Incontinence? These Medications Can Help

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Not only is incontinence embarrassing; it can be highly -- well, inconvenient. And unfortunately, bladder control therapy and pelvic floor exercises don't work for everyone. No surprise, then, that although some medications can trigger incontinence, there's plenty of interest in medications that increase bladder control. Here are the medications for incontinence that most doctors and patients turn to first.

Anticholinergics/antispasmodics

How they work: These drugs block the chemical messenger that triggers involuntary contractions of the bladder, preventing bladder spasms and holding off the urge to go.

Brand names:

  • Vesicare (generic: solifenacin)

  • Ditropan, Gelnique, Oxytrol (generic: oxybutynin)

  • Detrol (generic: tolterodine)

  • Enablex (generic: darifenacin)

  • Sanctura (generic: trospium)

  • Toviaz (generic: fesoterodine)

  • Flavoxate (generic: flavoxate hydrochloride)

  • Pro-Banthine (generic: propantheline)

Best for: Overactive bladder, urge incontinence, stress incontinence

Tips: Many of these drugs are now available in an extended-release form, allowing you to take them just once a day. Extended-release formulations tend to have fewer side effects, and some patients find them more effective. Oxybutynin is now available in two topical forms, the Gelnique gel and the Oxytrol patch, which, according to some studies, can be easier to tolerate than oral medications.

Estrogen

How it works: This female hormone plays a central role in maintaining the elasticity and flexibility of tissues. The drop in estrogen levels during menopause leads to deterioration of the strength and flexibility of the muscles and tissues of the bladder and urethra. Topical estrogen applied via a low-dose estrogen cream, tablet, slow-release patch, or ring releases estrogen directly into the vaginal and urethral tissues.

Brand names:

  • Climara - patch

  • Premarin and Estrace - cream

  • Estring, Femring "“ vaginal ring

  • Vagifem -- tablet (generic: estradiol, estriol, estrone)

Best for: Menopause-related stress incontinence and urge incontinence

Tips: Topical estrogen, in the form of a cream, patch, or vaginal ring is the best way to treat menopause-related incontinence. Oral estrogen is less effective, and some women find it makes incontinence symptoms worse. Combination hormone therapy (estrogen and progesterone) is likewise not effective for incontinence, experts say.

Certain tricyclic antidepressants

How it works: A couple of tricyclic antidepressants have been found in studies to prevent incontinence by preventing contractions of the smooth muscles of the bladder.

Brand names:

  • Tofranil (generic: imipramine)

  • Sinequan (generic: doxepin)

Best for: Overactive bladder, urge incontinence

Tips: These antidepressant medications can also affect mood and cause fatigue and sleepiness, so you have to balance the positive effects on bladder control against other effects they may have on you.


Melanie Haiken

Melanie Haiken discovered how important it is to provide accurate, targeted, usable health information to people facing difficult decisions when she was health editor of Parenting magazine. See full bio