Stress Incontinence and Metabolic Syndrome: what you need to know.

There is a strong correlation between stress urinary incontinence and metabolic syndrome. In a previous blog, we looked at a research articles examining the relationship between bladder function and metabolic health. In this blog, we want to discuss what that means for pelvic floor physical therapists and how we screen our patients with incontinence. 

Metabolic syndrome is a group of conditions that cluster together and increase the risk of heart disease, stroke, and type 2 diabetes. The conditions or risk factors are:

– a high fasting blood glucose level (>99mg/dL)
– high triglycerides (>149 mg/dL), low HDL (<50 mg/dL)
– a waistline larger than 35 inches
– blood pressure >130/85.  

With metabolic syndrome, the autonomic nervous system (ANS) is affected. The ANS helps to regulate the organs in our body including genitourinary, gastrointestinal, and cardiovascular systems. An early indicator of metabolic syndrome can be elevated resting heart rate (tachycardia), orthostatic hypotension (dizziness when moving from lying to sitting or standing), and poor tolerance to exercise. These changes are most likely caused by elevated blood sugar which can cause damage to nerve endings. One of the first nerves affected is the vagal nerve, the longest parasympathetic (rest and digest) nerve in the body. This nerve regulates us, and works to keep us in balance. With elevated blood sugars, the sympathetic nervous system (the fight of flight) is more active. This is what contributes to some of the bladder symptoms we see in the clinic with patients with metabolic syndrome.  

We can screen for these changes in the parasympathetic nervous system if we are suspicious of metabolic syndrome involvement. The Cardiac Autonomic Reflex Tests are a battery of screening tools we use in the clinic to assess how someone’s heart rate changes with deep breathing (heart rate should go down), holding their breath (heart rate should go up), and standing up (heart rate should go up). The reverse will occur if the sympathetic nervous system is more active. If these screening tests show a change in the parasympathetic nervous system, the physical therapist can work as a team with your medical provider to manage your metabolic syndrome along with the urinary leaking.  

Urinary incontinence is common, but it is not normal. It is an important symptom that you should talk to your PT or medical provider about. It may be an early indicator of other changes going on with your health. We have talked about vagal nerve stimulation in previous posts that include gargling, squared breathing, humming, and sternal massage. We can incorporate these tools into treatment along with the musculoskeletal treatment and medical treatment that you may need to combat urinary leaking, vagal nerve under activity and metabolic syndrome.

Don’t Ignore Urinary incontinence, a pelvic floor physical therapist can be your guide to reducing leaking and addressing important health concerns that you may be overlooking. We offer a free 15 minute phone consultation to answer questions you have an make sure you are in the right place for your care.