set your bathroom intervals. Using your bladder diary, pinpoint the amount of time from one bathroom break to the next. Then extend that interval by 15 minutes. So, if your usual interval is one hour, you work to extend that interval to an hour and 15 minutes.
• Stick to your schedule. Once you've established a schedule, do your best to stick to it. Start by urinating immediately after you wake up in the morning. Thereafter, if an urge arises but it's not time for you to go, try as hard as you can to wait it out. Rhythmically contracting and relaxing your pelvic floor muscles may help you wait it out until the urge goes away. If you feel that you're going to have an accident, go to the bathroom but then return to your preset schedule.
• Increase your intervals. Gradually lengthen the time between trips to the bathroom until you reach intervals of two to four hours. You might do this by extending your intervals an additional 15 minutes each week until you reach the desired goal. Be sure to increase your time limit slowly, so that you give yourself the best chance for success.

Don't be discouraged if you don't succeed the first few times. Keep practicing, and your ability to maintain control is very likely to increase.

Your role in treatment

Behavior therapies can improve bladder control with a minimum of side effects. Your doctor can help you in many ways — by teaching you how to implement different therapies, providing you with feedback and helping you manage your medications — but you also play a vital role in your treatment.

These techniques take some time and practice before you begin seeing results. But persistence pays off. If you stick with the program, you'll more than likely see an improvement in your symptoms. And if one of these approaches doesn't work, talk with your doctor about exploring other treatment options that may serve you better.