It can come from a cough, a bout of laughter or a run across the field playing your favourite sport. Whether mild or severe, the involuntary loss of urine can have an enormous impact on your work life, social life, and mental wellbeing. While urinary incontinence (UI) is common, especially in women (one in three women between age 41 and 64, and one in six under 40 years old, struggle with this issue), it’s important not to think of it as “normal.” Once you think of it as normal, you are less likely to seek help. There are many things you can do to prevent and treat incontinence. The sooner you address the issue, the easier it is to get effective treatment.
Symptoms
There are two main types of incontinence: stress and urge. Stress incontinence involves a small to moderate involuntary leakage of urine, especially with a cough, sneeze or laugh. Urge incontinence is the frequent and sudden uncontrollable need to urinate, usually resulting in a moderate to significant leakage. If you have both types at once, it’s called mixed incontinence. Depression and social isolation are common results of incontinence since it often causes a fear of leakage in public. Potential embarrassment also holds many women back from having meaningful conversations with their doctors or other healthcare professionals about their condition and what can be done. As well, if we feel this leakage is a normal process of aging and having children, we are less likely to seek help or mention our concerns to healthcare professionals.
Causes
Urinary incontinence in women is caused by problems with muscles that help to hold or release urine. Age, weight, chronic cough, diabetes, constipation, and smoking are all risk factors for UI. Women often encounter issues with UI following pregnancy, with or without a vaginal childbirth as the muscles that support the bladder can weaken; the pelvic floor. It is important to note many younger women leak as well. Studies of high-level athletes in the first-year university showed as many as 45% experienced stress UI associated with their sports.
Who’s affected?
Anyone can both suffer from incontinence, but women are twice as likely to deal with the issue.
Treatments
Many options are available without medication or surgery, such as:
Diet and lifestyle changes
Firstly, take precautions to prevent bladder infections. Be sure to cut back on bladder irritants like caffeine and cigarettes. Drink plenty of water; this will keep you hydrated as well as decrease your urine concentration which can be a bladder irritant. Lastly, increase your fibre intake to reduce constipation. In combination, these small measures can help a lot.
Bladder training
It is normal to go to the washroom every 2-3 hours. Your bladder should be able to hold 300-500ml of urine. If you are going more frequently or urinating in smaller amounts, bladder training may be appropriate. If you are urinating too frequently, you can learn to delay going to the bathroom, increasing the time by five-minute intervals.
Devices
A pessary (a removable rubber or silicone insert) is placed inside the vagina to support the bladder. This is most commonly used for pelvic organ prolapse but can help with urine leakage as well.
Pelvic floor or Kegel exercises
Often recommended for women after they give birth. Kegel exercises strengthen the muscles that support the bladder through methodically contracting the relaxing the pelvic floor. With regular practice, it has a 70% success rate for stress incontinence.
Many women have overactive pelvic floor muscles, which can actually increase urgency and frequency. These women need to learn to relax their pelvic floors. An assessment by a qualified practitioner is appropriate to determine which exercises are right for you.
Getting Help
For your pelvic floor to handle the weight of everyday activities, you need a well-coordinated pelvic floor, strong postural muscles, and good bladder habits. Correct technique and persistence are paramount to seeing success with any of the exercises discussed above. Most importantly, a physiotherapist can help discover the cause of your incontinence and ensure you’re doing exercises correctly using tools such as biofeedback machines that measure contractions.
Though the topic may be uncomfortable, the best thing you can do is address the issue with your healthcare professional so that you can start your recovery. To see what physio can do to help with your UI, book an assessment today.