If you want to do this on your own, consider one of the relatively inexpensive pelvic muscle trainers. For example, the Myself Pelvic Muscle Trainer utilizes a sensor inserted in the vagina to help you learn how to increase strength effectively. Ask your doctor about the various models. Newman says Dr. Kegel himself devised a similar gizmo using a tire-pressure gauge many years ago. As with any exercise program, the more regularly you do the exercises the better they work. "There is no question Kegels work," says Dmochowski, "but you have to make a commitment to it, like when you're training for a marathon. Doing it for a couple of days won't make a difference." (For a detailed description of Kegeling, go to http://www.seekwellness.com/incontinence/kegel.htm)

Newman says she looks forward to the day when American women are counseled about incontinence risks before their first pregnancy and are routinely offered rehab after the baby is born. "In France women get 18 doctor visits to deal with this after the birth of their babies," she says. "They insert a vaginal cone, put them on a treadmill, ask them to contract the muscle, and ask them to walk. It's standard physical therapy. In England women typically get three visits to a physical therapist to deal with this after childbirth." Postmenopausal women also need to give this serious thought. The loss of estrogen after menopause seems to make women more vulnerable to incontinence, as does aging.

Later this year the National Institutes of Health plan to host a State of the Science conference on the issue of incontinence. Those sessions are to be followed by a round of new research and increased funding. Let's hope so. Women have been crossing their legs and waiting for help for long enough.

© 2007