Urinary incontinence and frequent urination
Often you need to urinate and urinary incontinence are various symptoms, but can also occur together. In frequent urination you should clearly go to the toilet more often than before, during the day and/or at night. In case of urinary incontinence you lose unwanted urine. This can happen for example when coughing, sneezing or exercising, but also in case of sudden strong urge.
There are different forms of incontinence and there are many possible causes. Menopause, enlarged prostate, urinary tract infections and neurological disorders can all play a role.
Within Chinese medicine, therefore, not only how often you pee or when urine loss occurs. Also the amount and color of urine and additional complaints such as cold, heat, fatigue, stress and digestive problems help determine which TCM-pattern is at the forefront.
Possible Western disorders
Micturition frequency and loss of urine can have various causes. Also, the form of incontinence may vary:
- Stress incontinence: loss of urine at increased pressure in the abdomen, for example during coughing, sneezing, laughing, jumping or exercising.
- Incontinence (urge incontinence): sudden strong urge to lose urine before reaching the toilet.
- Overflow incontinence: the bladder is not sufficiently empty and remains too full, allowing urine to leak out.
- Functional incontinence: The bladder function itself does not need to be disturbed, but one cannot get to the toilet in time due to mobility problems.
- Enuresis: accidental loss of urine during sleep, especially known as bed wets in children.
Other possible causes of frequent urination or incontinence include:
- pregnancy and childbirth;
- weakness of pelvic floor muscles;
- urinary tract infections;
- an overactive bladder;
- changes in urinary tract and pelvic floor around and after menopause;
- prostatitis or enlarged prostate;
- Bladder or kidney stones;
- chronic irritation or bladder disorders;
- constipation;
- neurological disorders affecting bladder function;
- certain medicines.
Alcohol and caffeine can also temporarily increase the pressure and urine production.
Possible causes
In case of stress incontinence, there is often insufficient support for the urinalysis and bladder through the pelvic floor. This can occur after pregnancy and childbirth or by changes in muscles and connective tissue during aging.
In case of urgency incontinence, the bladder contract unexpectedly, resulting in sudden strong urges. Sometimes there is no obvious cause for this. A urinary tract infection or other irritation of the bladder can also cause temporary pressure and frequent urination.
In men prostate problems can affect bladder emptying. If urine remains, this may sometimes lead to increased urination or overflow incontinence.
The amount someone drinks, caffeine and alcohol, medications, constipation and certain neurological disorders can also affect bladder function.
How can acupuncture help with urinary incontinence and frequent urination?
The treatment is tailored to the type of urinary problems and the underlying TCM pattern. For example, it looks at when urine loss occurs, how much urine you pee, whether you often wake up at night to urinate and if there is a sudden urge.
Additional symptoms are also important. A person with frequent clear urination, cold and fatigue receives a different treatment within TCM, for example, than someone with small amounts of dark urine, warmth and irritation of the bladder.
Depending on the grievance picture, acupuncture can be aimed at:
- support the function and control of the Bladder;
- Strengthen kidney-Qi and kidney-Yang when insufficient control is in the foreground;
- Support kidney-yin in dryness and relative heat;
- Enhance crevice and Lung-Qi when general Qi deficiency and insufficient muscle tension play a role;
- Dampness and Heat reduce when signs of irritation of the urinary tract;
- regulate the flow of Liver-Qi when stress and tension affect the symptoms;
- Heart and kidney support when urinary problems are strongly related to anxiety, restlessness or sleep.
Acupuncture can be combined with pelvic floor therapy and bladder training where appropriate.
How can Chinese herbal medicine help with urinary incontinence and frequent urination?
Chinese herbs are also chosen based on the underlying pattern. In case of emptiness, for example, treatment can be aimed at strengthening the functions that are responsible within TCM for maintaining and regulating urine. At Dampness-Heat, the focus is precisely on reducing Dampness and Heat and calming irritation of the Bladder.
Depending on the pattern, Chinese herbal medicine can be aimed at:
- Enhance kidney-Qi and support urine control;
- Heat and strengthen kidney-Yang;
- Kidney-Yin feeding and reducing relative Heat;
- Support slit and Lung-Qi;
- Reduce Dampness and Heat from the Bladder;
- Liver-Qi regulation and reduction of tension;
- to support the balance between Heart and kidney.
Herbs can be used daily between acupuncture treatments. Regular treatment and possible interactions are taken into account in a defined condition or drug use.
How does Chinese medicine view urinary incontinence and frequent urination?
Within Chinese medicine, the kidney plays an important role in regulating and holding urine. The Bladder ensures its storage and excretion. When kidney-Qi or kidney-Yang is weakened, according to TCM, control of the ladder can be reduced. This can result in frequent urination, nocturnal urination or urine loss.
The Spleen and Lung can also play a role. Within TCM, these systems are involved in the processing and distribution of moisture and also support the holding of tissues and good muscle tension.
In other people there is an irritation of the Bladder by Dampness-Heat . The urge goes with small amounts of strongly smelling or concentrated urine and possibly a burning sensation.
In addition, the free movement of Liver-Qi can affect. If complaints increase significantly due to stress, frustration or stress, Liver-Qi-stagnation may be part of the pattern.
In a smaller group, the relationship between Heart and kidney may be disturbed. In TCM theory, these systems are linked to rest, emotional stability and control of lower body functions. Urine tract symptoms can then fluctuate remarkably with anxiety, restlessness, emotional tension or previous shock or traumatic event.
What is a TCM organ system?
A TCM organ system describes a group of related body functions and is wider than just the anatomical organ with the same name. Read more at TCM basics .
What is a TCM pattern?
A TCM pattern is a recognizable combination of complaints and physical characteristics that indicates which imbalance is likely to contribute to the complaints. Read more at TCM basics .
Below are only the most common patterns discussed. Other patterns are possible and multiple patterns can occur at the same time. This allows you to recognize yourself in different descriptions. Also, someone with a certain pattern does not have to have all the symptoms mentioned. The pattern is determined on the basis of the overall picture of complaints.
Most common TCM patterns
Kidney-Qi- and Kidney-Yang-deficiency
Brief explanation
This is an important pattern for frequent urination and urinary incontinence within TCM. According to Chinese medicine, kidney-Qi helps regulate and retain urine. In addition, when kidney-Yang is weakened, there are often clear signs of cold and general weakness.
Among younger people, especially Kidney-Qi deficiency can be at the forefront without pronounced cold symptoms.
Common symptoms
- frequent urination;
- urine loss;
- relatively clear urine;
- strong urge and difficulty in holding up urine;
- need to urinate regularly at night;
- bed wets in children;
- symptoms which may become worse due to cold, tiredness or physical exercise;
- fatigue and general weakness;
- weak or painful lower back and knees;
- in the case of Kidney-Yang deficiency: crookedness and cold hands and feet;
- Sometimes sticking fluid around the ankles.
Examples of Western disorders
This pattern can be found in stress and urge incontinence, nocturnal urination, bed wets and some urinary problems with an enlarged prostate.
Kidney-Yin-deficiency
Brief explanation
Within TCM, kidney-Yin represents the nourishing and cooling aspects of the kidney system. In case of a deficiency, relative heat can occur. This may stimulate the bladder while at the same time reducing urine control.
This pattern is described for urinary problems around and after menopause.
Common symptoms
- frequent urination or loss of urine;
- small amounts of concentrated urine;
- strong pressure;
- a feeling of warmth or irritation, if any;
- dry mouth and throat;
- heat from palms and soles of the feet;
- hot flushes or night sweats;
- restlessness and poor sleep;
- dizziness or ringing in the ears;
- weakness or lower back and knee pain;
- dry stools or constipation.
Examples of Western disorders
This pattern may include urge incontinence, stress incontinence and chronic urinary or bladder problems, including symptoms around and after menopause.
Heart-Kidney-axis disharmony
Brief explanation
Within TCM there is talk of communication between Heart and kidney. If this relationship is disturbed, urinary problems can be remarkably associated with mental distress, anxiety and sleep problems.
The symptoms can change with the emotional state. In some cases, the pattern arises or worsens after a strong shock or emotionally incriminating event.
Common symptoms
- frequent urination;
- sudden strong urges;
- sometimes loss of urine or bed wet;
- feeling that the bladder is not completely empty;
- only small amounts of urine at a time;
- symptoms that worsen with anxiety, tension or emotional overstimulation;
- nervousness or anxiety;
- palpitations;
- bad sleep and lots of dreams;
- fatigue;
- dry mouth or recurrent mouth ulcers.
Examples of Western disorders
This pattern can be recognised for functional or stress-sensitive urges, bed wets and some chronic bladder problems where anxiety or emotional tension clearly affects the symptoms.
Spleen- and Lung-Qi-deficiency
Brief explanation
The Spleen and Lung play a role within TCM in the processing and distribution of moisture. Spleen-Qi also supports retention and muscle tension. When these functions are weakened, urine control can be reduced.
This pattern is especially recognizable when urine loss is associated with general tiredness, weak digestion and sometimes respiratory complaints.
Common symptoms
- frequent urination or loss of urine;
- relatively clear urine;
- loss of urine that gets worse during exercise or fatigue;
- loss of urine in case of cough or sneezing;
- feeling heavy or depressed in the lower abdomen;
- fatigue;
- paleness;
- be quick out of breath;
- weak voice;
- chronic cough may be present;
- low appetite and bloated stomach;
- loose stools;
- sometimes mild fluid build-up.
Examples of Western disorders
This pattern may occur in case of stress incontinence, attenuation of the pelvic floor and loss of urine in case of sagging. Also chronic cough can provoke urine loss in case of a weakened pelvic floor.
Dampness-Heat in the Bladder
Brief explanation
In this pattern the Bladder gets irritated according to TCM by a combination of Dampness and Heat. This can cause strong and frequent pressure, while at times little urine is produced.
When obvious pain and a strong burning sensation are the main symptom, the symptoms are more appropriate for painful urination.
Common symptoms
- frequent urination and strong urge;
- small amounts of urine;
- dark, concentrated or highly smelly urine;
- sometimes turbid urine;
- possible urinary loss due to sudden urge;
- burning or irritating sensation around the urethra;
- pressure or discomfort in the abdomen;
- thirst, often without much need to drink;
- constipation or alternating stool.
Examples of Western disorders
This pattern may be found in urinary tract infections, cystitis, urethritis and prostatitis.
Liver-Qi-stagnation with Heat
Brief explanation
If Liver-Qi does not move freely according to TCM, tension and pressure in the lower abdomen can occur and the function of the Bladder can be affected. In addition, if prolonged stagnation occurs Heat, making the Bladder more irritated.
Characteristic is the obvious relationship between urinary problems and stress or emotional tension.
Common symptoms
- frequent urination or sudden strong urge;
- uncommon urine loss;
- small amounts of urine;
- feeling that the bladder is not completely empty;
- symptoms which are clearly aggravated by stress, frustration or emotional tension;
- feeling tense or bloated in the lower abdomen;
- irritability;
- a lot of sighs or an oppressive feeling;
- alternating bowel movements;
- in women, possibly more menstrual complaints.
Examples of Western disorders
This pattern can be recognised for stress-sensitive urges, functional bladder problems and some forms of an overactive bladder.
What can you do for yourself?
Depending on the cause, simple measures can help to gain more control over the bladder.
Blowing training can be useful especially in case of strong or frequent urge. It gradually tries to allow a little more time between toilet visits. A puddle diary can help you keep track of how often you pee, how much you drink and when urine loss occurs.
Bone floor training can be important in case of stress incontinence and a weakened pelvic floor, for example after pregnancy or childbirth. A pelvic physiotherapist can assess whether the pelvic floor is actually too weak. Not every form of incontinence is caused by a weak pelvic floor; sometimes the muscles are too tense.
It can also help to see if caffeine and alcohol worsen the urge. Drinking less is not automatically wise: sufficient moisture remains important.
Constipation can also increase pressure on the bladder and pelvic floor. Regular bowel movements can therefore be part of the treatment.
When to contact your doctor?
Frequent urination or urinary loss is often not dangerous, but new or unexplained symptoms may require research.
Please contact the GP when:
- incontinence or frequent urination occurs suddenly without any clear explanation;
- you have pain or a burning sensation when urinating;
- there is blood in the urine;
- you have fever or chills;
- you have pain in the side, back or abdomen;
- you have difficulty in emptying the bladder;
- you always keep feeling that urine is left behind;
- symptoms associated with new neurological phenomena;
- you pee remarkably heavily and are also constantly thirsty;
- the complaints continue to be sustained or significantly increased.
In children bed wets are normal up to a certain age. If a child starts to pee regularly in bed after a prolonged dry period or if there are other urinary problems, it may be wise to discuss this with the general practitioner.
Outlook
The course of treatment depends on the type of incontinence, the duration and severity of the complaints, the underlying TCM pattern and the medical cause. Complaints due to temporary irritation of the Bladder have a different course than prolonged stress incontinence, neurological bladder problems or symptoms due to a structural disorder.
In chronic deficiency patterns of Spleen or kidney, a more gradual course of treatment is usually expected. Bladder training and, where appropriate, pelvic floor therapy may be an important part of the treatment pathway.
In the initial phase, one acupuncture treatment per week is a common guideline. Depending on the severity of the complaints, temporary more frequent treatment can be done. If the symptoms become less stable, the frequency can be reduced. Chinese herbs can be used daily between treatments where appropriate.
Contact
Do you experience frequent strong pressure, need to urinate much more often than before or lose unwanted urine and want to know whether acupuncture and/or Chinese herbal medicine can fit your symptoms? During a first consultation we discuss your urine pattern, the type of urine loss and other relevant symptoms and symptoms. Based on the overall complaint picture we will look at which TCM-p