I have a health issue no one wants to talk about
Having secretly battled bladder problems for years, TV star ASHLEY JAMES is now fronting a new awareness campaign. She tells Maddy Fletcher why she’s going public
Ashley James – age 36, Instagram follower count 345k – is known for modelling, presenting, DJing and appearing on reality shows such as Made in Chelsea and Celebrity Big Brother. Today, however, she is talking about incontinence. James has had bladder problems since her 20s and after more than a decade of suffering in silence she’s taking back control, fronting Tena’s
‘End Bladder Shame’ campaign.
She’s not alone. In the UK a 9 per cent incidence of urinary incontinence was found in the adult population. However, a similar Irish study found the figure to be much higher, at 33 per cent. Most say they are too embarrassed to tell their family and friends about their condition.
‘In my 20s, I had recurring kidney infections and with that there was incontinence,’ says James, on Zoom from her home in Essex. It was mild but it was frustrating.
When she was 23, she had an operation to enlarge her urethra, and for years afterwards the doctors continued to run tests. ‘They were just trying to figure out why I was getting kidney infections,’ she says. ‘Was it due to kidney problems, bladder problems or urethra problems?’ Then lockdown started and James’s medical tests stalled.
In January 2021, she gave birth to her first child, Alfie. She experienced bad perineal tearing during labour, but, she says, ‘Because I’m relatively fit and healthy – I’d done exercise leading up to the birth and I’ve run marathons – I just assumed, from the information that was out there, that I’d have the baby, it would take six weeks of recovery and then I’d be “back” to the person I was before, physically and emotionally.’
She laughs at the idea now, as the reality wasn’t so straightforward. James had to deal with both incontinence and faecal incontinence, prolapse, piles and ‘stitching issues’. None of it disappeared in six weeks.
It was debilitating, the incontinence especially. ‘It impacts your life in a way you just truly don’t appreciate,’ says James. She couldn’t exercise, and even meeting friends was stressful. Everything became a tricky and tiring calculation of: will there be a nearby bathroom? ‘Walking to the park, walking to work, getting the train – just leaving your house or any environment where there are bathrooms is hard. That’s the simple fact of it.’
For a long time, James simply put up with it. Then she got angry. In her industry – but also in society generally – there was so much pressure to lose weight and ‘bounce back’ after childbirth. It was absurd. ‘I just felt,
“Why is everyone talking about whether we lose baby weight or not? It’s insulting!”’ she says. ‘I felt, “I really don’t care if I ‘bounce back’ or not. I care about having incontinence and piles. I care about having prolapse. I care about making sure my baby’s happy. I care about seeing my friends and I care about sleep.
‘Losing weight – or not losing weight – is the last thing on my mind!”’
James was also infuriated by the vagueness of it all – a by-product, she thinks, of embarrassment. ‘The expression that always makes me laugh – and I say it sometimes but I try not to now – is that when we talk about anything to do with our genital area we say “down there”. Even after going through childbirth! It’s a bit like referring to our arms as “over there”.
‘There’s this shame and stigma around the female anatomy and I think because we don’t talk about it, we don’t actually demand better care. I think if more of us came out and said, “Actually, yeah, I have incontinence, too,” then maybe postnatal care would look very different.’
After two months, James saw a pelvichealth physiotherapist. ‘In lots of European countries they get pelvic-health physiotherapy as part of the postnatal package,’ she says, ‘so I think other countries are quite behind in postnatal care.’
The physiotherapist showed James how to do pelvic-floor exercises. She recovered from prolapse and her incontinence ‘massively improved’.
‘I’m still definitely on a road to recovery with it,’ she says. ‘These things, sadly, aren’t quick fixes for lots of people. But, I mean, four years ago, I didn’t even know what the pelvic floor was, so I’ve come a long way!’
Today, James has cut down on caffeine and alcohol and still does her exercises. She also recommends the app Squeezy, which helps users set a ‘pelvic-floor routine’ then sends prompts throughout the day, reminding you when to do your exercises.
Frankly, though, James finds it astounding she was never doing all this before. When she was in her 20s, having tests on her kidneys, one doctor suggested injecting her bladder with Botox to help with incontinence. They breezily told James that a possible side-effect was she might need a catheter. She declined. ‘Now, it blows my mind that no one ever said, “Have you tried pelvic-floor exercises? Have you tried lifestyle changes, like giving up diuretic drinks [which increase urine production]?’’’
James, it seems, is not an easily embarrassed person. She chats confidently about prolapse; she does not like to say she ‘suffers’ from incontinence, rather she just
‘has’ it.
Was this always the case? Not really. When her incontinence worsened after giving birth, she didn’t tell anyone except her partner. Then, she says, ‘I did what all good millennials do: rather than talking to friends about it, I consulted the internet.’ James did an Instagram post detailing her symptoms. Most of the comments were from women saying they were the same.
After that, it was easier to speak to friends. ‘I was surprised. Even one of my guy friends was like, “Oh, I’ve always had it. I’ve got
‘LEAVING YOUR HOUSE OR ANY ENVIRONMENT WHERE THERE ARE BATHROOMS IS HARD. THAT’S THE FACT OF IT’
such a weak bladder!” It started this real conversation without any shame.’
James says her partner – tech professional Tommy Andrews – was amazing, too. ‘I’ve never felt embarrassed with him,’ she says, before pausing and adding, ‘Also, I think that he should just feel really lucky that
I gave him children!’
Did the incontinence impact her sex life? ‘I remember not feeling ready for so long.
But Tommy was like, “You know, I was in the room. I saw what happened in childbirth. I don’t want to hurt you, either!” I think there’s an idea that men are just these cavemen with sticks, that are like, “Oh, what? You’ve got incontinence. How does that impact me?”
‘But I think that we can give men – not always, but in this case – a bit more credit. Hopefully, they care about our health and our physical wellbeing above their ability to get sex,’ she says. ‘Otherwise, I think that could be grounds for separation.’ Quite.
Before we finish speaking, I ask James if she felt any lingering embarrassment or nerves about fronting a campaign on the subject of incontinence. It is, after all, a little different from the typical glossy, Instagram-influencer fodder. She shakes her head decisively. ‘Honestly, no. I just felt really proud.’