Millions of Americans live with urinary incontinence. If you’re one of them, it’s likely that you’re a woman over 50 who has given birth. But men and younger women can also suffer from it. Regardless of your age or gender, losing control of your bladder can be distressful and embarrassing. The good news is that there is help for your condition whether it is mild or severe. The first step is talking with your doctor. Urinary incontinence may be a symptom for a seemingly unrelated health concern like diabetes or an enlarged prostate. Communicating with your doctor openly will get you the answers (and effective treatment) you deserve. Your doctor can tailor your treatment plan to your specific symptoms. But individualized care starts with a conversation. Here are topics to bring up with your doctor that will help him or her decide the best course of treatment—for you. Describe Your Symptoms Your doctor will want to know about your symptoms. Try to describe them in detail and consider keeping a symptom diary. The diary will help you remember and communicate when you leak urine, what you are doing at the time, and how much urine leaks. You should also record what you drink, when and how much you drink, and when and how much you urinate. Remember to note how incontinence is affecting your daily life. For example, do you avoid certain activities because of your incontinence? Your doctor will also perform a physical exam and may recommend some additional tests. This may include a urinalysis, blood tests, and tests to measure how well your bladder empties and how you urinate. Explore Your Treatment Options There are several treatments for urinary incontinence. The goal is to improve your symptoms, prevent leakage from getting worse, and delay or prevent surgery. Your doctor can find the right treatment for you and your lifestyle based on the cause and type of your incontinence. Options to discuss include: Behavioral modification. This is often the first step in treating incontinence and it involves changing some of your behaviors. Your doctor may suggest cutting back on fluids, not drinking close to bedtime, and eliminating caffeine, alcohol, and spicy foods. Bladder training. Your doctor may recommend bladder training to go hand-in-hand with drinking behavior modification. It involves scheduling bathroom trips at set times each day and gradually trying to delay going to the bathroom by small increments. The goal is to gain more control over urges and increase the amount of time between bathroom breaks. Pelvic floor training. Many women are familiar with Kegel exercises, but men may not be. These exercises strengthen pelvic floor muscles to improve stress and urge incontinence in men and women. Your doctor may recommend using biofeedback to maximize pelvic floor training. Medicines. Sometimes medicines can help urinary incontinence. It depends on the type and cause of your incontinence. Pessaries. A pessary is a medical device that women insert into the vagina. It supports the bladder and urethra by reinforcing the vaginal wall. Your doctor may recommend a pessary for stress incontinence. Surgery. There are many types of urinary incontinence surgeries depending on your gender and the type and cause of your incontinence. One of the more common procedures is incontinence sling surgery. Ask your doctor why he or she thinks a certain treatment is right for you, and what other options might be available if it doesn’t help. Having a plan may help you feel better. Consider Your Age Talk with your doctor about how your age may affect your treatment decisions. For example, if you are young, ask about the chances of incontinence recurring after surgery. On the other hand, waiting until you are older may mean you have other medical conditions that make surgery risky. Discuss Your Pregnancy Plans Some women with urinary incontinence are still in their childbearing years. Women who still want to have children should consider putting off surgery until they have completed their family. Pregnancy increases the risk that urinary incontinence will recur. Talk About the Risks of Surgery Before deciding on surgery, make sure you understand the risks of developing new problems afterwards. There is also a risk of some symptoms continuing despite surgery. After surgery, some people have a return of urinary incontinence, worsening incontinence, and damage to nearby organs such as the rectum. Difficulty emptying the bladder is also a risk. This may mean you need to use a urinary catheter for a period of time to help you empty your bladder. Your doctor can lead you through all these treatment considerations. You may also want to consider getting a second opinion before making a decision. A second opinion can offer new insight about your situation or confirm your treatment decision. Having another opinion may give you the confidence you need to move forward with your plan and not second-guess your decision.