Why women shouldn't be embarrassed to talk about urinary incontinence- it's actually very common

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By Liz Connor

It's affects more Brits than hay fever, yet you're far less likely to
hear your friends bring this condition up over brunch or coffee.

We're talking about urinary incontinence, which is believed to affect
around 14 million people in the UK, in some form or other. Despite this,
a new survey by Boots Staydry reveals there's still a lot of taboo
around the topic - and it's having a significant affect on people's
lives and confidence levels.

In a poll of 1000 women living with bladder and incontinence issues, 79%
said they avoid enjoyable activities for fear of wetting themselves,
while over a third don't talk to anyone about the condition, so are
currently not getting the support they need to help them enjoy life to
the full again.

However, they're by no means alone. Urinary incontinence is one of the
most common health conditions GPs get asked about, while celebrities
like Kris Jenner and Katy Perry have spoken openly out about their
experiences with it.

"I've always been a champion of eliminating stigmas associated with
so-called 'embarrassing' health conditions, and this is one that I am
keen to bring into the open," says Dr Dawn Harper, from TV's
Embarrassing Bodies.

"As a GP, I know just how common this condition is in women, especially
after childbirth which causes a weakened pelvic floor, and the impact
that it can have on their confidence is huge. Women tend to feel
embarrassed and become isolated as they keep it a secret, instead of
talking with their friends and loved ones. If they did start sharing,
they would probably find many of their peers are experiencing similar
symptoms."

Here, Harper talks about the causes and treatments of urinary
incontinence, and why women shouldn't ever feel embarrassed to talk to
their doctor about it...

What are the causes of urinary incontinence?

"There are two main types of incontinence. Stress incontinence and urge
incontinence," Harper explains. "The first is generally more common in
women than it is in men, particularly after childbirth, where a woman
may have stretched their pelvic floor muscles."

Harper explains that this is the type of incontinence you get when you
cough, sneeze, run or jump, although for some, reaching up to get
something off the top shelf might be enough strain for their pelvic
floor to cause them to leak.

"The other really common form of incontinence is something called 'an
overactive bladder', or a sensitive bladder," she adds, explaining that
people with an overactive bladder feel like they need to go to the
toilet right away when they feel the urge to pee.

"I've had patients who only leave the house when they know exactly where
every toilet is," says Harper, "so they know they can comfortably get
around."

While many people experience just one type or the other, Harper says
it's also possible to experience both stress and urge incontinence
together.

Other causes include a blockage or obstruction of your bladder, where
your bladder may fill up as usual, but as it's obstructed you won't be
able to empty it completely. You can also get incontinence secondary to
nerve damage and conditions like MS.

What can you do about it?

"The first thing to do is to ask yourself what sort of incontinence you
think you have," says Harper. If you aren't sure, a GP can sometimes do
tests to help confirm, but if you're someone who leaks during activity,
it's likely to be stress incontinence.

If this is the case, Harper says the first course of treatment is pelvic
floor exercises, to help strengthen the muscles around your bladder,
vagina and back passage.

"Three-quarters of ladies who have stress incontinence can actually
improve, if not cure, their condition with pelvic floor exercises alone.
I usually refer patients to incontinence specialist or a physio with a
special interest, where they can learn to do the exercises correctly,"
she adds. "I've had some women who religiously do their pelvic floor
exercises but aren't doing them correctly, so they're making matters
worse.

"I would encourage anyone to go and have at least one session, to make
sure that they know exactly what they're doing."

If you're not sure how to properly exercise your pelvic floor muscles,
the NHS also has a handy information page on its website (visit
www.nhs.uk and search for 'pelvic floor exercises').

What else can help?

For any form of incontinence problem, Harper says losing weight (if you
are overweight) can help, as it takes some of the pressure of the
bladder. It's also important to stay hydrated. "If you have an urge
problem, the tendency can be to cut back on drinking water, and that
might seem logical, but actually it reduces your bladder's capacity, so
you can actually make things worse," says Harper. "I would encourage
people to drink enough to keep their urine straw-coloured.

"Unfortunately, alcohol, caffeine and fizzy drinks can irritate the
bladder, so cutting back on those might be useful. Interestingly,
smoking also causes the bladder to be more sensitive, so if you've got
urge problems, I would encourage you to try to give up smoking - or
certainly cut back."

Harper also advises those experiencing urge incontinence to try bladder
training, where you teach your body to hold more urine. When you feel
the urge to pass urine, don't immediately go; instead, try to distract
yourself for five to 15 minutes from the time you get the first urge.

"Ultimately, we have medicines too," says Harper. "There are
prescriptions that GPs can offer to treat both forms of incontinence,
and there are now a whole host of different operations available. If
we've tried lifestyle measures, a patient is a healthy weight, they've
tried bladder retraining and dietary measures, then it's something that
can be explored."

Why does it still cause so much embarrassment?

"Women are much more comfortable talking about their sex lives and their
periods - and I think It's partly because virtually all women have
periods, and most of us have sex. It's normalised," says Harper.

"I think there is a perception that incontinence problems are the domain
of the elderly, so if you're struggling as a younger woman, then you
likely feel like you're on your own.

"There's an awful lot of misinformation out there, because I see lots of
teenagers and very savvy women in their 20s, 30s and 40s who are
suffering with incontinence; it's a very common problem that can affect
all ages."

Harper's advice for any woman suffering in silence is to speak to your
GP, as there are lots of options available. "There's so much we can do
to help, but we need to know it's a problem before we can.

"Boots Staydry (boots.com/staydry) also have a careline (0800 0723 899),
which is manned by fully trained experts who can give you advice on
lifestyle measure, and perhaps, the confidence to go and speak to your
doctor."

Catherine Devane