My bladder’s fallen and it can’t get up.Sadly, there’s no LifeCall button for your bladder when it hits the floor—the pelvic floor, that is. Bladder prolapse, a leading cause of urinary incontinence, is a failure of your pelvic floor muscles to hold your bladder in place. When that sling of muscles and ligaments gets weak and gives way, the bladder can sag into the vagina. It can even drop through it. Well, hello there! The usual culprit for bladder prolapse is the strain and stress of childbirth, but heavy lifting, chronic cough, obesity, menopause, or constipation can play a role. (Try these 4 essential moves to strengthen your pelvic floor.) Laughter is so not the best medicine.Bridesmaids Yeah, is hilarious, but if you have urinary incontinence (as 18 million women do), anything starring Kristin Wiig or Melissa McCarthy is just a bathroom accident waiting to happen. Laughing (or coughing, jumping, running, or anything that puts pressure on your tummy muscles) can cause the bladder to leak urine. It’s sometimes called stress urinary incontinence and really, there’s nothing funny about it. When I gotta go, I gotta go. With your bladder making the great escape you may feel like you need to pee all the time. You may dribble urine when you’re active (or laughing, see above), or you may find you often can’t make it to the bathroom in time, which is characteristic of overactive bladder syndrome, AKA urge incontinence. You might even feel a heaviness or pain in the groin. MORE: What’s A Normal Amount Of Times To Get Up And Pee At Night? Sometimes “not tonight dear” is just about every night.Kegels Thinking you might leak a little urine during sex is a real passion killer. And bladder prolapse can also cause pain during sex. Don’t panic—you can fix this with (see below). I’m exercising right now and you can’t see it. Kegels—they’re the invisible exercise. No Spandex required. And they can tighten the pelvic floor muscles in as few as four weeks if you do them consistently and correctly. Here’s how: First, figure out what it feels like to tighten the pelvic floor muscles. Next time you pee, start and then stop. You should feel the muscles in your vagina and rectum tighten and move up. Once you’ve ID’d them, squeeze the muscles purposefully and hold for 5 seconds (10 seconds when you get good at it), and relax them purposefully in between. The relaxing is as important as the squeezing—it’s actually possible to make vaginal muscles too tight. Do 10 reps lying down, 10 sitting, and 10 standing twice a day. And plan on doing these invisible exercises forever; otherwise your incontinence will return. My undies don’t come in thong style. One reason so many women don’t talk about urinary incontinence—sometimes not even to their docs—is because it’s embarrassing and they’re afraid the talk will turn to…adult diapers. But unless you have serious leakage, you won’t really wear adult diapers. You can wear disposable pads or special washable underwear made from waterproof fabric. A sling is the best thing that ever happened to me. One of the most successful surgeries for incontinence turns you into a living sewing project. A strip of animal or donor tissue or synthetic mesh can be surgically stitched under your urethra—that’s the thin tube that carries urine from your bladder to the outside of your body. That will help keep urine from escaping. Incisions are small and recovery time is short. And they’re successful most of the time. There’s a more complicated operation in which your urethra and the bladder neck—the muscle that connects the urethra to the bladder—is stitched to either a ligament near your pubic bone or directly to the cartilage of the pubic bone. That keeps them both in place and gives your urethra something to lean on to help keep you from leaking. MORE: Your 12 Most Awkward Sex Questions, Answered I totally get those transvaginal mesh commercials on cable. Scary stuff. While generally safe, mesh slings have been associated with injuries to nearby organs, nerves, and blood vessels. That mesh you’re hearing about on those class actions suit commercials between episodes of Law & Order: SVU has been taken off the market. However, even the US Food and Drug Administration thinks it’s worth chatting with your doc about the other options, including donor tissue or sterilized pig and cow intestines, which may have fewer complications (just don’t think about it too much). I’m dry all over, including my mouth. Many of the drugs that treat (but don’t cure) incontinence can leave you with dry undies and a dry mouth. They include the decongestant pseudoephedrine which helps your bladder neck muscles contract to control leakage, and anti-cholinergic drugs, such as antihistamines and migraine meds, which help the bladder muscle relax so you don’t have the urge to pee every other second. (Though you may actually need to because you’re drinking more.) MORE: 7 Things Only People With Anxiety Would Understand Your conversation starters include, “I have a pacemaker in my butt.” If you have overactive bladder (urge incontinence), tiny electric charges aimed at the nerves that tell you it’s time to pee can help stop the need-to-go-all-the-time feeling. Your doc may suggest implanting a tiny pacemaker-like device under the skin of your buttocks that will carry electric impulses to your sacral nerve, a triangular shaped bone at the bottom of your spine. Those electrical bzzzts will block those unwanted “it’s bathroom time again” messages between your overactive bladder and your brain. And if that doesn’t work, you can have a needle inserted into your leg to stimulate your tibial nerve. The electrical impulses travel from the nerve to your spine where it connects with the nerves that control your bladder. This remedy requires a half hour session weekly for about 12 weeks, with follow-ups periodically to let that bladder know who’s boss.
