Acupuncture Treatment of Stress Incontinence

Stress Incontinence

Stress incontinence is a condition I frequently help with in my acupuncture practice. It’s an all too common problem after having a baby, prostate surgery, or developing over time, and it causes involuntary urine leakage during everyday activities like coughing, sneezing, or physical exercise. It’s not something people always want to talk about, but it affects many aspects of your life. For many patients, stress incontinence can significantly impact confidence and quality of life, and the embarrassment around it can keep people from seeking help.

Stress incontinence occurs because of weakening of the muscles of the pelvic floor and bladder sphincter. The good news is that acupuncture has been shown to help reduce stress incontinence, and a growing body of clinical research supports it as an effective, natural option — including alongside pelvic floor muscle training.¹

Electro-acupuncture for stress incontinence

I have treated many people with urinary incontinence and frequent urination with electroacupuncture and acupuncture in my clinic. My therapy focuses on acupuncture points that lie on the urinary bladder and kidney meridians on the lower back and legs.

Within acupuncture theory, stress incontinence may result from an imbalance in the body’s Qi, the body’s energy. Qi deficiency or stagnation will disrupt the body’s ability to control the bladder. Electroacupuncture helps restore that balance by stimulating specific points associated with urinary control, addressing the underlying imbalance rather than just the symptom.

From a Western medical perspective, electroacupuncture on the sacrum and lower back works by targeting the nerves and muscles involved in bladder control. The mild electrical impulses enhance the effects of traditional acupuncture by:

• Stimulating the nerves that control the pelvic floor muscles, particularly the sacral nerve (S3) and pudendal nerve, which play key roles in bladder support
• Improving blood flow and muscle tone in the pelvic region, helping strengthen the urethral sphincter and reduce urine leakage
• Enhancing neuromuscular coordination, so the muscles respond more effectively to sudden increases in abdominal pressure (such as coughing or sneezing)

For stress incontinence, electroacupuncture is typically applied at two key points in the lower back and sacral region:

• Urinary Bladder 33 (Zhongliao) — located over the third sacral foramen
• Urinary Bladder 35 (Huiyang) — located next to the tip of the coccyx

These points are traditionally used for incontinence and bladder issues; stimulation here is thought to act on the third sacral nerve and pudendal nerve that control the bladder sphincter. A typical session lasts 20–30 minutes, and patients often report a mild tingling sensation during treatment.

What the research shows

A 2023 randomized controlled trial studied 304 women across four hospitals in China, comparing Pelvic Floor Muscle Training (PFMT) plus electroacupuncture against the exercises plus sham (placebo) electroacupuncture. The study ran eight weeks, with follow-up through 32 weeks.¹

• Reduction in urine leakage: the electroacupuncture group averaged a 9.8 gram reduction in urine leakage after eight weeks, compared to 5.8 grams in the sham group
• Fewer incontinence episodes: the EA group also had fewer incontinence episodes per day, with a higher percentage of participants reaching a 50%+ reduction in leakage
• Long-term benefits: improvements were sustained for up to 32 weeks after treatment

A second randomized clinical trial, published in JAMA in 2017, examined electroacupuncture in 504 women across 12 hospitals in China, with participants randomized to an EA or sham EA group, each receiving 18 sessions over six weeks:²

• Reduction in urine leakage: the EA group saw a 9.9 gram average decrease versus 2.6 grams in the sham group — a 7.4 gram difference between groups
• Incontinence episodes: the EA group had a 2.9 episode reduction in 72-hour incontinence episodes by six weeks, versus 2.0 in the sham group, with the gap widening further at weeks 15–18 and 27–30
• Clinically meaningful improvement: by the end of the trial, 64.6% of the EA group had a 50%+ reduction in urine leakage, compared to just 21.7% of the sham group; quality-of-life measures also improved and were sustained past 30 weeks
• The treatment was well tolerated, with only minimal adverse effects such as mild fatigue or subcutaneous hematoma

Together, these studies show that adding electroacupuncture to pelvic floor muscle training produces meaningfully greater, longer-lasting improvement than pelvic floor training alone.

Pelvic floor muscle training (PFMT)

Pelvic Floor Muscle Training is a non-invasive therapy for strengthening the muscles that support the bladder, uterus, and rectum. These muscles play a crucial role in maintaining continence by helping control the release of urine — when they weaken, small amounts of urine can leak out during activities like coughing, sneezing, or exercise.

PFMT involves specific exercises, commonly known as Kegel exercises, that require contracting and relaxing the pelvic floor muscles in a controlled manner. They’re simple to perform once learned, though proper guidance and consistency are key to success. Many of my patients are doing pelvic floor therapy and PFMT alongside acupuncture, and as the research above shows, combining the two can offer more relief than either alone.

How does acupuncture work for stress incontinence?

Acupuncture works on many levels to address the mind and the body. We say acupuncture addresses the underlying imbalance in the body causing the condition. Once we treat the root imbalance, the body can improve. This may be an imbalance in the body’s Qi.

Acupuncture also works physically with the body: calming the nervous system, resetting patterns in the body, and, as electroacupuncture specifically does, stimulating the nerves and muscles that govern bladder control directly.

Feel better, get acupuncture

Stress incontinence can have a significant impact on your daily life, but effective, holistic treatment options are available that go beyond traditional approaches alone. In my practice, I’ve found that combining pelvic floor therapy with acupuncture and electroacupuncture offers powerful results.

If you’re struggling with stress urinary incontinence, I encourage you to explore how electroacupuncture can be part of a personalized treatment plan. Don’t let stress incontinence hold you back — take the first step toward regaining control and improving your well-being. Call us at 212-319-5757 or you can make your appointment online. 

References:

1. Tang K, Su T, Fu L, et al. Effect of electroacupuncture added to pelvic floor muscle training in women with stress urinary incontinence: A randomized clinical trial. Eur Urol Focus. 2023;9(2):352-360.
2. Liu Z, Liu Y, Xu H, et al. Effect of Electroacupuncture on Urinary Leakage Among Women With Stress Urinary Incontinence: A Randomized Clinical Trial. JAMA. 2017;317(24):2493-2501.