Pelvic Power: Strengthening Your Way to Better Bladder Health

Heavy incontinence can present unique physical, emotional, and social challenges—and it’s more common than many women think. In this episode, integrative medicine specialist Dr. Karen Koffler shares supportive guidance for managing heavier leaks, with expert tips on pelvic floor strength, product fit, and real-world strategies. The goal: to equip women with the knowledge and tools to live fully and confidently.

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Episode Transcript

Speaker 1 (00:00):
Each week, we aspire to bring you the good news
on women's health by talking to renowned scientists and medical experts,
and by sharing health advice that can help you live
healthier and happier. Last week we talked about bladder leaks,
the minor loss of fluid that so many women experience
at one time or another in their lives. Today we
deal with heavier leaks, and we brought back doctor Karen Kaffler.

(00:24):
Doctor Koffler is an Assistant Professor of Medicine at the
University of Miami School of Medicine and a physician at
Lifespan Medical with an emphasis on longevity medicine. She also
has her own private practice focused on women's health and longevity.
Welcome doctor Kaefler, thanks for being with us.

Speaker 2 (00:41):
Thanks for having me back again.

Speaker 1 (00:43):
We're talking today about heavier bladder leaks or heavy incontinence,
and I think it's a really important issue because it's
really more common, I believe than people think. Is that true?
It really is.

Speaker 2 (00:58):
You know, at lee fifty percent of women over the
age of fifty have some degree of incontinence, and some
of them it's it can be pretty substantial. So it
is if you think about fifty percent of the women
over age fifty are sufferings from some degree of incontinence.
That's a very large number.

Speaker 1 (01:19):
Yeah, that's probably more than people realize, which means that
somebody you know is dealing with it, if not yourself.
So why is this the case? What causes this heavy incontinence?

Speaker 2 (01:30):
There's a fair number of reasons why women develop incontinence,
and again it's not just limited to older women. We
do know that up to twenty percent of women eighteen
and older experienced some degree of incontinence.

Speaker 1 (01:45):
Again, there's a variety of reasons.

Speaker 2 (01:47):
But as we age, we see the loss of estrogen
affects the tissues and the pelvic floor, just as it
affects tissues throughout the body. If we gain weight as
we age, that can increase the pressure on the bladder.
The tissues weaken just in general as we lose muscle
mass with age, but also if we've had children, if

(02:10):
we've had surgery in our pelvic region, the tissues can
be weaker. There can be stretching, a laxity to the
tendons and ligaments, as well as the musculature in that region,
all of which changes how well we can hold onto
urine and can result in incontinence. So there's a variety

(02:31):
of issues at play.

Speaker 1 (02:32):
And when we say heavy incontinence, what do we mean
by that?

Speaker 2 (02:36):
You know, if you think about it, lighter incontinence is
a couple of drops, and heavier incontinence means a great
deal more than that.

Speaker 1 (02:44):
And the bladder.

Speaker 2 (02:46):
Itself can hold about up to five hundred c seas
of fluid, So that's like a quarter of one of
those big soda bottles, or maybe better understood as two
cups of urine is what our typical bladder can hold.
And if you lose more than a few drops, if
you lose a half a cup a cup, that's considered

(03:07):
to be heavier incontinence, and it can be quite debilitating
for women.

Speaker 1 (03:13):
What kind of physical and emotional challenges as I suppose.

Speaker 2 (03:18):
When we reflect on our kids, we always changed our kids'
diapers quickly when they pede because we want to make
sure that the urine is not irritating their skin. So
it can be irritating to the skin. Emotionally, it can
be quite upsetting because it can come completely unexpected. It
can obviously show through your clothing if you wore it

(03:41):
white or beige or something obvious, and it can also
really disrupt a woman's confidence. It could make her feel
quite limited in what she can do and where she
can go and how long she can be out. So
it can alter her life and actually lead to a
quality of isolation.

Speaker 1 (03:59):
But it doesn't have to be that. I understand there
are things we can do and that all the needs
to know about because it will likely happen to many
of us. So what are some of the things we
can do.

Speaker 2 (04:08):
I think that's really important because I think a lot
of women sort of just deal and the reality of
it is is we've advanced a great deal. There's a
whole field in physical therapy called pelvic floor physical therapy,
and they do incredible work. They teach you how to
pay attention to the bladder, well to the pelvic floor

(04:30):
as well as the core, so that you can begin
to control those tissues and strengthen them. They'll use things
like biofeedback to help achieve that. There are other devices
that they use, very sophisticated in terms of weights to
help ensure strength in that region, things like pilates which

(04:51):
help you focus on the core, as well as yoga.
They even have the mulabunda in yoga means root and
strengthening the roots, and obviously that's an ancient practice, so
it's clear that this has been an issue for a
long time. There's practical things you can do. There's a
variety of absorbent pads all the way through in underwear,

(05:14):
all the way running the gamut depending on the degree
of leakage a woman experiences. There's more sophisticated techniques like
surgical techniques or ways to bulk up the urethrust so
that that's stronger and can endure more. There's bladder retraining
exercises that are very very effective.

Speaker 3 (05:35):
So there's a whole variety of ways that this can
be addressed today.

Speaker 1 (05:47):
It's really great to know because I think again knowledge
is power in this kind of environment, and sort of
knowing a that you're not alone, but be that there's
very practical things you can do, from the exercises that
you talked about to the right kinds of product and
pads and liners. But also, as you said, in some
instances people need more medical help and that's available to

(06:09):
but on a day to day basis, we don't want
to be curtailed in our activities. Obviously, and I think
that that's why it's so important to have these conversations.
On a practical level, what would you tell women who
are facing this today and want to sort of do
something about it today or tomorrow.

Speaker 2 (06:24):
Just practically speaking, planning your sort of your fluid intake,
just the way you know, when I travel, I sort
of plan my meals, or if I'm going out to
eat at a restaurant that maybe doesn't have the full
selection that I'd be looking for, I look at the
menu beforehand and sort of get an idea of what
I'd probably order. Planning goes a long way, So if

(06:47):
you know you're going to be out for a while,
you can certainly take in your fluids earlier in the
day and allow it to taper off as you get
within a couple of hours of being out and about.
So very practical again, don't be ashamed to look for
the right pad absorbentcy that works for you. And some

(07:10):
of these are quite excellent the way they're constructed, they
really are far more absorbent than anything that has existed before.
So I think the whole industry is becoming much more
aware that this is an issue, and they've created a
variety of pads for different degrees of leakage, wearing appropriate clothing.
You know, patterns are probably best. Learning to take a

(07:33):
change with you just in case on the outside chance.
So those are just some very practical tools that you
can use to be able to maintain your life and
not see this as you know, some sort of personal flaw,
but recognize in many ways this is part and parcel
to aging. And you know, many of us have things

(07:55):
that we have learned to work around and continue on
doing the things that we love, and this is another
one of those health issues that we can learn to
work around.

Speaker 1 (08:06):
That's why I love talking to you so much. Just
be able to share these things and know that none
of us are alone in this and that this is
very normal. We talk about normalizing conversations, but I think
this is so so important, and I know a lot
of people are suffering in silence for something like this,
which is pretty easily addressable. So really appreciate your time
as always and look forward to having further conversations.

Speaker 2 (08:29):
Great to be with you again.

Speaker 1 (08:32):
Here are the top takeaways. First, know that you're not alone.
Heavy incontinence is not a personal flaw. It's a common
occurrence as we age due to factors like childbirth, hormonal changes,
and muscle loss in the pelvic region. Second, heavy incontinence
is very treatable. Core strengthening practices like pelvic floor physical therapy, pilates,

(08:56):
and yoga can all make a real difference. You don't
need to restrict your social life because of heavy incontinence.
Today's products can effectively meet a variety of absorbency needs.
With a little planning and the right products, life can
go on as usual. Thank you for listening, and please
share today's episode with others in your life. Have a

(09:18):
great day. For more podcasts from iHeartRadio, check out the
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