Gotta Go? Women of Every Age Can Improve Bladder Health

While there’s no shortage of advertisements touting products for “leaky pipes,” many women hesitate to broach the topic of bladder problems with their doctors. Some may dismiss the issue, believing that it’s a normal part of aging.

Certainly, urologists can tackle some of the issues women face, but the proximity of a woman’s bladder and urinary tract to her reproductive organs can complicate issues. Urogynecologists — specially trained physicians with expertise in both gynecology and urology — may be best equipped to address issues unique to women’s bladder health.

We sat down to discuss bladder health issues specific to women with urogynecologist Gunhilde Buchsbaum, M.D., who is hosting a free educational event for women on Nov. 14, “Maintaining Your Bladder Health.” (Please click here for details.)

Scripts:  When women think of the term “bladder health” they probably think mostly about incontinence. Are there other related issues they should be concerned about?

Buchsbaum:  Besides the common concern of incontinence, many women experience urinary tract infections, problems with frequent urination, and even bedwetting. Other concerns include painful bladder syndrome, bacterial cystitis, and bladder cancer.

It’s important for women to be aware of these problems, and to know they aren’t alone in facing them. So many women suffer in silence, either embarrassed by the problem or believing nothing can be done for it. In reality, there are many tools for evaluating and treating bladder problems, as well as steps women can take on their own to improve bladder health.

Scripts: What are some symptoms that might signal bladder problems?

Buchsbaum:  There are many things women can look for, some of which they might write off as normal, but may be worth investigating. Take urine leakage. It’s a common complaint of women. If you have this problem, you should tell your doctor. Don’t assume it’s something you just have to live with; there are many things that can be done to address it. Frequent or painful urination is another fairly common symptom, which may be a sign of infection or urethral stricture.

Other signs include blood in urine, which can indicate infection, kidney or bladder stones, or, in some cases, even bladder cancer. Without exception, if you find blood in your urine, you should consult your doctor. While it doesn’t necessarily mean there is a serious problem, if there is one, catching it early can make a big difference in identifying and treating a problem.

Scripts:  Issues with incontinence and that “gotta go” feeling seem so prevalent now. TV ads tout medications for it and women often crack jokes about it. Is it a normal part of a woman’s aging, especially if the woman has gone through childbirth? And is there really anything you can do to avoid it, or to treat it?

Buchsbaum: While it’s true that urinary incontinence becomes more common with age, it’s not a normal part of aging. There are steps women can take to help prevent it. These include doing pelvic floor exercises (think Kegel’s exercises); avoiding consumption of bladder irritants like caffeine, alcohol, and artificial sweeteners; and developing habits that will help with the urge to go to the bathroom.

When necessary, there are various treatment options depending on the type of incontinence and of the needs of the woman. For instance, stress incontinence – which occurs commonly with exercise, coughing, sneezing, or laughing – may be corrected with pelvic floor exercises, insertion of a device called a pessary to help control leakage, or surgical intervention.  Urge incontinence – a sudden and/or strong urge to urinate – can be treated with behavioral changes and, in some cases, medication or nerve stimulation techniques. Overflow incontinence – also known as urinary retention, when bladder is unable to fully empty – is usually treated with self-catheterization or, in certain cases, surgical intervention.

The bottom line is that there are very effective treatment options. Just ask.

Scripts:  What should women in their 20s know that might help them in their 30s, 40s and beyond? And if a woman is 50+, is it too late?

Buchsbaum: It is never too early and rarely too late for starting good bladder habits. Developing strong pelvic floor muscles (again, by performing Kegel’s excercises) is key for addressing stress and urge incontinence at all ages, but it’s best to start young, especially for women in childbearing years.  Limiting caffeine in your diet is a smart habit at any age.

Also, it is helpful for women to recognize symptoms of urinary tract infections (bladder) infections. These may vary from person to person and become less obvious in elderly women. For example, a young woman usually has the classic symptoms: urgency, frequency, and pain with urinating. An older woman may notice fatigue, confusion, low backache, or perhaps an increase in urinary incontinence. Women of all ages should know that incontinence is not normal.  Bladder leakage can get worse if not treated.

Scripts: What one thing do you recommend that a woman asks her doctor at her annual checkup with her primary care physician or gynecologist?

Buchsbaum: All women should ask about Kegel’s exercises, why they are important, and how to do them properly. They are perhaps the simplest step a woman can take to maintaining her bladder health.

Gunhilde Buchsbaum is a professor Obstetrics and Gynecology, professor of Urology, and director of urogynecology at URMC. She founded and directs the Pelvic Health and Continence Specialties practice at URMC’s Women’s Health Pavilion.

Can You Really Die From a Broken Heart?

Sappy cards.  Impossible dinner reservations. Rose bouquets for twice their typical cost.

If you’re annoyed by the hype of the Valentine’s holiday, take heart: There might be something worth celebrating after all. Scientists continue to find ways that nurturing relationships, like a supportive marriage, confer health benefits to the heart – and conversely, how stress and grief from love lost can take their toll on it.

In fact, one recent University of Rochester study showed that wedded people who undergo coronary bypass surgery are at least three times as likely as their unmarried counterparts to be alive 15 years later. On the flip side, more and more scientific evidence is mounting, making a strong case for the long-romanticized notion of people dying from “broken hearts.” It turns out, in rare instances, suffering a devastating loss can literally kill you.

To understand how emotions affect the heart, we sat down with cardiologist Dr. Leway Chen, who specializes in caring for patients with heart transplants and artificial hearts.

To learn more about the advanced heart health care and treatments offered by URMC’s cardiologists, click here.

Too Tangled Up in Preparations to Enjoy the Season?

As a child, a blanket of fresh-fallen snow or the buttery scent of warm sugar cookies was all it took to arouse that delicious sense of wonder.

Somehow, as an adult, that thrill is harder to come by. Maybe it’s because, rather than snuggling up and watching the Charlie Brown special, you’re pulling late-nighters to dutifully manufacture cookie trays, shovel driveways, unravel knotted lights, and battle paper-cuts (and sore backs) during gift-wrapping marathons.

But does it have to be that way? Do hectic preparations have to dominate the weeks leading up to the celebration? What if, rather than focusing on the “big finish” or making a future moment perfect, we slowed down and made a point to intentionally enjoy the season, stress and shopping and all?

Practicing mindfulness – a fancy way of saying “being in the moment” or “tuning in” – can be a solution, says URMC internist Dr. Michael Krasner. An expert on the art (and science!) of intentionally “appreciating the journey,” Krasner travels worldwide training physicians as to how they can bring “intention, attention and reflection” to their clinical practice (thereby reducing stress, heading off burnout, and improving patient care).

But can his insights apply to your holiday hubbub?

Definitely. Granted, you can’t buck those time-intensive traditions altogether (bah, humbug!), but Dr. Krasner says we can find ways to enjoy the planning, and the season, itself. In this week’s clip he offers some practical tips for unwinding, including:

(1)    Setting the tone. Lighting a spicy fragranced candle or whipping up a special hot drink before setting to work on a wrapping or baking bonanza makes a big difference.  This cheerful tone helps to make those must-do chores part of the fun – rather than something to rush through.

(2)   Making it social. Not only do you split the work when you invite pals to tag along – but you transform a task you’ve been avoiding into a special gathering.

(3)    Slowing down. To avoid the post-holiday let-down, let up on the gas. Pause to enjoy aromatic sensation of baking, the textures and colors of fancy wrapping supplies, the glitter of the lights in your neighborhood. If you want to treasure vivid memories of the season, you have to slow down, like a child, and take time to wonder afresh at its beauty.

To learn more about Dr. Krasner’s work training physicians to be mindful, click here.

Hair Loss and More: When Stress Takes its Toll

Last week, the celebrity gossip mill was atwitter with supermodel Tyra Banks’ juicy confession: The stress of writing her first fiction novel recently took a toll on her tresses.

The model-turned-media-mogul claimed that she “got a little alopecia (hair loss)” while juggling her many professional pressures.

While some might be quick to poke fun at the starlet’s plight, Banks raises an important issue that too many Americans ignore: Stress is neither something to brag about (that silly one-upmanship of “who’s busiest”) nor to suffer through silently. It puts real strain on our bodies, and if sustained, can suck years out of our life (not to mention life out of our years).

To learn more about stress, and its very real effects on our bodies, we spoke to mind-body research expert Dr. Jan Moynihan, who directs the Rochester Center for Mind-Body Research.

To learn more about the research underway at the Rochester Center for Mind-Body Research, click here. For a fascinating article on how our personality type affects our ability to withstand stress, click here.