Below the Belt!
There is a silent epidemic amongst women; one that it is hidden by a mix of embarrassment, shame or, perhaps worse one that is being normalised by the media and adverts for “sensitive bladder” products!
If you leak when you cough, sneeze, jump, run or take part in any high impact activity (and that includes bouncing on a trampoline) then you have urinary stress incontinence (USI). Whilst this is common (1: 3 women will suffer from this) it is NOT NORMAL. It is most common in women who have been through pregnancy and childbirth but USI can also affect many young women (including the super fit) who have not had children.
Why Does It Happen?
In the majority of cases, USI arises from poor function of the pelvic floor muscles. The pelvic floor is a sling of muscles that supports the organs of the pelvis and has a key role in managing bladder and bowel function in both men and women. Weak, poorly co-ordinated or damaged pelvic floor muscles can result in reduced control and leakage. It can also lead to pelvic organ prolapse where the bowel or bladder intrudes into the vagina. These muscles are put under considerable stress during pregnancy, child birth and in some sports which involve a lot of high impact or impact on the abdomen. Other factors that affect the performance of pelvic floor muscles are the changes in the quality of connective tissues that occur as a woman transitions through menopause.
Do Not Accept!
Our culture of hiding this problem in plain sight leads us to mask the symptoms. This might be by not taking part in activities that cause us to leak, moderating fluid intake, wearing a pad or clothes that can hide an accident. You can now buy special pants that absorb leaks and reduce odour. These are being marketed to the fit and active 30-40 age group! All of this normalises USI and conditions us into not taking control of our pelvic health. How much better would life be if we focused on education to let women to know that, in the vast majority of cases, USI can be vastly improved or stopped altogether?
The Way Forward
As is the case with most muscular weakness, injury or dysfunction; co-ordination and strength can be greatly improved by the use of the correct training and rehabilitation. In some cases surgical intervention may be needed, but in uncomplicated cases of USI or mild prolapse, good functionality can be returned to meet the requirements of daily life. You also need to know how to manage load when lifting e.g. taking heavy shopping out of the car, picking up small children or any of our daily activities which challenge our core stability. Which types of exercise are good for your pelvic floor and which ones will load it beyond its capacity? How do you nourish yourself to maintain good bowel health as constipation can be a significant driver of poor pelvic floor health?
How to Take Action
There are a variety of NHS and private options for dealing with pelvic floor dysfunction. Through the NHS you can visit your doctor and ask for a referral to the Women’s Health Physiotherapy team at Princess Royal. You can see a women’s health physiotherapist privately. Or for those with uncomplicated USI and those that have been diagnosed with mild prolapse the Holistic Core Restore® “Everywoman” program offers a conservative pelvic floor wellness and fitness program that combines progressive and functional pelvic floor exercise with nutrition, self-care and lifestyle advice. This is also suitable for new mums looking to return to exercise in a graded and pelvic floor safe environment, peri and post-menopausal women and those in the advanced stages of recovery from abdominal surgery such as hysterectomy.
However you choose to tackle this problem remember this might be something to expect at certain life stages but it is not something you have to accept. Be proactive with your pelvic floor health and it will serve you well throughout your lifetime.
For details of the Holistic Core Restore® “Everywoman” program visit the Women's health page on this website.