Retraining and weight lifting
Overactive bladder fix #2: Bladder retraining
"A lot of bladder control issues start in the brain," ob-gyn Jill Rabin says. By adjusting your mental associations with bathroom visits, you can help extend the length of time you can last between them.
If, say, you feel the need to urinate every 20 minutes, work on extending that amount of time by small increments -- just five minutes a week. Instead of giving in automatically to the overwhelming urge, try to sit quietly for a few minutes. Focus on deep breathing or distract yourself in another way (listening to one more song on the radio, doing a series of pelvic floor muscle exercises). Know that the need to urinate is felt in waves, so an initial urge that's resisted tends to subside a bit.
Don't be discouraged by occasional breakthrough leaks. "Through timed voiding, you can gradually stretch the interval from every 20 minutes to every 2 hours," Rabin says.
Some people find it useful to set a timer to help extend the intervals between bathroom breaks. Urinating on a timed schedule -- whether you feel the need or not -- is another way to introduce a structure of less-frequent bathroom visits.
Overactive bladder fix #3: Weight lifting
Another way women can build up the muscles of the pelvic floor: Work out with weights. Internal weights, that is. Special cone-shaped weights inserted into the vagina are often prescribed to women experiencing leakage that's at least partly caused by stress incontinence. Variously called vaginal weights, vaginal cones, and Kegel weights, these sterile plastic devices come in sets of five, ranging in weight from half an ounce to more than three ounces.
"You put one in, like a tampon, and wear it for a specific length of time until you can go 30 days without it falling out," Rabin says. "If it doesn't, you put the next-heavier weight in. If it does fall out, you start over at day one until you can reach 30 days."
As the pelvic floor muscles work to hold in the cones, they strengthen. It can take up to three months for the therapy to take effect. A doctor or physical therapist can suggest a specific program and supervise progress.