Is Urinary Incontinence An Inevitable Part of Aging?

Urinary incontinence is something we associate with old age. Yet an overactive bladder (OA) can be a consequence of childbirth, or even constipation. So it’s not uncommon for women in their 30s to 60s to experience urgency, frequency and yes, even urinary incontinence. We do seem to hear more about OA in women than men, so I contacted an expert in the field, Dr. Charles Nager, to ask him about the causes and possible cures for this embarrassing condition, and if there’s anything women can do to prevent light leakage or incontinence from occurring in the first place.

Dr. Nager is a urogynecologist, a specialist in female pelvic medicine and reconstruction, and director of the Women’s Pelvic Medicine Center  at the University of California, San Diego.Here’s a transcript of my interview with him:

Is urinary incontinence an inevitable fact of life?

Dr. Nager:  It is not inevitable. It increases as we get older. It’s more common in women than in men. Although symptoms of urinary urgency and frequency are as common in men, they just have less incontinence.

Why is that?

Dr. Nager:  The urethra in women is just not as strong, or as obstructive as it is in men. So even though they may have a equal likelihood of developing symptoms of what’s called an overactive bladder, which is urgency, frequency, sometimes incontinence, the men are more likely to have just the urgency and frequency.

This Doc Says Forget The Health Rules and Live A Little!

Lose weight, exercise more, get 8 hours of sleep, eat more fruits and vegetables, reduce stress, take supplements… have you grown weary of all the health rules offered by TV doctors, magazine articles and well-intentioned friends? Dr. Pauline Chen, in her New York Times column last summer, wrote about a patient’s difficulty in absorbing “a fire hose of advice.” “Thanks to some dazzling advances in preventive medicine and public health,” she wrote, “doctors in almost every specialty of medicine now have a panoply of proven preventive recommendations to keep their patients from getting sick.”

Dr. Susan Love, the well known breast cancer researcher, takes issue with many of those recommendations, or “health rules” as she calls them in a book called Live a Little!: Breaking the Rules Won’t Break Your Health. She goes down the list of well-known “to do items for healthy living” and questions the etched-in-stone rules that seem to be guiding many of our every day decisions. She writes;

Health rules can mislead you into half way believing that if you eat only the right things, or exercise in the proper way, you can escape not just run of the mill illnesses but death itself. This way of thinking leads to a distorted set of priorities: Instead of trying to be healthy so that you can enjoy life, you squander your happiness in the pursuit of more health.

Dr. Love “studied the studies” in six areas that generate the most health rules; sleep, stress management, health screenings, exercise, nutrition, and personal relationships. While new research has added to our knowledge (and grown the list of rules) since then, her thoughts about putting research findings in context, and using common sense to guide our actions, still holds up. Here are a few examples from her book:

10 Best Foods To Lower Blood Pressure

If you have elevated or high blood pressure, a common condition in menopausal women, you naturally want to reduce your sodium intake. But you also want to make sure that your diet includes enough potassium, which as a natural diuretic, will promote the excretion of water and sodium from your body

If you’ve been diagnosed with hypertension, (half the U.S. population has high blood pressure, according to the Center for Disease Control), The American Heart Association recommends that you consume as much as 4700 mg/day of potassium and not more than 1500 mg/day of sodium to achieve an effective balance.  However, sodium intake can be slightly higher — 2300 mg/per day — for those with normal blood pressure.

Here’s a list of 10 best foods to lower blood pressure and that are delicious enough to make a part of your daily diet.

Bananas – I’ll start the list with this deliciously sweet, grab and go kind of food because it’s readily available and I’ve never met a person who didn’t like them. Each medium size fruit has between 350 and 800 mg of potassium per cup depending on size. But it also contains some magnesium, which offers additional health benefits.

Mother’s Day Gifts for Hot Mamas

Hot flashes is the theme of my picks for mothers’s day gifts this year. There’s no reliable natural remedy to make them go away. Even hormone therapy is no guarantee. But there are plenty of products that claim to make us more comfortable so we can at least get a good night sleep. Here are a few ideas for mother’s day gifts – that you may like too.

The Rejuvenair Fan – I’ve personally tried this nifty fan and I highly recommend it. Its small size makes it convenient to use anywhere, but its creator, Dr. Lorrie Klein, a dermatologist in Laguna Niguel, CA, had menopausal women in mind when she added features like a pre-set timer, timed cooling intervals of 2.5, 5 and 10 minutes, and automatic shut-off, fast/slow and oscillating switches.

If night sweats are a problem, consider trying Wicked Sheets, created by founder Alli Truttman. She’s clearly too young to have experienced a hot flash herself, but she had the idea of applying the smart fabric technology found in athletic clothing to bedsheets. So they’re soft, absorbent, moisture-wicking and comfortable.

What I’m Reading: The Latest On Calcium Supplements

Are you still taking a daily mega dose of calcium to prevent bone loss? It was advice that we dutifully followed for years. But recent research findings have led to updated guidelines. If you’re confused about if, when, and how much Calcium you should be taking, these articles will help.

Calcium Could Harm Women’s Hearts- Harvard Women’s Health Watch (May 2013, subscription )

If you’re dutifully taking a big dose of calcium every day, consider the findings of a Swedish study that followed more than 61,000 women for two decades. It showed that those who took more than 1400 mg of calcium per day from diet and supplements were at higher risk of death from all causes. The increase in risk for women who consumed 1400 mg of calcium from diet alone was more moderate. This study relied on women’s recollections of their diet, so it might not be that accurate. Nevertheless, the U.S. Preventive Services Task Force (USPSTF) does not recommend

The Connection Between Fibroids and Vitamin D

A new study from the National Institute of Environmental Health Sciences has found a possible link between fibroids and vitamin D. In a three-year study of just over 1000 women, aged 35-49, researchers reported that those who had sufficient amounts of vitamin D were 32 percent less likely to develop uterine fibroids than participants with insufficient vitamin D.

If you have been experiencing fibroids, it’s worth having a simple blood test to see if your levels of Vitamin D are adequate. Click here to order a home Vitamin D test kit.

Vitamin D is a fat-soluble, steroid vitamin, that is essential for enhancing the absorption and metabolism of calcium and phosphorous. It is obtained from the sun, not from food, which explains why it’s often referred to as the “sunshine vitamin.” You can see why the increasing use of sunscreens have contributed to deficiencies in this important vitamin.

How Safe & Effective is Gingko?

Ginkgo, a perennial top-selling herbal supplement used to enhance memory function came under fire late last week as a threat to our health by the Center for Science in the Public Interest (CSPI). Citing a new study from the government’s National Toxicology Program (NTP) that found “clear evidence that the ingredient caused liver cancer in mice and thyroid cancer in rats,” the CSPI urged consumers to “avoid ginkgo in the wake of new cancer concerns.”

But just a day earlier, in a webinar led by Mark Blumenthal, the executive director of the American Botanical Council (ABC) on The Science of Herbal Medicines: What Works and Why (see my last blogpost for a summary), I learned that ginkgo extract had been shown in a meta-analysis of several “gold-standard” clinical trials to be effective in improving cognitive function in people with mild dementia. An earlier examination of 16 clinical trials in 2005 also showed that gingko was just as effective in improving mental performance  (i.e. remembering shopping lists and short term memory) in non-impaired, healthy adults.

The research findings, as explained by Blumenthal, are certainly compelling. But is the gingko extract product we buy in the U.S. carcinogenic?

Do Botanical Medicines Work? An Expert Explains.

If I had to guess, I’d estimate that nearly every reader of this blog has, at one time or another, tried botanical medicines. Perhaps it was for hot flashes, or depression, or to alleviate cold symptoms. It seems remarkable to me that names like Ginkgo Biloba, St. John’s Wort and Kava Kava roll off our tongues so easily, as if we were all botanists.

That we are so familiar with the potential benefits of these and other odd-sounding plants reveals not only the high level of consumer interest in natural medicines, but also how often we read about them in the news media. The headlines announce compelling evidence that something proves to be effective one week, followed by an article that contradicts those findings not long after. It’s hard to know what to believe if you’re not a trained researcher.

That’s why last week, I listened to a webinar led by Mark Blumenthal, founder and executive director of The American Botanical Council on the Science of Herbal Medicines: What Works And Why. He walked listeners through more than two dozen botanicals and explained what the studies of the studies concluded. That’s right. There may be dozens of research studies on a particular botanical, but only a small percentage of them meet high enough standards to be included in a meta-analysis of their findings.

The Healthy Way To Boost Your Energy

It’s not unusual to feel lethargic once in a while, especially if you’ve had a poor night sleep, or you’ve been under a lot of stress. But if you’re finding that you can’t get out of first gear most days without a caffeinated beverage to pick you up, consider this advice from nutrition expert Keri Glassman, on how to boost your energy the healthy way:

Stay Hydrated

“People don’t realize that when they’re not hydrated properly, their energy is lower,” said Keri,  “Sometimes just staying hydrated is the key to feeling better.” She also recommends foods that are high in water volume, such as fruits and vegetables, that have the added benefit of keeping you full. And stick with water and herbal teas, she told me – not sodas or anything with artificial sweeteners.

Eat Consistently Throughout The Day

Another way to maintain a high energy level is to start your day with a good breakfast and then eat consistently throughout the day. But don’t rely on low-nutrition, grab and go kind of food to get you through the day. “Eat real foods that aren’t going