Treatment
Treatment of pelvic support problems may involve special exercises or insertion of a special device called a pessary. These treatments may improve support. Your doctor may suggest a high-fiber diet or medications to soften the stool and make bowel movements easier. Keeping your weight under con-trol, eating right, not smoking, and not doing activities that stress pelvic support muscles also can help. Hormones may be given to improve the quality of the tissues. Many women with pelvic support problems do not need further treatment. Some bladder control problems respond best to changes in voiding habits, diet, and medications. Others may be treated by surgery. No form of treatment, even surgery, is certain to solve the problem. The chances for getting some degree of relief, though, are quite good.

Hormone
Estrogen is a hormone often prescribed to preserve or improve the quality of the pelvic tissues. It can be given as a pill, skin patch, or vaginal cream. Sometimes a combination of these methods is used.
Hormone Replacement Therapy (HRT) may be used after a women has gone through menopause. It eases her symptomes of menopause and protects her from heart disease and bone problems. If a woman still has a uterus, the hormone progesterone is given as well.
Hormone Replacement Therapy may improve the results of surgery or pelvic exercises. Women who are note taking HRT may be prescribed an estrogen cream to help relieve symptoms.

Special Exercises
Exercises called Kegel exercises, or pelvic muscle exercises, are used to strengthen the muscles that surround the openings of the urethra, vagina, and rectum (see box). Do these exercises three or more times a day. In time, you may be better able to hold urine.

Diet
The doctor may suggest that you drink fruit juices to help reduce the risk of bladder infection. You also may need to cut down on caffeine, which acts as a diuretic. It is found in coffee, tea, and soft drinks. A high-fiber diet may be prescribed to help with bowel control and to prevent constipation.

Medicines
Sometimes a medication that softens stools is pre-scribed along with a special diet to help control intestinal symptoms. A medication that puts bulk in the stool also may be given with a high-fiber diet. There are special medicines that help to control urination. These drugs suppress bladder contrac-tions. Other drugs will help prevent leakage by increasing the pressure inside the urethra. If there is a urinary tract infection, antibiotics may be need-ed. Some of these drugs have some side effects.