Your Urinary Tract: A User's Manual

Ever wonder why you spend so much time in the bathroom? It’s because your urinary tract is your body’s drainage system, designed to remove waste and toxins. (Think of it as your own regular natural cleanse!) Unfortunately, women are more prone to urinary problems than men, thanks to our unique anatomy, hormone changes and the effects of pregnancy and childbirth. But don’t fret: Here’s everything you need to know to resolve your loo-related issues.

Problem No. 1: Urinary incontinence

The lowdown: About a quarter of women leak urine when they’re not actively trying to go. The most common culprits? Pregnancy and labor. “The increased weight during pregnancy puts pressure on your pelvic-floor muscles, and childbirth stretches them out, causing tears that can lead to urinary incontinence,” explains Costas Apostolis, MD, director and chief of female pelvic medicine and reconstructive surgery at Akron General Medical Center in Ohio. But you can be susceptible even if you’ve never had a kid. “As estrogen levels decline through menopause, your urinary tract muscles weaken, making it more likely that you’ll leak,” Dr. Apostolis says. And while we’re all about staying active, running and classes that require a ton of squatting and lifting (like CrossFit) can put stress on pelvic muscles and make the problem worse.

What it feels like: Coughing, sneezing, laughing, squatting or lifting something puts pressure on your bladder, leading to leakage—as little as a few drops or as much as a geyser.

Rx: Visit your ob-gyn. She may recommend pelvic-floor therapy to strengthen those muscles. If you’re dribbling during exercise, your doctor can prescribe a device called a pessary (inserted into the vagina) or outpatient surgery to support your bladder.

Problem No. 2: Urinary tract infections

The lowdown: Blame bacteria like E. coli that invade your urinary tract, often from your stool. Your ureters, urethra, kidneys or—most often—your bladder gets infected as a result. And women can be especially vulnerable. Why? “The proximity of the rectum to the urethra in women allows for easier transmission of bacteria into the bladder,” explains Courtenay K. Moore, MD, a female reconstructive surgeon at the Cleveland Clinic Glickman Urological Institute.

A tendency to get UTIs can run in families. You’re also more likely to get one if you have multiple sexual partners—or are simply having sex frequently (good for you!). And you may start getting UTIs after menopause, due to declining estrogen levels in your system: “Estrogen promotes an acidic pH in the vagina, which protects against the bacteria that cause UTIs,” Dr. Moore says.

What it feels like: The classic symptom is a burning sensation during and after peeing. You might also constantly feel like you have to go while only passing a small amount of urine.

Rx: See your doctor pronto: If left untreated for several days, infection can spread to your kidneys, causing permanent damage. She’ll likely put you on antibiotics. And if you’re truly in agonizing pain, she can also put you on a bladder-numbing drug like Pyridium.


Problem No. 3: Overactive bladder

The lowdown: OAB, or urge incontinence, makes you get a strong, sudden feeling that you need to go. “The muscles in your bladder contract involuntarily,” explains Mary Rosser, MD, an ob-gyn at Montefiore Medical Center in New York City.

What it feels like: You have an immediate urge to pee. You might go as often as eight times a day, even if you’re not drinking a lot.

Rx: The first line of treatment: Kegels and/or pelvic-floor physical therapy to prevent urine from leaking out of your bladder. Your doctor might recommend bladder training, which means you work on delaying going to the bathroom when you feel the need. (Don’t try this without a doctor’s supervision.) If that doesn’t work, she may prescribe a drug that targets the beta-3 receptors on the bladder muscle, relaxing it and increasing its capacity. Botox also appears to reduce symptoms by about 50 percent.

Problem No. 4: Interstitial cystitis

The lowdown This condition acts like a UTI, but it’s not really an infection at all. “Interstitial cystitis happens a lot in women who get recurrent UTIs,” says Lisa Dabney, MD, a urogynecologist at St. Luke’s Roosevelt Hospital in New York City. “The theory is, their bladder gets so traumatized and irritated that they begin experiencing pain even when they don’t have an infection.”

What it feels like Chronic pelvic pain and a persistent feeling that you need to pee.

Rx Your doctor will take a urine sample to rule out infection. If necessary, she’ll perform more invasive tests to examine your bladder lining. One such test is a cystoscopy, in which a lighted scope is inserted into your urethra. Treatment usually involves avoiding foods that exacerbate the symptoms, such as caffeine or acidic fare. Pelvic-floor physical therapy can help, too. If these tactics don’t work, your doctor may prescribe Elmiron, a drug that helps repair the bladder lining.


The truth about kegels

“I see a lot of women who complain that Kegels don’t work, only to find that they’ve been doing them wrong,” says pelvic-floor physical therapist Kerry Kress Levy, based in Towson, Md. To get the right squeeze:

Find the key muscles The next time you’re on the toilet, stop urine midstream. The clenched sensation is a sign that you’re engaging your pelvic-floor muscles. (Don’t do this routinely while peeing, though—that can actually weaken the pelvic floor, Levy says.)

Repeat often Lying on the floor, tighten your pelvic-floor muscles. Hold the contraction for 5 to 10 seconds (don’t stop breathing!), then relax for 5 to 10 seconds. Repeat 20 times a day, eventually working up to 100.

Keep focused While doing Kegels, put your hands on your stomach and butt to ensure that your belly, thighs and glutes aren’t moving.

What your pee color really means

Transparent: You’re drinking a lot of water. It’s fine to be this hydrated, but you don’t need to be. So if you’re forcing yourself to guzzle H[subscript 2]O, you can safely cut back a bit.

Pale straw color or transparent yellow: You’re well-hydrated.

Amber or honey: Your body isn’t getting enough water.

Syrup or brown ale: You may be severely dehydrated. Amp up your fluid intake, and see your doctor if the color persists.

Pink to reddish: Eaten blueberries or beets recently? If not, you may have blood in your urine. It could be nothing, or it could be a sign of a UTI or other condition, so check with your doc to be sure.

Blue or green: It’s probably a dye in something you ate or in a medication (like certain antidepressants and anti-inflammatory drugs), but it may also be a sign of a rare genetic disease. The condition won’t kill you, but to be safe, see your doctor if the color doesn’t go away.

Foaming or fizzing: This could indicate excess protein in your diet or a kidney problem. Talk to your doctor if you notice that it’s happening all the time.

Source: Health Levitra

3 Types of Birth Control That Aren't the Pill

Raise your hand if you’re so over remembering (read: forgetting) to pick up birth control pill refills. Is your arm up? Then it’s high time you considered LARC—long-acting reversible contraception—such as an intrauterine device (IUD) or implant. When it comes to preventing pregnancy, these devices, which a gynecologist inserts into your uterus or under the skin of your arm, “are as effective as getting your tubes tied, but they’re easily reversible,” says Andrew Kaunitz, MD, a professor in the department of obstetrics and gynecology at the University of Florida College of Medicine—Jacksonville.

RELATED: 16 Worst Birth Control Mistakes

In fact, research shows that LARC is more than 99 percent fail-safe. That’s because you can’t mess it up: Once it’s in, simply ignore it until you want to have it removed. Done.

IUDs and the implant are particularly good options if you’re over 35: Most release progestin, a hormone that can relieve bleeding associated with fibroids, which we’re more prone to as we age. They’re also safer for women who smoke or have high blood pressure than estrogen-based options like the pill or ring.

Intrigued? Read on to find the method that’s best for your life situation, and you’ll never have to agonize over an unfilled pill Rx ever again.

I want birth control without hormones in it.
Your pick: A copper IUD (ParaGard)

How it works: The only LARC that doesn’t release progestin, ParaGard has a copper frame that kills sperm. If a sperm did happen to get through, the lining of your uterus would be inhospitable to a fertilized egg.

When to skip it: Steer clear if you have Wilson’s disease, a rare condition that alters the way your body handles and removes copper. And if you’ve noticed reactions to copper jewelry in the past, talk to your doc before getting it. ParaGard may also make your periods heavier when you first start using it, so heavy bleeders might want to pass.

Lasts for: It’s FDA-approved for up to 10 years of use; research suggests it works even longer.

RELATED: 7 Common Birth Control Side Effects

My periods are the worst.
Your pick: A hormonal IUD (Mirena, Skyla or Liletta)

How it works: All three plastic devices release progestin into the uterus. The hormone seems to block sperm from entering your uterus by thickening mucus in your cervix. It may also thin your uterine lining so any eggs that do get fertilized can’t implant. A side perk: After one year, about 20 percent of Mirena users stop getting periods; most of the rest menstruate for just one to two days per cycle, says Mary Jane Minkin, MD, clinical professor of obstetrics, gynecology and reproductive sciences at Yale School of Medicine. (Periods return when the IUD is removed.) Mirena can also reduce menstrual cramping.

Never had kids? Skyla, a compact version of Mirena, may fit more comfortably into your smaller uterus. It also stops periods for some women. Lastly, if cost is a factor, ask for Liletta at your local health clinic—this newer version works the same way as the others but can be more affordable.

When to skip it: If you’ve had breast cancer, your doctor will likely advise against any hormonal birth control.

Lasts for: Skyla and Liletta are approved for up to three years of use, and Mirena for up to five years, but studies show it may be effective for up to six years.

RELATED: The Best Birth Control for You Now

Sticking something up my uterus? No, thank you.
Your pick: A hormonal implant (Nexplanon)

How it works: If you’re nervous about IUD insertion, or if your gyno determines that you’re not a good candidate, consider Nexplanon, a small, flexible plastic rod that’s placed under the skin of your inner upper arm, where it releases progestin into your bloodstream. “You can have it done in five minutes,” Dr. Kaunitz says.

When to skip it: Women who’ve had breast cancer shouldn’t use the implant. FYI: Nexplanon can cause spotting. Mirena can, too, but it typically stops after four months; with the implant, it may go on for longer, Dr. Minkin says.

Lasts for: Up to three years.

Source: Health Levitra