Urinary Incontinence
How Acupuncture Supports Bladder Control and Pelvic Floor Health
Urinary Incontinence (UI) can happen for a variety of reasons, but in my practice I most commonly see it affect postpartum patients and those entering menopause. It can also be an issue during pregnancy itself; symptoms tend to increase with each trimester as pressure on the bladder and pelvic floor increases. Those who have had previous pregnancies also have a higher risk for UI. In postpartum patients, those who delivered vaginally have a higher risk for postpartum UI compared with surgical delivery, and those who experienced 3rd or 4th degree tear also have a higher risk.
The research really illustrates why it’s important not to ignore the issue- 3 months postpartum anywhere from 17-31% of new moms experience urinary incontinence, and if untreated 38% still had symptoms a whopping 12 years later (source). That’s the minority, but not by much! You can see why it’s so important to seek out help for the issue absolutely as soon as possible- the sooner you can get help after the issue the begins, the better your chances of overcoming it.
Why Does Postpartum Urinary Incontinence Happen?
Typically (but not always), it’s more common for postpartum patients to experience stress incontinence (with sneezing, coughing, jumping or other physical activity). A combination of issues can be responsible including:
Damage to the pelvic floor during pregnancy and childbirth
Hormonal changes which contribute to problems with urethral function, pelvic floor ligament laxity and pelvic floor musculature weakness
Why Do We Get Urinary Incontinence During the Menopausal Transition?
Declining oestrogen levels can lead to a loss of elasticity of the urethra, bladder and vaginal tissues as well as weaker pelvic floor muscles. In this population, incontinence can be stress incontinence (with sneezing, jumping or other physical activity), urge incontinence (unable to control the flow when there is a strong urge) or a combination.
What are My Treatment Options?
Typically you would be offered pelvic floor physical therapy, guidance on lifestyle modifications (such as avoiding caffeine) or in more severe cases injections, surgery or medications.
Acupuncture is another little-known treatment option. While we don’t have a large body of research around its use, we know that it is safe and seems to be promising. Many of my patients successfully use acupuncture alongside physical therapy and other treatment modalities.
How Might Acupuncture Help?
Through the lens of Traditional Chinese Medicine, there could be a disharmony in organs such as the kidney, urinary bladder, liver or heart (and more!) that could be aggravating the issue. Your acupuncturist will ask questions to learn more about your triggers for UI as well as other factors such as your stress level, aches and pains, your sleep quality and body temperature. These all come together to help us determine what might be out of balance. From there we can choose appropriate acupuncture points.
In addition to this holistic view, there are several acupuncture therapies which I feel beautifully integrate Traditional Chinese Mediciine and western knowledge of physiology. These two methods have been studied in a few randomised controlled trials. Both send a message to regulate the nerves that innervate the bladder and pelvic floor, re-training them back to more normal functioning.
My Recommendations:
In addition to the techniques discussed above, we have many other acupuncture points and techniques to choose from that allow us to truly personalise treatment. While I recommend every patient suffering from UI get an evaluation and recommendations from a gynecologist, urogynecologist and/or Pelvic Floor Physical Therapist, you may want to consider acupuncture as an additional treatment or an alternative if first-line treatments haven’t been successful.
I recommend postpartum patients consider acupuncture if they have severe symptoms or if UI is still happening 4-6 weeks postpartum. If you are in menopause or transitioning into menopause, I recommend considering acupuncture if you are currently in pelvic floor PT or have already tried it or another therapy without much improvement.