7 Medications That Can Cause Incontinence
When you look in your medicine cabinet, chances are you're searching for help with incontinence, not worrying about making it worse. But some of the drugs you take every day may be doing just that: triggering incontinence or making a sensitive bladder overactive. Here are seven possible culprits:
1. Blood pressure-lowering drugs
Which ones: Alpha-blockers; brand names Cardura, Minipress, Hytrin; generic names doxazosin mesylate, prazosin hydrochloride, terazosin hydrochloride
Why they may be culprits: Alpha-blockers work to lower blood pressure by relaxing blood vessel walls. The trouble is, they also relax the bladder along with the blood vessels. And alpha-blockers can relax the urethra, the tube leading from the bladder to outside and the muscle at the neck of the bladder. This leaves you prone to stress incontinence, which is leakage when you sneeze, cough, laugh, run, or jump.
What to do: You can start by doing Kegel exercises to increase your ability to control the muscles of the bladder. Good muscle control might be able to overcome the relaxing effects of the alpha-blockers. But if leakage is really a problem, level with your doctor (despite the embarrassment -- he or she has heard it all) and ask to switch meds. Luckily, there are many options for controlling blood pressure, so your doctor can try using a calcium channel blocker or another class of medication that doesn't have this unfortunate effect on your bladder.
2. Hormone therapy
Which ones: Oral estrogen-only or combination estrogen and progesterone pills
Why they may be culprits: This came as a surprise discovery a few years ago, and experts don't know what exactly is going on. Until recently, hormone therapy was actually thought to help with incontinence, but it's now known to trigger or worsen both stress and urge incontinence.
What to do: Talk to your doctor about using topical hormones, such as estrogen and progesterone in cream form, or estrogen patches, which seem to have far fewer incidences of this side effect than oral hormone pills. In fact, for some women topical estrogen applied as a cream or patch helps prevent or lessen incontinence. You can also try progesterone-only therapy, either oral or cream, which hasn't been found to be associated with incontinence. Like so many hormone-related side effects, this one is very individual; it's important to experiment and see what works for you.