You can live your life without those little leaks
According to a recent survey, 70 per cent of women aged 35 to 65 have experienced urinary incontinence. It’s incredibly common, but the knockon effects can include stress, fear and anxiety – especially around being in public – a reduction in intimacy with partners, and reduced quality of sleep. Women have long been too embarrassed to speak out or seek help, but there’s support out there and a whole range of solutions, too.
What is it?
“Urinary incontinence is defined as the involuntary leakage of urine from the bladder,” explains Dr Zoe Williams. “There are several types, and the most common are ‘stress incontinence’ and ‘urge incontinence’.
“Stress incontinence is when you leak a small amount of urine when you cough or sneeze, laugh or exercise, for example. Urge incontinence is different and occurs when the detrusor muscles in the bladder are overactive and start to contract (to make you pee) before your brain has instructed them to do so. In this situation, women will often feel a sudden urge to go to the toilet without any prior warning and the bladder may contract when it shouldn’t, causing urine leaks.”
“Stress incontinence is closely linked to the health and strength of your pelvic floor muscles,” continues Dr Williams. “It can affect women at any age, but is most common in women over the age of 30 and tends to get more likely as we get older – with contributing factors including pregnancy, having had vaginal births, obesity and menopause.”
“The pelvic floor muscles lie across the base of your pelvis, to help keep the pelvic organs – bladder, uterus and bowel – in the correct position,” explains Dr Shirin Lakhani, cosmetic doctor and intimate health specialist (Cranleyclinic.com). “The onset of menopause can cause your pelvic floor muscles to weaken. These muscles support the pelvic organs, which means that a weakening of them can result in pelvic floor problems, such as prolapse and incontinence.”
“Many hormones affect muscle tone,” adds Claire Snowdondarling, alternative health expert, presenter and educator (Clairesnowdon-darling.com). “However, for the pelvic floor, the most notable are oestrogen and progesterone. When the levels of these hormones drop, the ligaments that hold the bowel, uterus and bladder in place become thinner, weaker and less resilient. These hormones can drop at various times in our lives, such as post-pregnancy and menopause, but also due to high levels of stress – as stress interferes with our bodies’ ability to make these hormones effectively.”
Our pelvic floor can be damaged in other ways, too. “Constipation
and straining put pressure on the pelvic floor and can cause it to weaken, as can being overweight,” explains Dr Lakhani. “Highimpact exercise can also put pressure on the pelvic floor.”
Finally, diet and lifestyle choices can contribute, too. “Blood sugar instability can cause the body to create too much stress hormone, which in turn can increase our need to urinate and eventually develop incontinence,” adds Claire.
Whatever the causes, the condition can have detrimental effects on women’s mental health, personal relationships and careers. “Incontinence hugely affects women’s emotional health,” explains Claire. “It can lead to anxiety about being away from home, and a fear of travelling, which can lead to social isolation, dependency on others and a very negative body image.
All of these issues can cause depression and other mental health issues if incontinence isn’t managed effectively.”
“In a recent customer survey, we found that 87 per cent of women said dealing with pelvic health issues had affected their mental health at some stage,” says Wendy Powell, founder of the Mutu system, an exercise and wellbeing programme for women (see right). “Women living with urinary incontinence have been shown to have a significantly lower quality of life compared with those who are continent. This impacts every element of a woman’s life, including their career. Forty one per cent of women said they have taken time off work for health issues that they did not feel comfortable discussing with their boss; 30 per cent said pelvic health affected their performance or focus at work; and 36 per cent felt anxious and embarrassed in the workplace due to pelvic health issues.
“Sufferers can experience humiliation, fear and anxiety over becoming incontinent in public, and distress at others finding out. It can also cause loss of sleep and sexual dysfunction. The stigma attached makes 75 per cent of women with incontinence suffer in silence, while those that do seek help take, on average, six to ten years to do so.”
When to seek out help
“We’ve probably all experienced ‘wetting ourselves’ on the odd occasion while laughing uncontrollably or being tickled, for example,” says Dr Williams. “And while the odd occasion is normal, persistently having urine leakage, no matter how small the amount, is not normal. What’s more, there are many potential solutions that can help us improve, and often eradicate, incontinence, so I would urge people to seek advice from their GP. If people want self-help measures for stress incontinence, then I’d advise starting a regime of daily pelvic floor strengthening exercises.”
Meanwhile, to protect against any embarrassing leaks, Dr Williams recommends Tena Silhouette Washable Absorbent Hipster Underwear, £29.99 (Tenadirect.co.uk).
“For the odd occasional leakage, Tena’s Silhouette Washable Absorbent Underwear provides triple protection for light incontinence and looks just like regular underwear,” she says.
Alternatively, Always Discreet Boutique Incontinence Pants, £8.49 for eight pairs (Boots), are a good disposable option.