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‘Oops, I did it again’

Live in fear of little leaks? Don’t worry, help is here

D

oes every sneeze bring on a feeling of terror? Too afraid to join the kids on the bouncy castle? Well, you’re not alone – studies indicate that as many as one in three of us suffers from embarrassing leaks. And contrary to popular belief, it’s not all grannies and new mums. Armed with our advice, however, it could be time to rescue those white jeans from the back of the wardrobe.

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    What are the causes?

    OK, it’s not glamorous, but the umbrella term for these leaks is ‘urinary incontinence’ and there are two main types, with stress incontinence being the most common. ‘This happens when something weakens or damages the muscles of the pelvic floor, which supports the bladder,’ explains consultant gynaecologist Mr Gurminder Matharu, from the Spire Parkway Hospital in the West Midlands. ‘The most common cause of this is childbirth, but it’s not the only one. Anything that regularly puts pressure on the pelvic floor can trigger stress incontinence: a chronic cough, regular constipation, excess weight. Even some forms of exercise, such those that are high impact, or lifting weights incorrectly, can create pressure that weakens the muscles.’ Age is also a factor – just as the face sags as we get older, so do other tissues in the body.

     

    The other major type is known as urgency incontinence. ‘This is usually part of a problem called overactive bladder, which is linked to frequent urination and an urgent need to go,’ says Mr Matharu. In this case, the detrusor muscles (which relax and contract when you wee) start to contract too often. It’s also known as ‘latchkey incontinence’, as many women find they get to their doorstep OK, then as they put the key in the lock…

     

    You can have one of these types or a combination, called mixed UI, but the result is the same: leaks you can’t control.

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There are things you can do – which is why it’s such a shame that up to 74% of sufferers don’t think about seeking help
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    Help is out there

    Now the good news: there are things you can do about it. Which is why it’s such a shame that up to 74% of sufferers don’t think about seeking help, and instead try to manage the condition themselves. ‘That was me,’ says Elaine*, 44, from Edinburgh. ‘I knew I was a bit leaky after my first baby, but I ignored it. Two more children later, it got worse. Then there was the school sack race. I got halfway down the track before I had that “oops” moment and realised I wouldn’t be able to get out of the sack in time. Wetting yourself in front of 300 children is a good prompt to ask for help.’

     

    If you have stress or mixed incontinence, your GP may send you to see a women’s health physiotherapist – a specialist who works specifically on the intimate muscles. ‘We check exactly what’s wrong with the muscles, if you’re doing the strengthening exercises correctly and offer advice and other help,’ explains physiotherapist Clare Pacey, from Harley Street specialist Nuada Urology. ‘Getting a good assessment is essential. For example, one little-known cause of incontinence is actually pelvic floor muscles that are too tight. If this is you, doing strengthening exercises is absolutely the wrong solution.’

     

    For urgency incontinence, the key treatment is bladder training, which involves using your mind to help you relax when urges strike – such as that ‘latchkey’ moment. ‘I call this the curse of the jangling keys,’ says Kate, 34, from London. ‘I’m desperate as soon as I reach my front door, no matter how many times I’ve already been to the loo while I’m out.’ It can also help to limit bladder irritants, which may make the muscles contract more often. Funnily enough, drinking a bit more fluid can be useful here. ‘Many women restrict fluid in order to try to avoid accidents, but this concentrates the urine and may actually increase urgency,’ says Clare. Fizzy drinks, spicy foods and caffeine are other common triggers.

     

    Medication can be an option, too. ‘Drugs known as “antimuscarinics”, such as oxybutynin, tolterodine and solifenacin, can reduce the symptoms of urge incontinence, and help to increase bladder capacity,’ explains Boots pharmacist Angela Chalmers. ‘There’s also a medication called duloxetine, which is sometimes prescribed for moderate to severe stress incontinence in women.’ If these don’t work for you, there are surgical and other treatments available, so be sure to speak to your GP. It’s time to stop suffering in silence.

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The exercises you need to know

Repeat after us… Kegel exercises. They tone the pelvic floor and we should all be doing them, but they’re especially good for women with stress incontinence. Physiotherapist Clare Pacey explains the technique:

‘First, find the right muscle. Women are often told to squeeze the muscle they use to hold in urine, but you get a better result tightening as though you’re closing your back passage to keep in wind.

Begin by quickly squeezing and releasing the muscle 10 times.

Squeeze and hold for 10 seconds, then completely relax; repeat this 10 times. To help correct weakness,
do it three times a day.’

 

For extra help, download Squeezy**, the NHS physiotherapy app for pelvic floor exercises.


Words
Helen Foster Photography Getty Images *Elaine performs a comedy routine based on her experiences with stress incontinence (gussetgrippers.co.uk)

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