Bladder Control Medication to Tame Urge Urinary Incontinence

For women, urinary incontinence can bring more than the loss of bladder control. It can also lead to missing out on activities you love, skipping get-togethers with friends, losing sleep and not feeling like you. None of that, however, has to be part of your future. If you have bladder leakage caused by sudden urges to urinate, taking a bladder control medication may provide relief.

“The silver lining of urinary incontinence is that it’s highly treatable, and we have numerous options that can help,” says Matthew Baker, PharmD, PA-C, a certified physician assistant and pharmacist at Beaufort Memorial Urology Specialists. “Bladder control medication is just one approach, and it’s effective for many patients. Other treatments include lifestyle changes, such as getting active and achieving a healthy weight, pelvic floor muscle exercises, and bladder training.”

Read More: No Longer Controlled by an Overactive Bladder

Why Does Urinary Incontinence Affect More Women Than Men?

Both women and men can develop loss of bladder control, but it affects twice as many women, according to the Office on Women’s Health. Driving many women’s need for bladder control medication and other bladder leakage treatments is a set of risk factors unique to them.

“Throughout women’s lives, pregnancy, childbirth and menopause can reduce the strength and functional abilities of the muscles and nerves involved in urination,” Baker says. “As a result, the risk of urinary incontinence rises.”

Other risk factors for urine leakage aren’t exclusive to women. These include chronic constipation, an unhealthy weight and nerve damage related to diabetes or other health problems. Urinary tract infections, caffeine and diuretic medications can also cause bladder control problems, although they’re usually temporary.

Read More: Understanding — and Managing — the Risk Factors of UTIs

Stress Incontinence vs. Urge Incontinence

There are a few types of urinary incontinence, and knowing which type you have determines whether bladder control medication makes sense for you.

• Stress incontinence, the most common type, is a product of pressure. If your pelvic muscles are weak, they may press against your bladder and urethra, making it tougher to control urine flow. As a result, leakage can occur while you’re exercising or when you sneeze, cough or laugh.
• Urge incontinence is when you have intense, unexpected urges to urinate, which can lead to leakage. Also known as overactive bladder, urge incontinence can occur anytime, even while you sleep.

Read More: What Your Urine Smell, Color and Flow Are Telling You

Bladder Control Medication Options

If you’re dealing with loss of bladder control, tell your OBGYN or primary care provider. They may refer you to a urologist for evaluation and treatment.

The Food and Drug Administration hasn’t yet approved any medications to treat stress incontinence, but several types of medications are approved to treat overactive bladder.

Anticholinergic Medications

For your bladder to contract and trigger the urge to urinate, a chemical in your body called acetylcholine has to send a message to the brain. But if you often feel like you have to go even when your bladder isn't full, that's because your brain is getting those signals too early. This can make your bladder squeeze when it doesn't need to. There are medicines that can help with this. They work by stopping acetylcholine from sending those early signals to your brain. This helps your bladder muscles chill out and not squeeze so much, making you feel less like you need to pee all the time.

These medications are designed to stop a chemical in the bladder from sending signals that cause it to spasm or become too active. They do this by blocking the chemical's receptors in the bladder, helping the bladder muscles to relax. Ideally, they don't affect the brain, because that's when side effects, such as dry mouth and constipation, can happen.

Beta-3 Agonists

Beta-3 agonists trigger certain muscle receptors in the bladder. This process relaxes the bladder muscle and can reduce involuntary contractions. Beta-3 agonists may increase blood pressure in some patients.

Tricyclic Antidepressants

These medications affect nerve signals, which can help reduce involuntary contractions. Side effects include dry mouth and constipation.

Botox

An injection rather than an oral medication, botulinum toxin, commonly known as Botox, can relax the muscle and help it hold more urine. These injections may cause discomfort or swelling at the injection site.

Read More: UTIs vs. Kidney Infections: How to Tell the Difference

Beyond Bladder Control Medication: More You Can Do to Control Leaks

Whether you have stress incontinence or urge incontinence, your health care provider may recommend lifestyle changes that can reduce symptoms. For example, they may suggest drinking fewer liquids during the day, avoiding liquids in the hours leading up to bedtime or limiting beverages known to trigger leaks or increase urine output, such as tea, coffee and alcohol.

In addition to watching what, when and how much you drink, you can make other changes to cut down on bladder leaks:

• Eat more fiber to reduce your risk of constipation.
• Exercise regularly, which can help you lose weight.
• Stop smoking, which can increase your risk of stress incontinence.
• Train your bladder to hold more urine by slowly increasing the length of time between bathroom trips.

Strengthen Pelvic Floor Muscles

“Your bladder depends on the pelvic floor muscles to help hold in urine,” Baker says. “If these muscles are weak, they can’t offer much support. Your medical provider may recommend working with a physical therapist who has special training in strengthening the pelvic floor muscles. They can teach you how to do Kegel exercises, which involve contracting and releasing the pelvic floor muscles to boost their strength.”

More Nonsurgical Treatment Options

For some women with urinary incontinence, other nonsurgical treatments may hold the key to controlling symptoms, including:

• Bulking agents, thickening substances injected around the urethra to reduce urine leakage
• Electrical nerve stimulation, mild bursts of electricity that help strengthen the muscles that control urination
• Using a pessary, a flexible, insertable device that puts pressure on the urethra to decrease leaking
• Using a catheter, a tube to drain urine from the bladder

“We’ll make every effort to help you treat urinary incontinence without surgery,” Baker says. “Whether by taking a bladder control medication, changing your lifestyle or trying another nonsurgical form of treatment, every patient has the potential to manage symptoms. We’ll partner with you to find an option that works.”

Tired of bladder leakage intruding on work, hobbies and time with loved ones? Take the first step toward control and request an appointment with a Beaufort Memorial OBGYN or women’s health provider.