Incontinence - don't make me laugh

By Phebe Corey

Incontinence can be an awkward topic. No one likes to talk about it, yet it is a serious and common issue among many women, in particular after pregnancy. It’s not normal and can be cured.

We will focus on urinary incontinence, which is when you experience an accidental or involuntary loss of urine from your bladder. This can range from the occasional leak when laughing or exercising to the complete loss of control, which can be both physically and emotionally debilitating.

There are several types including:

  • Stress incontinence - leakage on exertion or effort which is caused by activities that increase the pressure in the abdomen that then presses on your bladder for example sneezing, coughing, laughing or exercise

  • Urge incontinence - is a sudden and strong need to urinate and occurs when your bladder is contracting abnormally causing the sensation that you need to pass urine (even when your bladder isn't full) and may wake you several times in the night to do so

  • Overflow incontinence - when the bladder doesn’t empty properly and you may cause you leak small amounts of urine

A normal bladder needs to empty 4-8 times a day (every 3-4 hours), may wake you once at night to go to the bathroom (up to twice if you are over 65) and empties completely each time you pass urine.

Your pelvic floor muscles play an important role in controlling this process as they support the pelvic organs (such as your bladder) and control the release of urine. These muscles can become "loose" and not work effectively for a number of reasons and when this is the case you can begin to experience sneaky leakage.

Urinary incontinence in general is most commonly associated with pregnancy, menopause, obesity, some medications and also conditions such as asthma, diabetes or arthritis.

Post pregnancy incontinence

During your pregnancy, it is the hormones produced by your body in conjunction with the weight of your baby that can make your pelvic floor muscles loose and weak.

During childbirth your pelvic floor muscles are stretched even more. You’re also more likely to experience postnatal stress incontinence if you had problems controlling your bladder during pregnancy, in particular during the first or second trimesters.

So add these all together and it’s no wonder childbirth can lead to ongoing problems with incontinence. It is one of the most common problems among new mums and 1 in 3 women who have ever had a baby experience it.

So what can you do about it?

The exact cause and contributing factors will vary depending on the individual and hence why an assessment by a qualified women’s health physiotherapist is essential to determine how to address them.

A physio's assessment may involve a discussion regarding the pattern of your leakage, the use of real time ultrasound to view your pelvic floor muscles ability to contract and sometimes an internal examination to measure the strength of your pelvic floor muscles.

Your physio’s role is to then determine the best management plan for you, as every woman is different. This will usually involve pelvic floor exercises (the starting point will depend on your assessment - this can be crucial in their effectiveness) as well as a bladder-training program including looking at your fluid intake and toileting routine.

Top tips:

  1. Yes there are products available such as panty liners or pads to assist in the symptoms of incontinence however this does not mean it is normal. It is a serious issue depending on the cause for example a pelvic organ prolapse may require surgery. Be pro-active and seek help before it develops further
  2. Think you may have a problem but aren't entirely sure? I recommend to see a women's health physio for an assessment or speak to your GP (if you are unsure which physio to see your GP can refer you to someone brilliant)
  3. Don't have any symptoms of incontinence? Lucky thing! But it is important to know that you can also be pro-active by starting regular pelvic floor exercises

Don't let your leakage stop you from enjoying a good joke any longer!

Note: The views and advice expressed on this blog post are those of the author and are not representative of the Pregnancy Babies & Children's Expo.

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