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August 10, 2024 • 57min
I’ve Never Told This Story: Leaky Bladder, Pelvic Floor, UTIs, & Constipation (#1 Urologist Gives Solutions)
The Mel Robbins Podcast
In this episode, Mel Robbins opens up about her personal struggles with urinary incontinence after childbirth and interviews Dr. Rena Malik, a urologist specializing in female pelvic medicine and reconstructive surgery. They discuss common pelvic floor issues that affect both women and men, including urinary incontinence, overactive bladder, UTIs, and constipation. Dr. Malik provides expert insights on the causes of these issues, treatment options, and lifestyle changes that can help improve pelvic floor health.
I’ve Never Told This Story: Leaky Bladder, Pelvic Floor, UTIs, & Constipation (#1 Urologist Gives Solutions)
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Key Takeaways
- Pelvic floor health impacts 40% of women and 30% of men, affecting urinary function, bowel movements, and sexual health
- Common pelvic floor issues include urinary incontinence, overactive bladder, constipation, and pelvic pain - these are common but not normal and can be treated
- Childbirth, aging, and certain activities can weaken the pelvic floor muscles, leading to issues like urinary leakage
- Kegel exercises can help strengthen the pelvic floor, but should be done properly and consistently
- Staying hydrated by drinking 2-3 liters of water daily can reduce UTI risk by 46%
- Cranberry supplements with 36mg of proanthocyanidins may help prevent recurrent UTIs
- Men with enlarged prostates may have trouble urinating and should see a urologist if experiencing issues
- Lifestyle changes like avoiding bladder irritants, managing constipation, and maintaining a healthy weight can help with overactive bladder
- Don't suffer in silence - pelvic floor issues are treatable and you deserve to get help to improve your quality of life
Introduction
In this episode, Mel Robbins opens up about her personal struggles with urinary incontinence after childbirth and interviews Dr. Rena Malik, a urologist specializing in female pelvic medicine and reconstructive surgery. They discuss common pelvic floor issues that affect both women and men, including urinary incontinence, overactive bladder, UTIs, and constipation. Dr. Malik provides expert insights on the causes of these issues, treatment options, and lifestyle changes that can help improve pelvic floor health.
Topics Discussed
Understanding the Pelvic Floor (16:41)
Dr. Malik explains that the pelvic floor is a group of muscles that form a "hammock" at the bottom of the pelvis, supporting organs like the bladder, uterus, and rectum. It plays a crucial role in:
- Controlling urination and bowel movements
- Supporting pelvic organs
- Providing stability when walking or moving
- Contributing to sexual function and orgasm
- Helping with lymphatic drainage
The pelvic floor can become weakened due to factors like:
- Pregnancy and childbirth
- Aging
- Chronic coughing
- High-impact activities
- Genetic factors
Urinary Incontinence and Leakage (24:31)
Mel shares her personal experience with urinary incontinence after a traumatic childbirth. Dr. Malik explains there are two main types of urinary incontinence:
- Stress incontinence: Leakage during activities like coughing, sneezing, or exercise
- Urge incontinence: Sudden, strong urges to urinate with leakage
Treatment options for urinary incontinence include:
- Pelvic floor exercises (Kegels)
- Lifestyle changes
- Pessaries or other supportive devices
- Minimally invasive procedures like bulking agent injections
- Surgical options like slings
"It is very devastating. And we just sort of brush it off like it's nothing." - Dr. Rena Malik
Kegel Exercises and Pelvic Floor Strengthening (26:51)
Dr. Malik provides guidance on properly performing Kegel exercises:
- Focus on squeezing and lifting the pelvic floor muscles without engaging other muscles
- Start by practicing while lying down
- Hold for 5 seconds, relax for 5 seconds, repeat 10-15 times
- Gradually increase repetitions and try in sitting/standing positions
- Consider working with a pelvic floor physical therapist for proper technique
She notes that some people may have overly tight pelvic floors and need relaxation exercises instead.
Overactive Bladder Symptoms and Treatment (35:02)
Dr. Malik outlines symptoms of overactive bladder:
- Urinating more than 8 times per day
- Strong, sudden urges to urinate
- Waking up at night to urinate (nocturia)
Treatment options include:
- Lifestyle changes like avoiding bladder irritants
- Pelvic floor exercises
- Medications
- Botox injections in the bladder
- Nerve stimulation therapies
Urinary Tract Infections (UTIs) (44:31)
Dr. Malik discusses UTI symptoms, prevention, and treatment:
- Symptoms: Pain with urination, abdominal/back pain, frequent urges to urinate
- Prevention:
- Stay hydrated - drinking 2-3 liters of water daily can reduce UTI risk by 46%
- Consider cranberry supplements with 36mg proanthocyanidins
- Urinate after s*x
- Manage constipation
- Treatment: Usually involves antibiotics prescribed by a doctor
"You don't have to suffer in silence. You don't have to just live with it. Right? These things that we're gonna learn about and talk about today are not necessarily normal. They're very common, but they're not necessarily normal." - Dr. Rena Malik
Men's Urinary Health and Prostate Issues (52:21)
Dr. Malik explains that men commonly experience urinary issues due to an enlarged prostate:
- The prostate surrounds the urethra and can restrict urine flow as it enlarges
- 80% of 80-year-old men have an enlarged prostate
- Symptoms include weak urine stream, difficulty starting/stopping, and frequent urination
- Treatment options include medications and minimally invasive surgeries
She advises men to see a urologist if experiencing these issues, as there are many treatment options available.
Bowel Health and Normal Bowel Movements (56:55)
Dr. Malik provides guidance on what to look for regarding urine and bowel health:
- Urine: Should be light yellow ("lemonade color"), not dark or completely clear
- Red flags: Blood in urine, excessive foaminess, cloudiness with symptoms
- Bowel movements: Should be easy to pass, formed but not hard, and occur regularly (frequency varies by individual)
She emphasizes the importance of paying attention to changes in urine or bowel habits and discussing concerns with a doctor.
Lifestyle Changes for Pelvic Floor Health (54:37)
Dr. Malik recommends several lifestyle changes to improve pelvic floor health:
- Stay hydrated but avoid overhydrating
- Limit bladder irritants like caffeine and alcohol
- Quit smoking
- Manage constipation through diet and exercise
- Maintain a healthy weight
- Practice proper toileting habits (relaxed position, don't strain)
She encourages keeping a bladder diary to identify patterns and triggers for urinary issues.
Conclusion
Dr. Malik emphasizes that pelvic floor issues, while common, are not normal and can significantly impact quality of life. She encourages listeners to seek help from qualified professionals and not suffer in silence. With proper diagnosis and treatment, many pelvic floor issues can be improved or resolved.
Mel Robbins concludes by sharing how addressing her own pelvic floor issues dramatically improved her quality of life. She encourages listeners to use the information and tools provided to take control of their pelvic health and get the expert help they deserve.
"You're worth it and you deserve to take time for yourself, to take care of your body. Invest in yourself so that you can invest in others like you want to." - Dr. Rena Malik