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A report from the U.S. Department of Health and Human Services’ (HHS) Agency for Healthcare Research and Quality (AHRQ), reveals that adult women who suffer from urinary incontinence can benefit by performing pelvic floor muscle training exercises that have no adverse effects. The report also found that although medication treatments can be effective, their benefits are low and adverse effects are common.

The report, published in Annals of Internal Medicine, is a comparative effectiveness review prepared for AHRQ’s Effective Health Care Program by the Minnesota Evidence-based Practice Center.

Carolyn M. Clancy, M.D., AHRQ Director, explained:

“Urinary incontinence can affect women in a variety of ways, including physically, psychologically and socially – and some of these impacts can be severe. This new report will help women and their clinicians work together to find the best treatment option based on each patient’s individual circumstances.”

Approximately 25% of young women, up to 57% of middle-aged and postmenopausal women, and around 75% of older women in nursing homes suffer from urinary incontinence. Urinary incontinence can inflict considerable and potentially debilitating lifestyle restrictions. In 2004, the United States spent around $19.5 billion on incontinence care. In addition, one estimate reveals that the annualized cost of women’s nursing home admissions due to urinary incontinence was $3 billion and 6% of nursing home admissions of older women were due to urinary incontinence.

In this study, the team focused on stress incontinence and urgency incontinence. Stress incontinence is the inability to retain urine during sneezing or coughing and urgency incontinence is a sudden compelling urge to urinate that results in involuntary loss of urine.

According to the researchers, both stress and urgency incontinence usually occur when the urinary sphincter fails, often due to weak pelvic floor muscles. Pelvic floor muscles support the bladder, uterus and other pelvic organs.

The researchers found that exercises designed to increase the strength of the pelvic floor muscles (similar to Kegel exercises) were effective in a women’s ability to hold their urine. These exercises, in addition to bladder training, improved both stress and urgency incontinence.

Although the report found that estrogen treatment was effective in treating stress incontinence, it also had some adverse effects. Furthermore, another medication called duloxetine (antidepressant) was found to be ineffective and had a high risk of adverse effects.

According to the report, the drugs reviewed were comparable in effectiveness, although more women discontinued treatment with some drugs as a result of adverse effects. The report will help patients and clinicians select the best treatment options with the most benefits and least harms, via its comprehensive information regarding each medications adverse effects.

Even though there is significant evidence on clinical measures for treatment of the condition, such as grams of urine lost, there are less measures of quality of life associated to urinary incontinence and its treatments.

The report, Nonsurgical Treatments for Urinary Incontinence in Adult Women: Diagnosis and Comparative Effectiveness, is the latest comparative effectiveness review from AHRQ’s Effective Health Care Program.

Written By Grace Rattue

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Then, like clockwork, her name will appear on the maternity admissions board at the local hospital and the midwives will fight over who delivers her baby (always induced two weeks early now after she nearly had Katy in the car). She is a familiar face on the labour ward. ‘This time, one called another one over and they peered at my stomach. No stretch marks and completely toned,’ Sue says proudly. No matter what, Sue always finds time to do her tummy exercises and her pelvic floor exercises, either first thing in the morning or during the babies’ nap time. Sue does look amazing. ‘It’s all the babies!’ Katy chips in.

From the Daily Telegraph

And that is  one of the big problems about sex and Menopause – it’s regarded as a female concern.. Something the woman has to sort out.

But, the truth is, if you want your marriage to survive what can be around a decade of upheaval – if you’re lucky, it needs to be a joint venture.

Pelvic Floor Exercises For Men?

For men, these exercises can help to prevent problems with urine and fecal control, which will normally be a direct result of problems with the prostate gland.

Regular pelvic floor exercises will keep the muscles toned for women but, for men, they increase the blood supply to this peculiarly male part, helping to keep the prostate in good condition.

Pelvic Floor Exercises For Women

For many wives, Menopause starts off as hot sweats and mood swings with an increased libido that keeps him on his toes before revealing hitherto hidden problems with his own libido.

Once her hormones settle down, the lack of oestrogen means that her sexual desire decreases rapidly.  A problem which is made worse by pain during sex from vaginal thinning.  The combination of the two can be a powerful reason why a woman might not want to have sex much – if at all.  It hurts and she just doesn’t feel the same desire any more, although she does not love her partner any less.

For her husband, Menopause is a time of walking on eggshells with a woman who, one minute, is humping his leg like a dog in heat and the next is pushing him away every time he tries to get intimate.  It is a most confusing situation at a time when his own performance can become compromised due to prostate malfunction.

At such times, it is vital that  the two people can talk to each other about these physical symptoms as well as the emotional confusion for both partners at this difficult time.  They need to be able to look into causes and cures together.  It’s the next stage of their relationship.

Often known as Kegels, after the Austrian doctor who first documented their relevance, exercising the muscles of the pelvic girdle is vital to maintaining health in later life.

This hammock of muscle holds everything in place and needs to be kept at optimal tension to avoid organ prolapse. Allow it to slacken off and basic gravity means that things start moving downwards through whatever openings are available – whether you’re male or female.

The rather flawed design of a woman’s body means that kegel exercises are vital for all age groups, whether they’ve had children or not. The pelvic floor has three holes dissecting it, affecting the integrity of the muscles. If you have additional downwards pressure of extra weight through pregnancy or obesity and the result can be urinary and/or anal stress incontinence or, worse, prolapse.

But there is an important side effect of pelvic floor exercise because it works with the muscles that control the sexual organs for both genders, improving performance and sensitivity. For women suffering with vaginal atrophy which causes the pain during intercourse, the additional circulation of blood can help to plump up the flesh and avoid the need for hormonal supplements.

There are exercises that you can do together as you do household chores and you can even use special battery-operated devices which amplify the effects of the contractions. Alternatively, you can take your exercises to the bedroom and work out together to really feel the benefits.

There’s nothing works quite so well as having someone remark upon the effectiveness of your contractions and the improvement in your ability to squeeze.  Machines just don’t do that.

So, use pelvic floor exercises to retain your health and save your marriage.