Leaky taps. Faucets are intended to regulate the flow of liquid from a reservoir of fluid. They are supposed to be shut tight to keep the fluid in till when it’s supposed to be let out. However, occasionally, there are leaky taps. When this happens, the fluid drips with no control. In Urinary Incontinence, a malfunction of the urinary system, urine leaks out.
There is a complex interplay of muscles(both smooth and striated), nerves(both of the sympathetic and parasympathetic nervous systems), the brain, pelvic organs(including bladder, urethra, and prostate in men), that are responsible for the storage and expulsion of urine from the bladder. It is no wonder that there can be a misfiring anywhere along this track. Any misfiring can lead to urinary incontinence.
Urinary Incontinence is the complaint of involuntary loss(or leakage) of urine. It is primarily due to prostate enlargement in men or weakness of the pelvic floor muscles in women.
15-30% of people at 65 years are affected, and two times more women than men have this issue. However, the relative numbers become equal after the age of 80.
Urinary Incontinence can be embarrassing to the patient. No one likes that. It can lead to:
- Social withdrawal;
- Poor self-image;
- Sleep deprivation, as there is need to frequently rise up to empty the bladder;
- Reduced productivity due to frequent interruptions;
- Sexual dysfunction;
- Urinary tract infection;
- Falls with fractures;
- Pressure ulcers.
Thankfully, there are ways to regain control of those leaky taps, and avoid all the associated physical and psychological complications.
Urinary Incontinence can be of different types.
Based on the symptoms, urinary incontinence can be classed into different types.
- Stress Incontinence: Stress incontinence is the most common type, and accounts for about 49% of all cases. It is due to the failure of the sphincter mechanisms to preserve outlet closure during bladder filling. Also, in this case, the pelvic floor muscles are weak, and pressure is transferred to the bladder and urethra by making them work harder. As a result, any stress caused due even to common activities like laughing, physical exercise, coughing, sneezing, etc, can cause leakage of urine.
- Urge Incontinence: This is another common cause, accounting for 21% of all cases. There is a sudden urge to urinate, and this can cause a leakage before the patient is able to reach a bathroom. Volume of the leakage may be large or small. Eventually, on getting to the bathroom, there usually isn’t much to be let out, despite the strength of the urge to urinate. The frequency is high, and can happen around 8 times in a day. Urge incontinence also comes with nocturia(a frequent need to arise during the night to urinate).
- Mixed Incontinence: This happens in 29% of cases. It combines symptoms of both Stress and Urge Incontinence. That is, urine leakage due to stress occurs, and the sudden urges to urinate also occurs concurrently.
- Postural Incontinence: This is a very rare type of incontinence. There is urine leakage even with changes in posture.
- Transient Incontinence: This is precipitated by remediable factors. It usually wears off after the causative factors have been remedied.
- Overflow Incontinence: There is small continuous leakage of urine due to under-activity of the detrusor muscles(smooth muscle lining the bladder that is used to expel urine), or bladder outlet obstruction.
What Ayurveda has to say about Urinary Incontinence.
Urinary incontinence is a Vata Dosha disorder. It is a varigunya of apana vata(an abnormality in normal functioning of Vata located in the bladder, groin, and reproductive organs).
Although, this urinary problem doesn’t only affect older people, it is predominant among the aged population. This could be due to the fact that Vata is more predominant in older people. As a result, there is higher chance of a Vata disorder arising in old age.
Why are women more prone to this condition?
Women are more liable to urinary incontinence because of pregnancy, childbirth and menopause. These conditions place a lot of strain on the pelvic floor muscles. The pelvic floor supports the womb, bladder and the urethra. So, it only makes sense that it is weakened by pregnancy.
Additionally, the female urethra is shorter than the male’s, consequently, there is less muscle available to constrict the opening, and to form the sphincter that is supposed to pinch the opening shut. Thus, there is a higher chance of leakage.
What causes it?
Urinary incontinence can arise due to:
- Age Related Changes: With age, changes occur in the Lower Urinary Tract(LUT) and micturition. These changes can lead to incontinence, though not all the changes can be held responsible.
- Suppression of urine and feces put pressure on the muscles of the pelvic floor, and can weaken them eventually.
- Obesity: Excessive weight means there is a heavier load on the bladder, and the muscles there can be weakened in the long run.
- Constipation: The strain to have bowel movement can put pressure on the bladder and pelvic floor muscles.
- Nerve Damage: when nerves are damaged, they can begin to misfire, send signals at the wrong time, or send no signals at all to the bladder. Childbirth or multiple sclerosis can cause damage to nerves.
- Medications such as diuretics can also be a risk factor. The urinary incontinence resolves when the medication is stopped.
- Caffeine: Drinks containing caffeine cause the bladder to fill up quickly, and an overfilled bladder can begin to leak.
- Surgery: Surgery involving reproductive organs can tamper with the support offered by the pelvic floor muscles. Hysterectomy, uterus removal, can cause these complications.
Addressing Urinary Incontinence.
In modern medicine, there are methods of curing this condition, which include:
- Pharmacotherapy: Anticholinergic drugs, for example, help reduce involuntary detrusor contractions mediated by acetylcholine.
- Surgical Options: detrusor myomectomy and bladder myomectomy.
- Pelvic Floor Muscle Training(PFMT): Practising this for 3-4 months is also an effective remedy. People who practice this are 7x more likely to be cured.
But aside these, there are highly recommended Ayurvedic cures for urinary incontinence that you should try first, as they are highly effective and come with no risk or side effect. What’s more is that, they are cost-effective.
Some Ayurvedic Remedies for Urinary Incontinence.
- A cotton bandage dipped in dhanwantaram oil can be placed over the abdomen for 20-30 minutes daily. This normalizes the flow of Vata in the body.
- Regular consumption of 15-20 raisins and walnuts a day can help.
- Avagaha sveda with vatahara like dashamoola kashayan/dhanwantaram
- Amla: Amla juice mixed with honey and consumed with a ripe banana two or three times a day are useful. This helps to clear the bladder and also tones the muscles, helping to improve control over involuntary urination.
- Tulsi: 2-3 three fresh leaves of tulsi, crushed and taken with a spoon of honey can give good results. This is best in cases where the urinary problem is caused by infections.
- Reetha: soak if overnight and drink it early the next morning before any meal. This helps manage frequent urination, and the bonus is that it is great for hair.
- Yoga therapy that focuses on very gentle, guided, core strengthening and tightening, like vajrasana pose, ashwini mudra, help to resolve the problem too.
Lifestyle and Diet Changes to Cure, Manage or Prevent Urinary Incontinence.
Beyond the herbs and other remedies, to live healthy, you must be willing to help your body to take care of itself. Really, the body was made to be self-sufficient. However, some lifestyle and dietary habits that we indulge in antagonize the body’s natural intelligence. Correcting these habits go a long way to solving most health problems that are presented.
- Minimize fluid intake by evening if there’s a concern of nocturia.
- Bladder training: Go to bathroom at set times. Keep strictly to this schedule. You can start with hourly visits, and then increase the interval by about 15 minutes each successive week. This will help ‘force the bladder to remember’ when to discharge or not.
- Quit smoking.
- Treat constipation.
- Practice Kegel exercises. These help to strengthen the pelvic floor muscles.
- Lose excess weight.
- In case of leakage, clean self with dry cloth. Douching is not encouraged.
- If you have urinary incontinence, keep in mind that fear, worry and anxiety will not help. If anything, they disturb the signals sent by the nervous system to the bladder. You might have experienced or witnessed leakage due to fear or outright terror before, where a person’s bladder lets loose when confronted with a terrifying situation.
- Take less caffeine and carbonated drinks.
- Take fresh hot, nutritious foods.
- Limit intake of spicy foods.
- Take food rich in fiber, nuts, beans and legumes, and peas.
- Fruits like pears, apples, potatoes and melons are helpful.
- Vitamin D rich food should also be embraced, including egg yolks, mushroom, fatty fish, etc.