Louise Chang, MD
It's your body ... you think it would cooperate during the times you need it the most. But be it in public, socially, or on the job -- as anyone who's ever had an embarrassing personal moment can tell you -- sometimes your body just has a mind of its own.
From expelling gas, a case of the hiccups, an overactive bladder, and a belch you just can't swallow, to ill-timed yawns, cotton mouth, excessive sweating ... well, you get it. Any and all can easily occur just at the times when you want to look (and feel) your best.
But take heart -- you're not the only one. Doctors say it's more common than you think.
"Sometimes the body just doesn't do what we want it to do. Sometimes it's a result of a problem we already have, like an overactive bladder. But a lot of the time problems like excess gas or sweating can be exacerbated by stress, so it's not uncommon for them to occur when we find ourselves under pressure to be at our best," says internist Marc Siegel, MD, medical director of a new NYU-Sirius Radio program, Doctor Radio.
Moreover, says Siegel, the more pressure we put on ourselves to be perfect, the more likely our body will respond by doing something we don't like.
But regardless of the cause, psychiatrist Virginia Sadock, MD, tells WebMD sooner or later it happens to everybody -- and sometimes the best solution is to just ignore it.
"If your body makes a little blurp or blip that is unexpected, it's really OK to ignore it and keep on doing what you're doing. You don't always have to acknowledge every stomach growl or yawn with an explanation," says Sadock, a clinical professor of psychiatry at the NYU School of Medicine in New York City.
But what if you just can't ignore it? Sadock says acknowledge it briefly and move on.
"Just say, 'Excuse me.' There's no need to go into explanations," she says.
Still, some of these embarrassing problems can be avoided while others can be controlled, at least to some degree.
Of course, usually these are minor annoyances, but if symptoms are new, persistent, getting worse, or associated with other symptoms, then you should get checked by a doctor.
What follows is a guide to the five most common embarrassing body problems, their causes, and some quick tips on what to do about them.
Whether you have small leaks when you sneeze, laugh, or cough, or a bit larger loss while you exercise, urinary incontinence can cause extreme embarrassment. Known as stress incontinence, it's the most common type of bladder control problem in women. Another type, called urge incontinence or overactive bladder, happens when you have a strong need to urinate but can't reach the toilet in time.
"Pretty much every woman who has given birth to at least one baby is going to suffer some urinary incontinence problems -- you almost can't avoid it," says Siegel.
But while that might be true, there are still things you can do. First, Siegel says, see your doctor -- just to make certain there isn't anything more serious going on. "You can also chat about the various medications and other treatments for overactive bladder."
What's more, there are also things you can do on your own, including exercises designed to tighten bladder muscles that control the flow. These include Kegel exercises that strengthen the pelvic floor and bladder training -- stopping your urine flow mid-stream every time you go to the bathroom. "Just stop it and release it several times; this will help build the muscle that controls urination," Siegel says.
You can also try emptying your bladder before engaging in activities that might bring on a leak, such as exercising or dancing, says Fabienne Daguilh, MD, a family practice physician. Avoid coffee, tea, cola, and chocolate if you're going to be away from home and a bathroom.
"These act as a diuretic and can increase urine output -- and when the bladder is strained, leaks are more likely to occur," says Daguilh, medical director of the Montefiore Williamsbridge Family Practice Center in New York City.
Siegel says it's also worth investing in disposable panty liners, but skip the menstrual pad section at the drugstore and go straight to the incontinence aisle. Unlike menstrual pads, incontinence products will wick the leak or dribble away from your body and send it deep into the pad so you won't feel the wetness.
And Siegel offers this reminder: "If you know you have this problem, even occasionally, make sure you wear underwear, and carry an extra pair, just in case."
There you are in that business meeting with all the top brass. Just as you rise to give your presentation a loud growl is heard throughout the conference room. Yup, it's your stomach.
Worse still, are the times you open your mouth to speak and a belch erupts or you get a case of the hiccups.
What's going on? Daguilh says a combination of gas and irritation to the diaphragm come together to produce most, if not all of these symptoms.
"Belches and growls are usually due to gassy foods; hiccupping is the result of an irritation to the diaphragm which can also be made worse by gassy foods," she says.
Sadock says anxiety can magnify the problem.
"Burping and hiccupping can come on when you swallow a lot of air, and that's very common when we're anxious. If you're a person who sighs a lot, then you probably swallow air when you're anxious," says Sadock.
What can you do about it? The No. 1 defense is to cut down on gassy foods in the hours previous to when you want to be at your best. These include cruciferous vegetables like cabbage and broccoli, beans, and for some folks, dairy products and fried foods.
"Only you know which foods are gassy for you, and it can be slightly different for everyone," Siegel tells WebMD. If your tummy growls when you're hungry, then eating light, bland meals before going out is a good defense, he says.
Drinking more water also helps, Siegel says. "The GI tract is more likely to spasm when it's dry, so keeping well hydrated reduces the likelihood of hiccups, burps, and nervous coughs."
Daguilh suggests limiting alcohol: "In some folks [it] can increase burps, belches and hiccups," she says.
As the saying goes, "Never let 'em see you sweat." But wouldn't you know it, just when you want to project an image of cool confidence, "body central" has other ideas.
"There are some people who actually have a problem with overactive sweat glands, but for the most part, excessive sweating that occurs only in certain situations is all about stress," says Siegel.
A by-product of stress hormones such as cortisol, epinephrine, and norepinephrine, Siegel says nervous sweating is a reflection of sympathetic nerve discharge -- a manifestation of the fight-or-flight response that kicks in when we're anxious.
The way to prevent it, he says, is to condition ourselves ahead of time for facing stressful situations. "It's a matter of brain retraining. Gradually expose yourself to the nervous situation, and eventually your body won't respond as if you're in danger."
An easier way to prevent excessive sweating is simply to try an antiperspirant deodorant, Siegel says.
Avoiding coffee, tea, chocolate, or any food high in caffeine, as well as any hot, spicy foods can also help, Daguilh says.
"They increase heart rate and respiration, which can also increase sweating, so avoid them if you know you will be facing a stressful situation."
One more cool tip: Keep a glass of ice water handy, and if possible hold it against your wrists to help control sweating, Sadock tells WebMD.
"It's also perfectly OK to carry a hankie and dab the perspiration from your face, or wipe your hands," she says.
You've connected online with the one who could be your soul mate, and now you're really looking forward to a meeting in person. But by the time you arrive at the restaurant or coffee shop you can feel the dryness growing in your mouth. In fact, it's so dry you can hardly speak.
Or maybe you've been waiting all year for your boss to ask you to lunch, but right in the middle of the boss's reminiscences about college fraternity days, you start yawning ... and you can't stop.
While the two problems aren't related, experts say they often occur for similar reasons.
"Yawning happens when you're tired, but it also occurs when you're nervous or anxious and you breathe too shallow," says Siegel.
Similarly, shallow mouth breathing and the release of stress hormones combine to slow down saliva production, causing that sticky, uncomfortable "cotton mouth" sensation, he says.
Not surprisingly, both problems respond to similar solutions. "If you have a tendency to yawn when you're nervous, suck on a piece of hard candy; swallowing and yawning can't occur at the same time," says Siegel. Moreover, the candy will keep your mouth lubricated and saliva flowing, which will also help the cotton mouth.
The one thing you don't want to do: Chew gum. Sadock says it causes you to swallow more air, which not only causes you to yawn, but also can increase the risk of belching.
Instead, she says, keep a glass of icy cold water close at hand, and sip it slowly, particularly right before you start to speak. This will keep you from yawning and help resolve cotton mouth.
Passing gas, leaking urine, and belching -- embarrassing as they can be -- are usually quickly overlooked in most social settings. But when they happen during our most intimate encounters, they can feel like snafus of a lifetime.
Still, experts say they do happen -- and with good reason.
"When you're engaging in sex, particularly orgasm, you are giving up control of your sphincter muscles, the ones which normally control both urine and bowels," says Siegel.
If your bladder is full, he says, or if you've eaten a lot of gassy foods during the day, it's going to be very hard not to let some of that go during the heat of the moment.
So what should you do? "First, don't hold back and not have an orgasm or enjoy your partner because you're afraid of losing control of your body," Siegel tells WebMD.
You can avoid some problems by emptying your bladder before having sex and afterward. Not only will this cut down on leaks and gas, it can also help reduce your risk of sex-related urinary tract infection, says Siegel.
It can also help to avoid eating heavy or gassy foods right before having sex; and don't drink a lot just before hopping between the sheets. This is particularly true of carbonated beverages, which are both liquid and gas, Siegel warns. This also goes for coffee and tea, which can act as diuretics.
And what if it just happens anyway? Sadock says act the way you would in any embarrassing situation: "Say, 'Oops, excuse me' and move on!"
SOURCES:Marc Siegel, MD, assistant professor, NYU Medical Center; medical director, NYU-Sirius Radio program Doctor Radio.Virginia Sadock, MD, clinical professor of psychiatry, NYU School of Medicine, New York City.Fabienne Daguilh, MD, medical director of Montefiore Williamsbridge Family Practice Center, New York City.
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