Patricia Yarberry Allen, M.D. is a Gynecologist, Director of the New York Menopause Center, Clinical Assistant Professor of Obstetrics and Gynecology at Weill Cornell Medical College, and Assistant Attending Obstetrician and Gynecologist at New York-Presbyterian Hospital. She is a board certified fellow of the American College of Obstetrics and Gynecology. Dr. Allen is also a member of the Faculty Advisory Board and the Women’s Health Director of The Weill Cornell Community Clinic (WCCC). Dr. Allen was the recipient of the 2014 American Medical Women’s Association Presidential Award.

Dear Dr. Pat,

I am only 46 but I feel like one of those very old women in television ads for incontinence pads and Depends. It is almost summer and instead of shopping for a new bikini, I am buying long coverups for the pool and the beach. I developed frequency and urgency to urinate in the last year that is making my life miserable. Not only do I have an intense urge to urinate but if I don’t get to the  bathroom quickly, then I begin to lose urine! I wear pads just in case and I don’t drink before going to the gym, getting into a car for a drive longer than 45 minutes or going out anywhere unless I know where the bathrooms are. I am urinating more at night which is interrupting my sleep. These symptoms seem to be getting worse and I think about how to avoid losing urine all the time.

My two children weighed less than seven pounds at birth and I had easy vaginal deliveries. My periods are slightly less regular than they were but otherwise normal. I do smoke and drink too many diet sodas but don’t have any other bad habits. I have become so anxious that I will have an accident during intercourse that I have been avoiding sex and blaming it on menopause.

My GP tested me for diabetes and bladder infections several times and these tests were normal. I don’t have blood in my urine on the office urine test. My gynecologist told me that I didn’t have stress incontinence, which causes loss of urine with coughing, laughing or sneezing, and she found no evidence of a dropped bladder from childbirth so she sent me to a urologist.

The urologist insisted that I needed a painful procedure to look into my bladder to make sure that I didn’t have bladder cancer or an inability to empty my bladder completely but I couldn’t tolerate the procedure. He was unwilling to treat me unless I had this procedure. Is it really necessary to make sure that I don’t have bladder cancer before prescribing some medication to help with these symptoms? What do these drugs that I have read about in my midnight Google searches actually do to prevent the urgency and frequency and loss of urine?

I have been too embarrassed to discuss this with my friends but wonder how common this is in someone my age? I can’t believe that I have this problem that my grandmother had in her 80s.

Barb