Whoopi Goldberg and Kris Jenner find their “Poise”

A new advertising campaign by Poise Brand is using Academy Award winner Whoopi Goldberg and “Keeping Up with the Kardasians” mom Kris Jenner to shed light on a problem faced by 1 in 3 women- what they term “Light Bladder Leakage” or “LBL.” In the commercials currently airing, Goldberg portrays a number of famous women throughout the ages, including Cleopatra, Mona Lisa and Lady Liberty- all of whom bemoan their issue with LBL. Jenner is “starring” as Rosie the Riveter in the campaign, which is entitled “Great Women in History.” According to Jenner:

“Like millions of women, I have my own experiences with LBL, but I’ve never let it keep me from living life to the fullest,” said Kris. “Inspired by the impact that last year’s ‘Great Women in History’ series had on women with LBL, I’ve teamed up with the Poise brand to help women understand that LBL is common and manageable so it shouldn’t stop them from doing great things and being the incredible and accomplished women they are.”

What is light bladder leakage?

Light bladder leakage is actually a recently coined expression to describe the medical condition called stress urinary incontinence. Stress incontinence is an involuntary loss of urine that occurs during physical activity, such as coughing, sneezing, laughing, or exercise. It is the most common type of urinary incontinence in women.

The average adult bladder can hold over 2 cups (350ml – 550 ml) of urine. Two muscles are involved in the control of urine flow:

  • The sphincter, which is a circular muscle surrounding the urethra. You must be able to squeeze this muscle to prevent urine from leaking out.
  • The detrusor, which is the muscle of the bladder wall. This must stay relaxed so that the bladder can expand.

In stress incontinence, the sphincter muscle and the pelvic muscles, which support the bladder and urethra, are weakened. The sphincter is not able to prevent urine flow when there is increased pressure from the abdomen (such as when you cough, laugh, or lift something heavy).

Stress incontinence is often seen in women who have had multiple pregnancies and vaginal childbirths, and whose bladder, urethra, or rectal wall stick out into the vagina (pelvic prolapse).

Risk factors for stress incontinence include:

  • Being female
  • Childbirth
  • Chronic coughing (such as chronic bronchitis and asthma)
  • Getting older
  • Obesity
  • Smoking

Treatment depends on how severe the symptoms are and how much they interfere with your everyday life. There are four major categories of treatment for stress incontinence:

  • Behavioral changes-including changes in the amount of fluids drank and frequency of urination.
  • Medication- See below.
  • Pelvic floor muscle training- Pelvic muscle training exercises (called Kegel exercises) may help control urine leakage. These exercises improve the strength and function of the urethral sphincter.
  • Surgery- usually reserved for patients with significant symptoms for whom other measures have not worked.

Medications

Medicines tend to work better in patients with mild to moderate stress incontinence. There are several types of medications that may be used alone or in combination. They include:

  • Anticholinergic agents (oxybutynin, tolterodine, enablex, sanctura, vesicare, oxytrol)
  • Antimuscarinic drugs block bladder contractions (many doctors prescribe these types of drugs first)
  • Alpha-adrenergic agonist drugs, such as phenylpropanolamine and pseudoephedrine (common ingredients in over-the-counter cold medications), help increase sphincter strength and improve symptoms in many patients
  • Imipramine, a tricyclic antidepressant, works in a similar way to alpha-adrenergic drugs

Prevention:

Performing Kegel exercises (tightening the muscles of the pelvic floor as if trying to stop the urine stream) may help prevent symptoms. Doing Kegel exercises during and after pregnancy can decrease the risk of developing stress urinary incontinence after childbirth.

Picture your Diet

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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