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Acupuncture for Urinary Incontinence

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No one really wants to chat about their bladder issues, they are generally not considered appropriate small talk or a conversation starter. I spend a lot of time talking with women about all sorts of personal stuff, yet bladder problems still seem to be one of those things that we are most reluctant to talk about. A significant percentage of women will have some experience with incontinence at some time in their life, and that it can have a really substantial impact on quality of life and daily functioning. 

While some issues arise as a result of a difficult labour or birth, this can also occur after a straightforward delivery, or c-section, and during otherwise uneventful pregnancies. It can occur for menopausal women who have had no children, and in those who have had many. Incontinence may be present alongside organ prolapse, but it often occurs without. Often incontinence is dismissed by care providers as just a thing that happens as we get older or have babies, but there are treatment options available, and believe it or not, acupuncture can be very helpful. 

There are different types of urinary incontinence, primarily stress, urge and mixed incontinence. Stress incontinence is where you get a bit of leakage when there is some pressure, like when you cough, or pick up your baby etc. Urge incontinence is when you feel the urge to wee, and you have leakage before you can get to the loo. And mixed is when you have the full enchilada, both stress and urge incontinence combined. 

In western medicine the approach, depending on when the incontinence is occurring, is often kegel exercises, avoiding irritants (coffee, alcohol, chilli, chocolate and more) or wait and see what happens (especially in the early weeks after birth). There are also some medications used occasionally for urge incontinence There is no doubt in my mind that a good pelvic floor physio and targeted exercise can help many, but there have been a number of studies that show acupuncture is equally effective. A study published in the British Medical Journal in 2017 found that women in 1 a large, high quality trial, found similar improvements with 6 weeks of electro acupuncture treatment as with the pelvic floor training. A 2018 study of post menopausal with stress incontinence found electro acupuncture safely and effectively relieved the symptoms of stress incontinence in a 6 week period when compared to sham as the control . It may not be the first 2 modality that springs to mind to fix your leaking, but it appears that it is one well worthy of investigation. 

Possibly an integrative approach combining modalities of pelvic floor exercises and electro acupuncture may be the best way forward for individual women experiencing incontinence. Why not combine both modalities that appear to be both safe and effective? They work in different ways, so it seems like it might be the supercharged option. In some instances acupuncture may be a great starting place as it can be used at times when pelvic excercise may be difficult or inadequate, like the first weeks after having a baby when still healing, or during pregnancy. And for women who have experienced trauma and find the idea of internal examination difficult, acupuncture requires no such examination and may be a less confronting way to embark on a healing journey. 

In clinical practice treatment for incontinence during pregnancy is likely to be different (as with many treatments) than treatment during the antenatal period or during menopause. But the good news is that pregnant women tend to be so open energetically during this time, that they often respond very well to quite gentle and subtle treatment. No need for electro at this time! 

Incontinence may feel like a difficult issue to chat about, but seeking out some assistance can make a big difference to outcomes and your future pelvic health.

1Mayor, S. BMJ 2017;357:j3144 https://www.bmj.com/content/357/bmj.j3144

2 Wang W, Liu Y, Sun S, Liu B, Su T, Zhou J, Liu Z. Electroacupuncture for postmenopausal women with stress urinary incontinence: secondary analysis of a randomized controlled trial. World J Urol. 2018 Oct 13. doi: 10.1007/s00345-018-2521-2.https://www.ncbi.nlm.nih.gov/pubmed/ 30317381 

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