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An otherwise healthy older woman had so much trouble with urinary incontinence that she's afraid to go out of the house.

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Do you know about Kegels? You tighten your peepee muscles, hold them, and release. Look it up online.

I use Estring, a vaginal ring that releases estrogen. Whenever I get a brand new one, every three months, my bladder gets better. Maybe estrogen cream might help.

There are specific medications for overactive bladder, but I don't know too much about them. Is she embarrassed to tell her doctor? Go to her next appointment with her and spill the beans. If her regular doctor or GYN isn't helpful, look for a specialist. I Googled female urinary incontinence, and found several links.

This is a major issue that can ruin her life if she is afraid to go out. Encourage her to do what's necessary to regain her freedom.
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You could also try cutting out the coffee and tea as well as the excellent advice offered above. Kegels make a huge difference and they even have exercise devices to go with them.
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If you google "pharmacy times anticholinergic burden" you will find a professional article for pharmacists about the problem along with a chart that rates anticholinergic drugs by the numbers of 1, 2 or 3. It will show you how to calculate the anticholinergic load of your medicines and states that even taking one medicine of a level 1 on a regular basis could increase your chances of memory loss or dementia. I have personally send the link to 5 pharmacists who were unaware of the list's existence. And except for the neurologist, only two of my mother's doctors were alarmed at the combinations of medicines she had been taking.

I'm not blaming the doctors, mind you, for what she was being given before they knew any better. However, after 2010 when they knew, her primary doctor prescribed three additional anticholinergics without regard to the problem. Don't worry, I look them up myself, question the doctor, and either didn't give them to her or got alternatives. My ALERT to all of you is that the doctors should be up to date and very careful about this but they're just not, so if you don't do it yourself, you or your loved one is going to continue feeding the body with possible brain damage.
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Cranberry juice is very good for any urinary problems my mum drinks this alot since she became incontinent seems to stop infections she hasnt had one for awhile. Also no drinking after 6pm and limit tea and coffee.
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There are many causes for urinary incontince. I would have her seek medical advice on her possible resolution. It could be that she has an over active bladder and all she would need is a pill taken daily to relieve the bladder spasms that cause the frequent urges and leakage that goes along with it. Please try to convince her that this isn't the silent embarrassment for women, or men, for that matter, that it used to be, and seek the help she needs.
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My Mom has had the issue as long as I can remember, she even had surgery for it. Shortly after my Mom was diagnosed, they put her on meds (don't work). She does wear the adult diapers to bed and the pads during the day.
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Be VERY careful of the medications for urinary incontinence. DITROPAN was the first one identified in 2006 for causing dementia like symptoms. And these drugs are given more to women. Then a neurologist presented a paper at a 2008 convention implicating ALL drugs with anticholinergic action as possibly causative and the creation of dementia. My mom was the victim of this type of dementia, having been given a combination of several anticholinergic drugs before the medical profession knew or understood about the problem. She had memory loss onset starting in 2005 but, as her medications were continued, it wasn't until she had a psychotic break in 2010 that she was diagnosed by a neurologist. Taking her off the ascending medications did not reverse her condition.
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Some women respond to using estrogen creme, or a slow-release low-dose device.
Estriol is a type of short-acting [about 4 hours] estrogen, can be derived from natural sources, and has the added benefit of making the body hostile to certain cancer cells. There are a few Compounding Pharmacies around the country, that can make whatever strength creme is needed, to your Doc's prescription.

Just about ALL humans respond to using Kegal Exercises daily, often within days, if done right and often.
The trick is, tighten those muscles used to control holding back pee and poop--- AND keep those tightened, as long as possible--most can only manage a few seconds, but work up to a minute or so if you can---then release. Repeat these several times at a time, at least. Can be done repeatedly, in just about any position one is in--sit, stand, reclining. And these are free!

There are weighted devices that insert into the vagina, but those cost money for something you can do without them--besides--when those muscles are too lax, why start with something that keeps them stretched?
Bladders often get too relaxed, too, or get pressured by other body parts, so fail to totally empty when they urinate. When that happens, a person can be more vulnerable to bladder infections & more trouble with loss of urine at bad times. For that, it can be helpful to twist the torso or otherwise change position while sitting on the commode, or lift the lower abdomen to relieve excess pressure or tissue position on the bladder: these maeuvers can often help get that last bit of retained urine to empty while sitting on the toilet.

Drugs are more applicable for things like muscle spasms--which can also contribute to urine loss.

The very most important thing one can do, ever, no matter how many babies one birthed, are those blessed Kegal exercises, though! The longer one waits to get in the habit of doing them, the more work needs done to make them respond.
It's worth it!
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Oh--also, drinking enough water daily, makes a good difference, usually.
Drinking a couple cups of water 1st think in morning, and a few over the day, and one about an hour before bed, DOES help many health issues, getting a total of about 8 cups of water [not juice, not coffee] per day, seems to be the key.

Plain tea might be a decent tradeoff for some cups of water, as tea helps the body maintain a more alkaline state. Drinking water really helps so many body systems work better!
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