The short answer: sooner than you think
The U.S. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) advises talking with a health care professional about bladder control problems, and stresses: “Even if you feel embarrassed, it’s important to talk with your health care professional.” Leaks, urgency and frequent trips are common, especially after childbirth, around menopause and with age, but common doesn’t mean you have to accept them, and they can sometimes signal something that needs treatment.
Get medical help promptly if you have
- Burning or pain when you urinate, a frequent urge with only small amounts, or cloudy or strong-smelling urine (possible urinary infection)
- Fever, chills, or pain in your back or side (possible kidney infection; seek care the same day)
- Blood in your urine, even once
- Sudden loss of bladder control, especially with numbness, weakness or back pain (seek emergency care)
- Being unable to pass urine, or feeling you can’t empty your bladder
- A bulge or heaviness in the vagina
- Bladder symptoms in pregnancy
Don’t try to manage these with supplements. Cranberry, for example, is not recommended as a treatment for an existing UTI, according to NCCIH.
Book a routine appointment if
- You leak when you cough, laugh, sneeze or exercise.
- You get sudden, strong urges and sometimes don’t make it in time.
- You’re going to the bathroom more than usual, or waking at night to urinate more than once.
- You’ve had two or more urinary infections in six months, or three in a year.
- You’ve tried pelvic floor exercises and habit changes for six to eight weeks without improvement.
- Your symptoms are affecting your work, exercise, sleep, sex life or mood.
Preparing for your appointment
A little preparation helps you get the most from a short visit.
- Keep a bladder diary for three days. Note drinks, bathroom trips, urges and leaks. See our daily habits guide.
- List your medicines and supplements, including anything like FemiCore. Some ingredients can interact with medicines.
- Note your history: pregnancies and births, menopause, surgeries, constipation, chronic cough.
- Write down your questions and what you’d like to achieve.
What usually happens
Your clinician will ask about your symptoms and history and may:
- examine your abdomen and pelvis;
- test a urine sample for infection or blood;
- check how well your bladder empties;
- ask you to keep or review a bladder diary;
- refer you to a specialist (urologist, urogynecologist) or a pelvic health physiotherapist.
The most important step is working out which type of problem you have, because treatment depends on it. The main types include stress incontinence (leaks with pressure such as coughing), urgency incontinence (leaks with a sudden urge) and mixed incontinence.
Treatments you may be offered
According to NIDDK, treatment usually starts with:
- Lifestyle changes: fluids, caffeine and alcohol, weight, smoking.
- Bladder training.
- Pelvic floor muscle exercises, sometimes with biofeedback or electrical stimulation.
If those aren’t enough, options include:
- Medicines for urgency incontinence that relax the bladder;
- Botox injections into the bladder in some cases;
- Devices and procedures for stress incontinence or prolapse.
What about supplements?
If you’re thinking about a supplement such as FemiCore, tell your clinician. Some ingredients need care: berberine-containing herbs may lower metformin levels, cranberry has conflicting evidence on interacting with warfarin, and bearberry is normally limited to short-term use and avoided in pregnancy and kidney disease. Bring the label, or our ingredients page, so your clinician can check.
Talking about it
It can feel awkward to bring up. Some phrases that help:
- “I’ve been having some bladder leaks and I’d like to get them checked.”
- “I’m getting up at night to urinate and it’s affecting my sleep.”
- “I keep getting urinary infections and want to understand why.”
Health professionals discuss these problems every day. You won’t shock anyone, and you may be surprised how much can be done.
After the appointment
Ask for a written plan, including when to follow up and what to do if symptoms change. If you’re starting pelvic floor exercises or bladder training, schedule a review after six to eight weeks to check progress.
Bottom line
See a professional promptly for infection signs, blood, sudden changes or pain, and book a routine visit for leaks or urgency that bother you. Most women can improve, and the first step is a conversation.
Frequently asked questions
What should I bring to a bladder appointment?
A three-day bladder diary, a list of your medicines and supplements, notes on your history, and your questions.
Are bladder leaks normal as you get older?
They’re common, but they’re not something you have to accept. Many women improve with exercises, habit changes or treatment.
Who should I see for bladder leaks?
Start with your primary care clinician or gynecologist. They may refer you to a urologist, urogynecologist or pelvic health physiotherapist.
Can I treat a UTI with cranberry?
No. NCCIH says cranberry isn’t recommended as a treatment for an existing UTI. See a clinician.
Sources
Keep learning
*These statements have not been evaluated by the Food and Drug Administration. FemiCore is not intended to diagnose, treat, cure or prevent any disease. Information on this page is for education only. If you have bladder symptoms such as pain, blood in the urine, fever or sudden changes, see a health care professional.