Medication for Pelvic Floor Disorders

Medication can be used to help treat symptoms of urinary or bowel incontinence.

Medications are effective for treating overactive bladder associated with urgency incontinence. Many women with mixed urinary incontinence have also reported benefits from medication therapy.

• Local vaginal estrogen, in the form of a low-dose estrogen cream or tablet placed in the vagina, can improve symptoms of urinary frequency, urgency and urgency urinary incontinence by replenishing vaginal and urethral tissues.
• Antimuscarinic oral medications taken once a day can treat urgency urinary incontinence. Some examples include solifenacin, fesoterodine, tolterodine, darifenacin, trospium and oxybutynin. Although they are effective at treating urgency urinary incontinence, these medications often cause bothersome side effects, such as dry mouth and constipation. New research has also found that persistent use of these medications is associated with memory changes or dementia.
• Beta-3 agonist oral medications, such as mirabegron, can also be taken once a day to relax the bladder muscle and decrease unwanted contractions that cause urine leakage. These medications may be safer than antimuscarinic medications when taken over many months or years and are not associated with memory changes or dementia.

Chronic constipation or diarrhea can aggravate anal incontinence symptoms. Most women can find relief from their symptoms with lifestyle changes, but some may require medication. Medications for anal incontinence include:

• Anti-diarrheal remedies such as Loperamide (Imodium) can be used to treat diarrhea and help bulk-up bowel movements if diarrhea is causing fecal incontinence.
• Stool softeners like Colace can help make stool easier to pass and reverse the effects of impacted stool in the lower gastrointestinal system.
• Laxatives can also be used if chronic constipation is causing fecal incontinence.