Historically, feminine hygiene was a taboo topic. However, while a spotlight is shining on the importance of menstrual education, many of us still live in the proverbial dark ages, particularly concerning pelvic or urinary incontinence.
Whether you leak a little when you sneeze or find you can’t make it to the bathroom without having an accident, this not-so-funny little problem doesn’t have to be the punchline.
Urinary incontinence is a condition in which a person leaks urine by accident. It can affect anyone but is more common in women, especially as they age.
“It’s estimated one in four women will have experienced urinary incontinence,” said Michelle Monk, a pelvic floor physiotherapist currently working at the Centre for Sport and Orthopaedic Medicine. “And, it doesn’t just affect women after having babies. Some women will have symptoms even before they get pregnant.”
The most common types of incontinence are:
Stress: The most common type among women, stress incontinence, is the leakage of urine during activities that increase intra-abdominal pressure, such as coughing, sneezing and laughing.
“Stress urinary incontinence can happen for a variety of reasons,” explained Shirlene Dill, a myofascial release expert at Hands on Therapy. “The pelvic floor muscles are too weak from pregnancy and childbirth, both vaginal and c-section; menopause; chronic constipation; exercising incorrectly; hysterectomy.
“The [pelvic] muscles can have apparent weakness but are too tight, so they lose their ability to contract efficiently. How we breathe and use our abdominal muscles; are our reflexes kicking; whether or not our pelvic bones are balanced are all important to the proper functioning of the pelvic floor.”
Urge: The need to empty your bladder more than average during the day or night. “The average person will urinate six to seven times a day. Anything more than seven during the day and more than once at night may be considered urinary frequency,” Ms Monk noted.
“This occurs when you get the signal to go to the bathroom, there is no time to make it there, the bladder squeezes or contracts at the wrong time, and you leak,” Ms Dill explained, adding: “Sometimes there is no known cause for this, although it might be a result of cancer, inflammation or infection.”
Functional: A physical impairment, such as difficulty walking, prevents you from making it to the bathroom on time.
Neurological: Caused by brain, nerve or spinal cord damage.
Mixed: When displaying symptoms from both types listed above.
In 2006, a study found that, on average, women will spend around $750 on incontinence products. We can only assume that number has skyrocketed along with everything else. While the ramifications of incontinence may be few, that unnecessary dent in your pocket should be reason enough to seek help.
“Many women don’t own up to having a problem until it becomes a major issue,” Ms Dill said. “You often hear women say, ‘I laughed so much I peed myself,’ or ‘I leak a little when I do jumping jacks.’ Most people don’t pay attention to the pelvic floor until there is a problem.”
Are you one in four women hiding a package of Depends under the rest of your groceries? If yes, it might be time to seek professional advice.
“Help should be sought as soon as there is any leaking, no matter how small, or preventative after childbearing or during perimenopause,” urged Ms Dill. “Get a baseline evaluation by a pelvic health therapist.”
“An individualised assessment can help you identify when and why you’re experiencing incontinence,” explained Ms Monk. “Addressing the pelvic floor muscles and retraining the bladder can be useful in treating incontinence in men and women.”
If you’re not quite ready to bite the bullet and admit your ‘little’ problem might not be so little, there are a few things you can try at home on your own. Ms Monk stressed that women consider that “every case is different”. There is no recipe for the exact exercises that work for everyone. For example, some people will worsen their symptoms by doing Kegel exercises.”
Ms Dill agreed, suggesting that Kegel exercises work best if only weakness exists.
“Lift the pelvic floor muscles as if trying to stop your urine flow or stop yourself from passing gas and hold it for 10 seconds. Then, rest for 10 seconds, and do this ten times. If you aren’t able to hold that long, hold for as long as you can, and then rest for the same amount of time, or twice that long if you are weak.”
“These are basic Kegels,” she said. “The lift is important. You may repeat this several times a day. Other women may need relaxation exercises before doing Kegels; hence, breathing with the use of the abdominal muscles may be necessary. Women should seek advice even if just for a consultation.”
For urge incontinence, Ms Dill suggested sitting for a minute or so, distracting yourself, attempting a Kegel exercise, or putting pressure on the pelvic floor.
DIY isn’t always the answer and you can rest assured you’ll get a better result with an individualised programme guided by a professional.
“Your physiotherapist will also teach you exercises to improve strength and flexibility of the muscles surrounding the bladder and pelvic floor,” said Ms Monk. Additionally, a pelvic floor physiotherapist will educate you on the following:
• Diet and nutrition: things that you might be eating or drinking which might be contributing to your symptoms
• Identifying behaviours that might be making your symptoms worse
• Setting a healthy bathroom schedule
• Safe ways to achieve regular exercise and a healthy lifestyle.
They say life is cyclical, but you don’t have to end up back where you started, at least where the diapers are concerned. With a trusted professional by your side, who may also be able to determine whether other problems are brewing, you may see improvement in as little as six weeks.
“Don’t wait to see a pelvic floor therapist!” Ms Monk urged.