Medications may sometimes cause incontinence or worsen symptoms
Some medications (or drugs) are designed to help manage incontinence. But other medications we take may contribute to incontinence, or worsen incontinence symptoms that you might already have.
Medications affect many areas of our body – not just the area or areas they are intended to help. This is what we call “side effects”. Some ways in which medication side effects can cause or worsen incontinence include:
- Causing the body to produce additional urine, making it more difficult to control the increased amount of urine output
- Weakening the bladder’s ability to empty, causing urinary retention leading to overflow incontinence
- Affecting how well the muscles and mechanisms of compression and tension keeps urine from leaking from the bladder
- Causing constipation, which puts unusual stress on the bladder leading to leakage
- Causing confusion that contributes to difficulty with bladder control
Medications Which Potentially Can Cause Incontinence Symptoms
Adrenergic agonists or alpha-blockers (medications for high blood pressure and benign prostatic hyperplasia (BPH)) may relax the muscles of the bladder neck, which may cause stress urinary incontinence or urine leakage.
Drugs with anticholinergic effects (examples are antihistamines, tricyclic antidepressants, antipsychotics, benztropine) may relax the muscles of the bladder wall so that the bladder does not contract and completely empty. This can lead to urine retention and overflow incontinence. Note: Overflow incontinence occurs when you do not feel the urge to urinate. The bladder may become overfilled, and urine may start to leak out. You may also not completely empty your bladder, causing urine to back-up and overflow.
Some antidepressants may decrease the awareness of the need to go to the bathroom.
Calcium-channel blockers may decrease the ability of the detrusor muscle to contract so that the bladder does not completely empty during urination. Over time, this can lead to urine retention and overflow incontinence.
Diuretics increase how often a person urinates. By increasing the production of urine, and thus one’s output, a potential side effect is urge urinary incontinence (UUI). If nighttime incontinence is an issue, ask your physician if your prescription diuretic drug could be taken first thing in the morning, which would increase the urine output earlier in the day rather than later in the day and/or at night. Finding an appropriate time to take the medication when you have easy access to the bathroom and are awake, may improve the ability to be continent.
Sedatives and opioids alter a person’s awareness, which can lead to functional incontinence (difficulty in physically being able to get to the bathroom in a timely manner to urinate). Opioids may also cause constipation and urinary retention.
Everyone responds differently to medications and some people will not experience urinary incontinence side effects from the various medications discussed. So, let your doctor know immediately if you suspect a worsening of incontinence symptoms due to a medication you are taking.
Prevention, Treatment and Management
You may need to take a medication even though incontinence is a possible side effect. With your doctor’s help, you may be able to reduce incontinence symptoms by using a different type of medication, or adjusting the dosage or timing. Never stop taking a prescription medication before speaking with your doctor. Pelvic floor muscle (Kegel) exercises done methodically and regularly may be helpful to improve the strength of the muscles responsible for continence and calm an overactive bladder and thereby improve continence.
Medical Reviewers: Jeffrey Albaugh, PhD, APRN, CUCNS and Francie Bernier, PhD, RN
Dr. Albaugh
Jeffrey Albaugh, PhD, APRN, CUCNS is a board certified advanced practice urology clinical nurse specialist and researcher who is the Director of Sexual Health at NorthShore University HealthSystem in the Chicagoland area. He is an internationally recognized speaker and author. For more information on Dr. Albaugh and his practice go to: www.drjeffalbaugh.com
Dr. Bernier
Dr. Francie Bernier is Assistant Professor of Nursing at Shenandoah University, Leesburg, Virginia, at the Eleanor Wade Custer School of Nursing. Dr. Bernier’s areas of expertise include: Woman’s Health Care; Woman’s Pelvic Health; Non-surgical care for pelvic floor dysfunction. Dr. Bernier is President of the DC Chapter of the Society of Urologic Nurses (SUNA) & is an Associates Legislative Representative for the Society of Urologic Nurses and Associates, is a Liaison to the American Urologic Association for the Society of Urologic Nurses and Associates, and is a Member of Sigma Theta Tau (Nursing Honor Society).