Atchoo! How hayfever can cause bladder weakness

Hayfever symptoms are usually characterised by a runny or blocked nose, itchy eyes, and general discomfort and of course... sneezing. For those of us with a weak pelvic floor, constantly sneezing can cause regular trickles and gushes - but did you know that there may be other ways that hayfever is contributing to your bladder problems too.

Atchoo, atchoo, atchoo! ...leak?

How many times have you felt a sneeze coming and immediately crossed your legs to support your pelvic floor and prevent a gush?

This is because sneezing creates a sudden, forceful contraction of the abdominal muscles. The pressure then transmits to the bladder, which in turn forces the pee out of your urethra, especially if your pelvic floor is weak causing you to leak. If this happens more than just occasionally, it’s known as stress urinary incontinence (SUI). Many women experience this type of incontinence when they laugh, cough, or exercise, but it can also occur during a sneezing fit brought on by hayfever.

So what exactly is stress incontinence?

Stress urinary incontinence is a common issue that many women face, particularly after childbirth, during menopause, or due to ageing. The pelvic floor muscles, which support the bladder and other pelvic organs, can weaken over time due to low oestrogen levels or even physical stress. When these muscles are not strong enough to withstand sudden pressure, such as from a sneeze, urine can leak out.

Time to take an antihistamine?

Hayfever is often more than just a few sneezes; it can be debilitating if you suffer badly with it. The most common treatment for hayfever are antihistamines, and they are readily available from the chemist to provide almost instant relief from your symptoms. These medications work by blocking histamine, a chemical released during an allergic reaction that causes symptoms like itching, swelling, and mucus production.

Most of us take antihistamines without any problems and enjoy the relief they provide. But for some of us, it's worth noting that antihistamines can have side effects.  

How antihistamines can affect the bladder

So let's take a moment here - for most of us, antihistamines - especially when taken in isolation -are beneficial and won't cause further issues.

However, they do contain something called 'anticholinergic properties’. Anticholinergic drugs block the action of acetylcholine, a neurotransmitter involved in the contraction of the bladder muscle.

Medications used for overactive bladder (whereby you have urgency and increased frequency of urination) also work by blocking this receptor and this can help the bladder muscle relax and prevent overactive bladder symptoms. So some people taking antihistamines may experience some relief to their overactive bladder symptoms.

However if you don't have any bladder symptoms or don't have overactive bladder then the anti-cholinergic side effects of antihistamines can sometimes make the bladder too relaxed.When this muscle doesn’t contract properly, it can be difficult to empty the bladder fully and this can ultimately could lead to bladder problems such as a urine infection or incomplete emptying. It’s worth bearing in mind that bladder side effects of antihistamines are fairly rare especially at low doses.

What other medications have anticholinergic properties?

If you are only taking one type of anticholinergic drug, like an antihistamine, the risk of it causing urinary retention or incomplete emptying are pretty low. However, when we take more than one drug from this family of medication, the risk increases and it's important to always let your GP know if you are taking any other medication, like antihistamine, that could increase your risk. If you have an overactive bladder you may be on anticholinergic medications like oxybutynin or solifenacin.

Others include over-the-counter sleep aids, cold and flu preparations as well as prescription drugs such as antidepressants, antipsychotics, topical mydriatics and antispasmodics and many more.

Anticholinergic medications are used to treat a variety of conditions, including depression, and certain respiratory issues. Women who take multiple medications with anticholinergic properties may be at an increased risk of urinary retention. There are other side effects of these medications too such as dry mouth, constipation and confusion and taking more anticholinergic medications increases the risk of experiencing any of these, too.

Not all antihistamines have the same impact. Non-sedating antihistamines, such as fexofenadine, loratadine and cetirizine, tend to have fewer anticholinergic effects compared to older, sedating antihistamines like diphenhydramine. Your GP can prescribe or direct you to alternatives.

If you are concerned that you may be taking a number of anticholinergic medications and you are at risk, or experiencing bladder issues, then it's important not to immediately stop your medication but to discuss with your GP as soon as you can.

Team Jude's Top Tips to help manage leaks with hayfever

Now we know why hayfever can make our leaks worse, what can we do to support our body and ease the sneeze-induced leaks? Here's our top tips:

1. Do your Pelvic Floor Exercises

Strengthening the pelvic floor muscles through exercises such as Kegels can help improve bladder control. Regularly practicing these exercises can increase muscle strength and endurance, reducing the likelihood of leaks when you sneeze. Aim for 3 sets of 10 squeezes a day, and remember you can do them anywhere - why not try a set when sitting at traffic lights, or watching your favourite tv show?

2. Review your meds with your GP

If you’re experiencing bladder issues and are taking antihistamines or other anticholinergic medications, it may be worth discussing this with your GP. They can review your medications and possibly suggest alternatives with fewer side effects.

3. Look at your lifestyle

Making certain lifestyle changes can also help manage both hayfever and bladder leaks. Staying hydrated is important, but you may want to avoid diuretics like caffeine and alcohol, which can irritate the bladder. Additionally, maintaining a healthy weight can reduce pressure on the bladder and pelvic floor muscles.

4. Stay Prepared

Wearing leakproof pants, or absorbent pads or liners can help manage leaks and provide peace of mind. Choose products specifically designed for urinary incontinence, as they offer better protection and odour control compared to regular sanitary pads 

5. Practice Good Bladder Habits

Going to the bathroom regularly and avoiding holding urine for long periods can help maintain bladder health. Make sure that you are peeing properly too - your feet should be flat on the floor, elbows resting on thighs and let your pee flow naturally (don't rush it!). 

Jude’s clinically proven supplements give you better bladder and pelvic floor control, helping you sleep through the night and regain the freedom to live life on your own terms. With just one capsule morning and night, you'll have relief from need-to-go urgency in just 12 weeks.