In their ads, Pfizer barely mentions the term overactive bladder. They just show images of woman rushing to the bathroom, and then tell us about Detrol. Their icon is the little woman on the bathroom door, so that every time a woman heads to a public rest room, she will think of their drug. (See a typical ad on Ad Pharm Blog)
It’s brilliant marketing.
- Make time to pee. The first and most important thing to do is to take the time to go to the bathroom before it’s an emergency.
- Get real about your fluid intake – what goes in must come out. How many of you have a big plastic bottle of H2O on your desk at work? Getting your recommended 8 glasses of water a day, and even more if you’re dieting? If you’re going to drink that much water, you’re going to be in the bathroom. That’s just the way it is. You don’t need a drug. Just some common sense. If you’re going to guzzle water on a long car ride, you’re going to need to take bathroom stops. If you’re ordering the liter diet coke with popcorn at the movie, don’t be surprised if you miss the good part because you’re in the ladies’ room.
- If nighttime frequency is a problem, cut back on evening fluids. You can’t drink tea while watching Letterman and expect to make it through the night.
- Drink enough water. While a lot of us are water guzzlers, some of you out there actually may not be drinking enough water. Your urine is concentrated, and that can be irritating to the bladder as well, especially if you’re also post-menopausal. So for you, the trick may be to increase your fluid intake a bit.
- Cut back on the Starbuck’s Latte’s and Diet Cokes. Both caffeine and carbonated beverages can be bladder irritants, and caffeine is a diuretic. Put caffeine or diet coke habit together with an 8 cup a day water intake and you might as well just put your office in the ladies’ room, because you’ll be there more than you’re at your desk. Trust me on this. And it can be just as bad if you don’t drink enough water – now you’ve combined concentrated urine with a bladder irritant. You’ll go smaller amounts when you hit the stalls than the water drinkers, but you’ll still be there more often than you need to be.
- See if other foods are bothering your bladder. Other foods that can irritate the bladder are chocolate, tomatoes and citrus fruits and juices. Maybe not for everyone, but maybe for you. If this is the case, simply eliminating or limiting these foods may be all you need to do to control your symptoms.
- Try bladder training. Some of us have gotten ourselves into some bad habits when it comes to our bladders – running to the bathroom the minute we notice we have a bladder, jumping up out of bed 5 times before we fall off to sleep. But you can retrain it to hold out longer. It really is mind over body on this one.
What if these steps fail?
So let’s say you’ve tried everything up there and you’re still rushing to the bathroom. Maybe you’re even having occasional accidents. Your doctor has ruled out infection and other causes, and diagnosed you with irritable or overactive bladder. What can you do?
If you are post-menopausal, I usually first recommend a trial of low dose vaginal estrogen. (It’s an off-label use with some support in the literature.) For some women, this is all they need. If you don’t want to take vaginal estrogen or are not postmenopausal, then Detrol (or its generic) is definitely a treatment option, and it’s often quite effective.
Bottom Line
Urinary urgency and frequency are common symptoms in women. It’s important to see your doctor to rule out urinary tract infection (a very common problem in my practice) and other underlying causes. Once these things are ruled out, most symptoms can be controlled with simple changes in diet and fluid intake, along with some bladder training for more resistant cases, and if you are menopausal, a trial of vaginal estrogen. If these things fail, there are medications that can control symptoms, one of which is Detrol or its generic.
And as they always say, talk to your doctor.
What are your thoughts on PC muscle exercises/Kegels/PC squeezes (either earlier in life or at the onset of symptoms)?
I tune out drug commercials and wish everyone would. They should be banned.
Great post. I hate these adds, also. I hate pathologizing normal functions (like urnation, menstruation, etc.)
I know that bladder training is typically for urge incontinence, but I’ve had some patients have real success with it for stress incontinence, too.
I think it probably has something to do with the fact that maybe a really full bladder leaks a bit more.
1. My dear old mum taught me that when I was playing down the street and I had that “gotta go feeling” to just knock on a neighbor’s door and ask to use their bathroom. A simple solution (plus a chance to snoop into all the houses in Downlook.)
2. Most of these incontinence commercials run exclusively on shows my children watch. Kids are taught another reason that elders are foolish.
3. By the way, I’m in Manhattan now for the Macy’s Parade. Can I use your bathroom?
An excellent post, thank you! I marvel that these ads evoke a response in anyone, but the “mad men” are ingenious.
Simple and common-sensical treatments should always be the first things tried (or their generic!).
Pfizer is doing what they are doing to survive, and this is something that COULD help afterall. They emphasize that the person see their doctor to address everything that you write about. They never say that it is a solution for everyone. In fact, they probably say that it is NOT a solution for everyone.
Pfizer sells nearly $1 billion per year of this. It is important they not only protect it, but find ways for it to grow. Pfizer employs 120,000 people and is in the midst of laying off 10% of the work force. They have to do what they have to do. From their point of view, if they can get a woman to have the conversation with their doctor and find a new patient, then great. If they (patient and doctor) together determine it is not a fit, at least they (Pfizer) spurred on a conversation that might not otherwise had occurred.
Your post of course is a perfectly appropriate response from a doc – because you have the expert to which opinions that Pfizer refers. The patient is likily not aware of ANY of the solutions until they come see you, so why not have the conversation about meds too. There are lots of avenues to explore before taking a product, but some people may get relief from this, or prefer it to retraining their bladder. Shouldn’t the patient have the right to know that there could be a medicinal course towards improvement even if their doctor would prefer they do other steps first? Who’s life is it anyway?
Patients have to advocate for their own health, and have to be more informed than ever before. Shouldn’t advertising be ONE way of potentially becoming informed? Do they sell fear? I am not sure I agree with you there. Do they sell familiarity and fraternity? Absolutely. The “you are not alone” argument is a very powerful one that they hammer in these ads. I’ll give you that.
In looking at the sales data for the product over the last number of quarters, sales are flat to slightly increasing. Pfizer will never know if the ads are effective or not, but sales have not declined so they can’t be hurting. No real good way of knowing unless they were to remove the ads and monitor sales/new scripts over time. I doubt they are going to do that.
You knew this was coming from me…XOXOXOXOX
Women can’t stop going…men can’t get started if the Flomax commercials are to be believed.
🙂
I would add some PT, IMNSHO, it seems to help both urge and stress UI.
Stop performing hysterectomies.
As someone who has spent what seems like the equivilent of 2 years of her life with her legs crossed, waiting for a bladder spasm to pass so she could get to a bathroom (or already in the bathroom and just can’t uncross her legs to get her pants down) only to find that her bladder was far from full, I am grateful for these ads and others like them.
Discovering that there might be medical help for the misery I suffer daily, and have since I was a child, was quite liberating. It got me to bring the issue up to my doctor, which I had never done before.
Unfortunately the medications, and I’ve tried most of them, don’t work as well as I wish they did and the dry mouth side effect is pretty severe. Beyond pills, my options are pretty limited, so I have to decide whether I want to deal with the dry-mouth and use the most effective (on me) of the drugs or consider an implant. And yes, the condition is severe enough that I might consider the implant. Botox is being studied as a treatment but is not yet approved, I would almost certainly try it if it were.
Good post!
Something else I would like to mention, (And I wonder if it has been studied?)is the potential impact of this advertising on children. My son, who is on the Autistic Spectrum and therefore very literal, recently suggested I take a medication that he had seen advertised on the telly I can’t remember which med or why, but that is irrelevant.
That incident took me aback somethat, and certainly got me rethinking the remote control issue, but it also got me thinking abotu the potential long-term impact of this type of advertising advertising on children? I wonder is someday -not soon enough- the Detrol Lady will be sent to the same Hall of Shame that houses Joe Camel?
Can I make a suggestion? I feel youve acquired something good here. However what when you added a pair hyperlinks to a web page that backs up what youre saying? Or perhaps you can give us something to have a look at, one thing that might join what youre saying to one thing tangible? Only a suggestion.