I am working with a mother who has had several children (more than 5 - all vaginally) and she is suffering with stress incontinence. She notices that it gets worse around the time of ovulation and knows other women for whom this is also the case.

Why would this be and is there any recommendation about what to do about it?

By: Pam

I haven't researched this issue, but it would not surprise me to hear that incontinence fluctuates with hormones. I can tell you that one of the surprise findings of the Hormone Replacement Therapy trial was that women on HRT were more likely to have urinary incontinence. As to what to do about it, I would give her the same advice that I would give to any woman experiencing problems with urinary stress incontinence (involuntary loss of urine when sudden pressure is put on the pelvic floor such as when sneezing, laughing, coughing, or lifting a heavy object):

-- Contract the pelvic floor in anticipation of activities that cause loss of urine.

-- Maintain healthy body weight: the extra weight on the pelvic floor increases pressure

-- Avoid smoking: the cough smokers often develop is the likely culprit.

-- Continue pelvic floor muscle exercises: more intensive programs have been shown to produce better results than less intensive ones.

-- Avoid hysterectomy, when possible: this is probably because removing the uterus removes some of the support structures of the pelvic floor.

-- Avoid HRT, when possible: it's unclear why, but the association was found in a random assignment trial, which means it is probably real.

Of course, I'm assuming that her problem is stress incontinence, the type associated with childbirth. There is another type of incontinence called "urge incontinence" where a person leaks urine during a sudden urge to void. This is more of an irritability issue. We've all seen the commercials on this one, and as they make clear, there are medications for this type.

-- Henci
By: Henci Goer

For 10 months now I have experienced urine incontinence soley during ovulation time. Once a month for 3-5 days I will leak. It is very disturbing. I am 39 years old and overweight. I have had 4 c-sections.

I am sorry that you are having this problem. I hope that one or more of the suggestions I made in my post give you some relief.

-- Henci