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How Does My Heart Affect My Pelvic Floor?

Hi friends! February is American Heart Month and cardiovascular disease is the leading cause of death in women (Birnbaum, 2003). You might be asking yourself, what does my heart have to do with my pelvic floor muscles? Keep reading to find out!


Cardiovascular disease is a broad term for a number of conditions that affect our circulatory system, including coronary artery disease, high blood pressure, and peripheral vascular disease (PVD). Individuals with coronary artery disease are at a higher risk of serious health events like a heart attack or stroke.


Cardiovascular diseases, like high blood pressure and heart failure, are also linked to urinary issues such as overactive bladder (OAB) and urinary incontinence (John, 2019; Palmer, 2009). One study found that men with urinary incontinence were almost 3 times more likely to have a major cardiac event (John, 2019). The link between cardiovascular disease and urinary symptoms may be due to the effects of the disease itself, but may also be side effects of medications that are prescribed to treat cardiovascular disease.


Medications that are used to treat conditions like heart failure can make urinary incontinence or overactive bladder symptoms worse. These drugs can include: (Son, 2018; Patel, 2016)

  • Diuretics (water pills)

  • ACE inhibitors (like Vasotec or lisinopril)

  • Beta blockers (like carvedilol or metoprolol)

While they do have side effects, these medications are an important part of managing cardiovascular disease to prevent complications like heart attack or stroke.


So how do we manage urinary symptoms that are caused by cardiovascular disease and its treatments? This is only something that can be determined by you and your healthcare providers, but here are some common treatments.


Manage Fluid Intake

Most patients with heart failure are discouraged from more than 2 liters of fluid per day—think of a large soda bottle (Son, 2018). But, we know that not drinking enough water can increase the urgency to pee and cause you to go to the bathroom more often. Talk with your provider about the ideal fluid intake for you.


When fluid intake is limited, it can be helpful to avoid bladder irritants when managing urgency symptoms.


Bladder Training

Bladder training includes looking at what we are eating/drinking and when we are doing it, how often we are going to the bathroom, how strong our urges to pee are, and any urinary leakage. With all of this information, bladder retraining incorporates different strategies to help us avoid going to the bathroom too often, reduce strong urges to pee, and stop leakage.


Bladder retraining may use timed voiding, urge suppression strategies, and diet changes to avoid bladder irritation. A skilled healthcare provider, like a pelvic floor therapist, can help you with this. Ask your doctor for a referral to a pelvic floor therapist near you. You can also find one on your own at www.myPFM.com/find-a-pt.


Pelvic Floor Physical Therapy

Intensive pelvic floor muscle exercises, under the supervision of a physical therapist, have been shown to have clinically reduce urine leakage and have equal if not better results compared to medications to treat the symptoms (Son, 2018). Pelvic floor muscle training has the added benefit of few to no negative side effects, unlike prescribed medications.



To learn more about your pelvic floor muscles, check out these great resources:

For providers, check out our online courses to help your clients. Consider joining our Ambassador Program and most of our courses are included with your membership!

Written by Emily Reul, PT, DPT


References

  1. Birnbaum H, Leong S, Kabra A. Lifetime medical costs for women: cardiocasvular disease, diabetes, and stress urinary incontinence. Womens Health Issues. 2003;13(6):204-13.

  2. John G. Urinary incontinence and cardiovascular disease: a narrative review. Int Urogynecol J.2020;31(5):857-863.

  3. Palmer MH, Hardin SR, Behrend C, Collins SK-R, Madigan CK, Carlson JR. Urinary incontinence and overactive bladder in patients with heart failure. J Urol. 2009;182(1):196-202.

  4. Patel M, et al. Urinary incontinence and diuretic avoidance among adults with chronic kidney disease. Int Urol Nephrol. 2016;48(8):1321-1326.

  5. Son YJ, Kwon BE. Overactive bladder is a distress symptom in heart failure. Int Neurourol J. 2018;22(2):77-82.

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