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Stop Worrying, Start Understanding – The Causes of Incontinence in Women Given that incontinence, or what we call the Unexpected Leak™, affects 1 out of 3 women and can happen at any age, you'd think they would teach us about it at school. Certainly, if they did, then most of us seem to have missed that lesson! Anyway, here's a reminder of how the bladder or urinary system works and why sometimes it doesn't quite work perfectly. How the urinary system works The role of your kidneys is to filter unneeded substances from the bloodstream and send them to the bladder, a muscular bag that can stretch to hold up to 16 oz. when full. At half full, nerves tell the brain that it's time to urinate and urine passes down the urethra, which is kept closed by two sphincter muscles. The inner sphincter will open when the bladder is full, but the outer sphincter muscle can be voluntarily held shut to maintain control over urination. It's the job of the pelvic floor muscles, which lie beneath the bladder and around the urethra, to keep them working correctly. 1 out of 4 women and 1 out of 8 men experience an interruption to this process at some time in their lives. So what are the main causes of incontinence in women? Could you have weakened pelvic floor muscles? In the majority of cases, incontinence is caused by a weakening of the pelvic floor muscles that keep the urethra closed. Whenever they lose their elasticity, everyday activities such as laughing, coughing, lifting and running can cause a urine leak. However, they can be strengthened again – visit Exercises to Help with The Unexpected Leak™ to find helpful information about pelvic floor exercises. The main causes of incontinence in women in particular result from the changes that take place during pregnancy, childbirth and menopause (visit Causes of Incontinence in Men to learn more about the causes of male incontinence). Are you a mother? The joys of motherhood are many (despite those first sleepless nights…), but pregnancy and childbirth put your body through all kinds of changes, both hormonal and physical. Incontinence is therefore a very common side effect of pregnancy or childbirth. The combination of hormonal changes, pressure on the bladder from the womb and the exertions of childbirth itself can all reduce the efficiency of the pelvic muscles. Bladder leaks can occur during or soon after pregnancy, and for some women even long after their children have grown up. For those who experience it around pregnancy, it's often a temporary condition. Many women have seen real improvements by using the pelvic floor exercises that you'll find in Exercises to Help with The Unexpected Leak™. Have you experienced menopause? Several physical and hormonal changes occur with menopause. In particular, there's a reduction in the quantity of estrogen within the abdominal muscles. This can cause a shift in the position of the bladder, reducing the effectiveness of the muscles that hold it closed. Are you overweight? Being overweight can also put extra pressure on abdominal and pelvic muscles, leading to incontinence in women as well as in men. Medical conditions Other causes of incontinence include certain medical conditions such as stroke, dementia or diabetes. Often it's because of damage or interference to nerve passageways preventing the right signals traveling between the brain and the bladder or, in the case of dementia, failure to register those signals. This can lead to either an overactive bladder (need to urinate frequently) or an underactive bladder (the ineffective emptying of the bladder, causing leakage). Neurological Damage Parkinson's, Alzheimer's, Spina Bifida, Multiple Sclerosis or brain injury can also affect the way the brain and bladder communicate, resulting in an inability to control the bladder or empty it completely. Are you taking prescribed medications for another condition? Incontinence can be a side effect of certain medications, and some medicines have diuretic properties that make you want to urinate more frequently. If you have recently started on or changed medication, and this has coincided with a loss of control, it may be worth setting an appointment with your doctor to determine whether it's a possible cause of incontinence. Sometimes medications for other conditions can be changed or dosages reduced without altering their effectiveness. Do you regularly experience urinary tract infections? Urinary infections can lead to bladder hypersensitivity. This is when the bladder incorrectly sends urgent signals to your body to empty quickly when it's not completely full. If you have further questions on causes of incontinence, you should consult your health advisor. The Right Fit There are many options to help you control the Unexpected Leak™. Finding the right product is important.
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Prestanite brinuti, počnite shvaćati. Budući da tegobe s oslabjelim mokraćnim mjehurom pogađaju svaku četvrtu ženu, a njihova je pojava moguća u bilo kojoj dobi, bilo bi logično da se o tome uči u školi. Ako se uči, onda je većina nas zacijelo propustila tu lekciju! Bilo kako bilo, podsjetimo se kako funkcioniraju mokraćni mjehur i urinarni trakt te zašto katkad ne funkcioniraju savršeno. Kako funkcionira urinarni trakt Bubrezi filtriraju nepotrebne tvari iz krvotoka i šalju ih u mokraćni mjehur, mišićnu vrećicu koja – potpuno ispunjena – može prihvatiti do 500 ml tekućine. Kada je mokraćni mjehur dopola pun, živci šalju signal mozgu da je vrijeme za mokrenje, a mokraća prelazi u uretru, koju zatvaraju dva mišića sfinktera. Unutarnji sfinkter otvara se kada je mokraćni mjehur pun, ali vanjski sfinkter može se voljno držati zatvorenim radi zadržavanja kontrole nad mokrenjem. Za pravilan rad sfinktera odgovorni su mišići dna zdjelice, smješteni ispod mokraćnog mjehura i oko uretre. Svaka četvrta žena i svaki osmi muškarac tijekom života dožive smetnje u tom procesu. Koji su glavni uzroci oslabjelog mokraćnog mjehura? Mogu li mišići dna zdjelice oslabjeti? U većini slučajeva oslabjeli mokraćni mjehur uzrokovan je slabljenjem mišića dna zdjelice, koji uretru drže zatvorenom. Kada oni izgube elastičnost, svakodnevne aktivnosti poput smijanja, kašljanja, podizanja predmeta i trčanja mogu izazvati istjecanje mokraće. No moguće ih je ponovo ojačati – u Području za vježbe potražite korisne informacije o vježbama za jačanje mišića dna zdjelice. Kada je riječ o ženama, glavni uzroci koji dovode do slabljenja mokraćnog mjehura su promjene tijekom trudnoće, poroda i menopauze (uzroke oslabjelog mokraćnog mjehura u muškaraca potražite u odjeljku TENA za muškarce). Jeste li majka? Brojne su radosti majčinstva (unatoč besanim noćima...), ali trudnoća i porod uzrokuju razne promjene u tijelu – i hormonalne i fizičke. Oslabjeli mokraćni mjehur stoga je vrlo česta nuspojava trudnoće i poroda. Kombinacija hormonalnih promjena, pritiska maternice na mokraćni mjehur i napora tijekom samog poroda može smanjiti učinkovitost mišića zdjelice. Mokraćni mjehur može oslabjeti tijekom ili neposredno nakon trudnoće, a u nekih žena čak i kada djeca već odrastu. Ako do problema dođe u razdoblju oko trudnoće, često se radi o privremenom stanju. Mnoge su žene postigle znatna poboljšanja vježbama za jačanje mišića dna zdjelice, koje ćete pronaći u Području za vježbe. Jeste li u menopauzi? U menopauzi dolazi do brojnih fizičkih i hormonalnih promjena. Konkretno, u abdominalnim mišićima dolazi do smanjenja količine estrogena. To može izazvati promjenu položaja mokraćnog mjehura, što smanjuje učinkovitost mišića koji ga zatvaraju. Jeste li pretili? I pretilost može povećati pritisak na mišiće abdomena i zdjelice, što dovodi do slabljenja mokraćnog mjehura. Oboljenja Uzrokom slabljenja mokraćnog mjehura mogu biti i određena oboljenja kao što su moždani udar, demencija ili šećerna bolest. Često se u živčanim kanalima pojavljuju oštećenja ili smetnje koji onemogućuju prijenos pravih signala u mozak ili mokraćni mjehur, a u slučaju demencije posrijedi je nemogućnost registriranja tih signala. To može dovesti do pretjerane aktivnosti mokraćnog mjehura (prečeste potrebe za mokrenjem) ili pak do njegove smanjene aktivnosti (neučinkovitog pražnjenja mjehura, što uzrokuje istjecanje mokraće). Neurološka oštećenja Parkinsonova i Alzheimerova bolest, demencija, multipla skleroza i ozljede mozga također mogu utjecati na komunikaciju između mozga i mokraćnog mjehura, što dovodi do nemogućnosti kontrole ili potpunog pražnjenja mjehura. Uzimate li propisane lijekove za neko drugo oboljenje? Inkontinencija može biti nuspojava određenih lijekova, a neki lijekovi imaju i diuretička svojstva – zbog čega uzrokuju potrebu za češćim mokrenjem. Ako ste nedavno počeli uzimati neki lijek ili ste ga zamijenili drugim, a to je koincidiralo s gubitkom kontrole nad pražnjenjem mjehura, bilo bi dobro da se obratite liječniku i provjerite je li upravo lijek uzrok oslabjelog mokraćnog mjehura. Katkada ga je moguće zamijeniti drugim lijekom ili smanjiti njegovu dozu, a da se djelotvornost terapije ne promijeni. Imate li česte urinarne infekcije? Urinarne infekcije mogu uzrokovati preosjetljivost mokraćnog mjehura. To je stanje u kojem mokraćni mjehur šalje pogrešan signal tijelu da je potrebno hitno pražnjenje, a nije sasvim pun. Ako imate drugih pitanja o uzrocima slabljenja mokraćnog mjehura, obratite se liječniku.