I was staying overnight in a hotel recently, as I do now and again, for work, or sometimes just for fun because I like hotel toiletries. I was sat (in a lying down sort of way) on the bed, watching a bit of TV before going for dinner. I sneezed. I sneezed again, and a little bit of wee came out.
(Stops typing briefly to hide under my desk.)
It wasn’t a gush by any means – I didn’t need to pretend I’d spilt a glass of water and call down to reception for fresh sheets – but it was enough to make me feel about 63 years old. If I had had a Sunday supplement with me I’d have ordered some stretchy waisted trousers as a sort of reflex reaction.
I tell you this in a bid not simply to embarrass myself, but to show you that it’s okay to have the odd leak. Well, perhaps not okay exactly, but definitely normal. Because let’s face it, no matter how often the midwife tells us to do our pelvic floor exercises during and after pregnancy, we don’t do we? We forget. Or we think, as I certainly did at 17 and 24 – the ages I had my children – that we’ll never be old enough to have to think about it.
21 years after the birth of my first baby and I can tell you for sure that I am old enough to have to think about it, and if you haven’t yet, chances are you will at some point. Here are a few facts, just in case you’re still being all blasé about it, sneezing all over the place without a care in the world:
- In 1998 the World Health Organization (WHO) reported that bladder control problems affect more than 200m people worldwide.
- The NHS estimates that between 3 and 6 million people in the UK have some degree of urinary incontinence.
- A study in 2002 found that 32% of women in the UK, had symptoms of urinary incontinence in the previous 30 days.
That’s one in three of us, so pay attention.
For many, ageing alone is a significant contributory factor, particularly changes brought on by the menopause, but pregnancy and childbirth can have a big impact on urinary incontinence, as can other factors such as high impact sports – running for example. (I knew running was bad for you.) In fact, women can experience pelvic floor problems at any age, so just because you’re young, don’t imagine you’re immune.
While plain old embarrassing leaks might be the first thing you think of when you think ‘weak pelvic floor’, (a phrase I’m sure often pops into your head), incontinence isn’t the only sign that your pelvic floor might need a little help. Needing to go to the toilet more often than normal, pain in your pelvic area, finding it hard to empty your bladder or bowel, (because your pelvic floor supports the back door too…), and pain during sex could all be signs of a pelvic floor problem. You may even experience a vaginal (or rectal) prolapse – which may be felt as a bulge in the vagina (or rectum) or a feeling of heaviness, discomfort, pulling, dragging or dropping.
(I don’t think when I started blogging that I ever imagined using the phrase ‘vaginal (or rectal) prolapse’. Seriously, nobody wants that if they can help it do they?)
You can even experience problems with your pelvic floor muscles being too tight, something that clearly isn’t an issue for me.
So, what can you do to help keep your pelvic floor in shape and avoid those little leaks that can be the source of so much embarrassment and fear? I’ve done a bit of research, and pulled together seven ideas to get you started. Some are general lifestyle points, others are more pelvic floor specific:
Maintain a healthy weight
Stress incontinence – the sort when urine leaks out at times when your bladder is under pressure, for example when you cough or laugh – is the most common form of urinary incontinence in the UK. Obesity contributes to the risk of stress incontinence because it puts your insides, your bladder and your pelvic floor specifically, under chronic pressure. Research has shown that even a relatively small decrease in weight can have a big effect on incontinence, so if you’re experiencing bladder weakness and are overweight, losing a few pounds might be a good first step.
(Note to self – no biscuits at eleven o’clock today.)
Watch what you drink
I’m not saying drink less generally – dehydration isn’t an advisable solution – but do be a bit more mindful of what you drink. Alcohol, and drinks high in caffeine such as tea, coffee, and cola, are all diuretics, and so can irritate your bladder by causing your kidneys to create more urine. Cut back on these as much as you can, ideally sticking to water as much as possible – 6-8 glasses a day is fine. Don’t be tempted to reduce your intake of fluids as this can shrink the size of your bladder and actually make urinary incontinence more likely.
Stress incontinence, as we said, is the most common causes of urinary leaks, and this is often associated with persistent coughs. While quitting smoking won’t in itself strengthen your pelvic floor, it will help to prevent you doing further damage by excessive coughing and will help reduce the chances of accidents triggered by coughs.
Good old fashioned pelvic floor exercises (Kegel exercises)
One of the most effective ways to strengthen your pelvic floor is to regularly do your pelvic floor exercises – also known as Kegel exercises. The NHS has some guidance here, but one of the easiest ways to test out your pelvic floor muscles is to try to stop the flow of urine while you’re having a wee. This will give you a sense of exactly how and where they work. However, don’t do this regularly, as it’s not terribly good for your bladder. Instead, just find somewhere comfy to sit (you can do them while you read this) and clench your pelvic floor muscles for a few seconds, 10-15 times in a row. Ideally you need to do this every day, a few times a day.
The tricky thing is doing your pelvic floor exercises properly. You shouldn’t hold your breath, or feel your tummy, buttocks or thighs tense at all. Try it now and you’ll see how hard it is! Practice makes perfect though, so stick at it.
Use a personal trainer
No, not someone to shout at you every day to remind you, I’m talking about an electronic personal trainer like Elvie. I actually tried Elvie out for myself recently – (read how I got on here) – and found it really helpful. It’s a little device that you pop into your vagina, and which then connects via Bluetooth to an app on your phone, which give you targets and exercises to help you to practise the technique. The KegelSmart operates in a similar way, but uses vibrations rather than an app to guide you. Ooer.
White Pharmacy are currently running a competition to win an Elvie. They retail at £149, so it’s a great competition. Details of how to enter are on this page.
The risk when you are just freestyling your kegels is that you end up doing them wrong, and doing more harm than good, so having a gadget to guide you is very useful. If you’re worried about the logistics of getting things in and out, you might find it useful to get yourself a water based, organic lubricant.
Lift weights with your vagina
That’s a great image isn’t it? It’s wearing a little leotard and has those cartoon dumbbells. No? Just me? Anyway, it isn’t like that. Instead, you use a device like the Pelvix, which you insert into your vagina for around 15 minutes at a time, gradually increasing the weight inside it. The beauty of something like the Pelvix is that it essentially does the work for you. You stand up while you have it in, and it tries to escape. Your body instinctively tries to stop it by contracting your pelvic floor muscles.
Don’t get over ambitious – start without any weights added and build up gradually. It would be very disheartening to pop it in only to have it immediately fall out onto the floor with a clatter.
Although high impact sports can have a potentially negative impact on your pelvic floor, generally keeping fit and maintaining a strong core can be very beneficial in the prevention of urinary incontinence. Gentle strengthening exercises like pilates, which focus on core strength, are perfect for strengthening your pelvic floor and reducing the risk of finding yourself doing a random wee in a hotel room one day.
And finally… if you’re worried about any of the issues raised in this article, do pay a visit to your GP. Remember it’s not something to be embarrassed about – it’s incredibly common and there’s plenty you can do to help treat or relieve symptoms. If you want any more advice on any of the gadgets mentioned or products that might be helpful, you might want to try somewhere like White Pharmacy. They pride themselves on giving great customer service, so are perfect if you want a little help and information alongside your purchase. They have great reviews too.
Have you suffered as a result of a pelvic floor problem? What has worked for you?