ROYAL OAK, Mich. - It's a problem that affects at least 15 million Americans -- but one that few people actually talk about.
The technical name is stress urinary incontinence. Basically, the muscles that are supposed to support the bladder and the tube that carries urine have become too weak to do the job.
Up to 35 percent of adult women are affected. Many are suffering in silence. But Kathy Abourezk isn't shy about speaking up.
"I'm not uncomfortable because it affects so many people. There's nothing embarrassing about it. It's just a fact of life," said Abourezk.
The Troy attorney remembers exactly when the problem first hit in December of 2007.
"I went into menopause, and then I never got to reap the benefits of that because I ended up with this problem," said Abourezk. "And I'm like, 'Okay, I'm doomed to this. This is my fate.'"
Laughing, sneezing, coughing and exercise are common triggers. In Abourezk's case, her husband's jokes are often to blame.
"He's a real funny guy, and we do a lot of laughing. I want to be able to enjoy that," said Abourezk. "It's okay when I'm around my family, but when I'm out around other people, it's not okay."
"This is one of what we call 'the unmentionables.' Incontinence is clearly one of them because a lot of women are embarrassed by it," said Dr. Kenneth Peters, the chair of urology at Beaumont Hospital in Royal Oak.
Peters says pelvic floor exercises and surgery are the standard treatments for stress urinary incontinence. But Beaumont is testing another option.
"We're very excited about this trial. It's actually the first in the world," said Peters. "Kathy is the first person ever to be treated for this condition using this medication."
The medication is called enobosarm. It's a pill taken once a day -- a selective androgen receptor modulator (SARM) that's already been studied for its ability to rebuild muscle mass in patients with advanced cancer.
"I kind of call it 'Kegels in a bottle,'" said Peters. "It's like building muscle without having to do anything."
There's a reason doctors think it might be helpful for patients suffering from stress urinary incontinence.
"The highest concentration of the receptors you have in your body that this drug works in are in your pelvic floor muscles. It happens to be a perfect storm to consider studying it for this," said Peters.
Beaumont plans to enroll up to 35 postmenopausal women in the study to test the safety and effectiveness of the medication. There's no cost to the patient and because this is not a placebo controlled trial, every patient selected will get the drug.
After 90 days of taking the medication, Abourezk has seen a dramatic improvement.
"I'm pretty happy with the results as they are right now which I think is about an 80 percent improvement," said Abourezk. "If I can maintain that and possibly get 90 percent, I'd be very happy."
The only "side effects" Abourezk has noticed are more energy and overall strength.
"This year, I've been gardening like I've never gardened before in the past four or five years."
Whether those improvements will last after patients stop taking the drug is a question researchers want to answer.
"Over time, the muscles may start to waste," said Peters. "But maybe what you do is you build it up to a point of good muscle mass and now you maintain that with Kegel exercises or some core strengthening."
While the study has just begun, both doctor and patient say, they're encouraged.
"This is so novel, and it has, I think, a great potential to make a quality of life difference in the lives of patients who suffer from this," said Peters. "If there's a way to do this in a non-invasive way that's safe, it really could just change our entire practice of medicine."
"This isn't a situation you have to live with. Know that it isn't. Get help for it," said Abourezk. "If you asked me at age 30 if I thought I'd be in this situation, I'd say, 'Are you kidding me? Not me.' And boom, it just sprung up on me."
For more information on the study and its criteria, call Beaumont Urology Research at 248-551-3355.
To read more about the research, click here.
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