Do you worry about laughing? It could be a problem with your pelvic floor (Picture: Getty Images/EyeEm)
Do you avoid laughing, exercising or coughing in case it ends in a change of underwear?
Well, if you are a woman aged between 35 and 65 you are far from alone.
Around 70% of people in this demographic suffer from light incontinence, according to research conducted by a leading incontinence pants company.
Despite this, very few women talk about it, even to closest friends, and many feel it’s just something they have to learn to live with.
Dr Zoe Williams, the celebrity GP famed for dishing out her medical know-how on the This Morning sofa, is keen to bust the myth.
‘Light incontinence is very common among women and there’s this feeling it’s something they should put up with,’ says Zoe. ‘But they shouldn’t and there are things that can be done.’
There are two main common types of incontinence — stress incontinence, caused by weakened pelvic floor muscles, and urge incontinence, often caused by over active muscles around the bladder.
‘Stress incontinence is when the muscles that prevent us from leaking urine are weakened,’ says Zoe.
‘Things like coughing, sneezing, jumping up and down or laughing, which increase abdominal pressure, can cause leakage of urine because the muscles preventing it aren’t strong enough.
‘The muscles in the pelvic floor are like a sling. They sit under the bladder and womb and also support the rectum. There are a number of reasons muscles get weaker, such as pregnancy and childbirth. As we get older they can become lax, especially around menopause.’
But women don’t need to have had children, or be menopausal to develop stress incontinence.
‘If you have weak muscles in your back, which is causing you back pain, strengthening those muscles will get your back muscles stronger and get rid of that back pain.
‘The same is true with stress incontinence. If you have a weak pelvic floor, getting that pelvic floor strong and keeping it strong will improve your incontinence.’
Dr Zoe Williams suggests bladder training can help with incontinence (Picture: Olivia West)
The second common type of incontinence is urge incontinence. This isn’t related to the pelvic floor muscles and so needs to be treated differently.
‘Urge incontinence is when people have a sudden urge to pass urine and if they can’t get to the toilet quickly they’ll have an accident,’ says Zoe.
‘That’s when the muscles around the lining of the bladder are overactive. People can make lifestyle changes such as losing weight and reducing the amount of the alcohol and caffeine you drink.’
Other treatments are also available such as medication to reduce the activity in the muscles around the bladder. Sometimes Botox injections into the muscles are also used.
Zoe also advises bladder training to help overcome urge incontinence.
‘It’s a good idea to empty your bladder before you go on a long car journey but it isn’t a good idea to keep emptying your bladder throughout the day as it might reduce the capacity of urine you can store,’ she says.
Instead people with urge incontinence should try to hold off from going to the toilet as long as possible to try to improve their bladder capacity and diminish the urge response.
The good news is that one form of incontinence doesn’t lead to the other and that help is available for both.
‘As a GP I’ve found people don’t come forward early enough,’ says Zoe. ‘They only come forward if it’s significantly impacting their life or if they’re leaking a lot of urine.
‘It’s better to see your GP sooner than later because they can give you advice or refer you to a specialist if necessary such as a pelvic health physiotherapist.
‘People might mention incontinence at the end of a consultation. They might say, “Oh, by the way, when I run I leak a bit of urine so I’ve stopped running.” As a GP who is fanatical about physical activity I say, “No, don’t do that!’’’
Fitness enthusiast Zoe played rugby before becoming a doctor and first came to TV fame as gladiator Amazon on Sky TV’s 2008 revival of action game show Gladiators.
‘Running has so many benefits for your health,’ says Zoe. ‘And lots of women work out and strengthen their bodies but the pelvic floor is often forgotten about — and it’s really important.
‘It’s something we don’t talk about enough. But if people did, they’d discover friends and family might also have been affected and that light incontinence isn’t something you need to put up with. It can be treated.’
How to train your pelvic floor – Dr Williams’ pelvic floor exercise guide:
‘If people want to try something themselves before seeing a doctor they can do pelvic floor exercises.
Like other muscles in your body you can strengthen the muscles in the pelvic floor — it’s, ideally, a daily routine where you squeeze the muscles. These are sometimes called Kegel exercises.
Imagine you’re having a wee and you try to stop halfway — those are the pelvic floor muscles. Then imagine you’re trying to stop yourself passing wind — those are the pelvic floor muscles at the back.
Tense those muscles until you feel an upwards motion, hold it for ten seconds, and then relax. Repeat that ten times and then do ten quick pulses. If you do that three times a day, which is quite difficult as people don’t always remember, after two to three months you should see a significant improvement in your symptoms.’
Dr Zoe Williams is working with TENA Silhouette Washable Absorbent Underwear, tenadirect.co.uk