It’s thought that between 25% and 45% of women suffer from some degree of stress incontinence during their lives.
Jane Simpson, a leading UK continence specialist, says her patients are usually aged between 40 and 60, and they range from women who lead normal lives but avoid trampolines ‘just in case’, to those who are reluctant to leave the house, or have been getting through two or three incontinence pads every day for 10 years.
‘It’s a very under-reported subject because it’s taboo,’ says Jane.
‘Women will get together and talk about their sex life or the menopause, but they don’t talk about this.
‘We somehow hope it will go away.’
Jane continues, ‘It’s puzzling – we put on the best face creams we can afford, and care for our bodies by exercising and eating well, yet we do nothing for “down there”.’
Why do the pelvic floor muscles weaken?
The pelvic floor is a group of muscles that stretches from our coccyx at the back of the pubic bones, to the front, and wrap around our pelvic organs.
These muscles act like a hammock, keeping the organs in place and preventing urine from leaking.
As we age, these muscles start to weaken – especially after the menopause.
Childbirth, doing high-impact sports and constipation can all add to the deterioration of the pelvic floor.
Do men suffer?
Some of Jane’s patients are men, usually those who have had prostate surgery.
Again, pelvic floor exercises are key, and Jane finds men are generally better at doing these than women.
‘They are quite motivated because stress incontinence is such a shock to their system, as they’ve never worn a pad, had a period, or had anything leaking before,’ she explains.
What you can do to help…
The best way to help stress incontinence is to strengthen the pelvic floor muscles.
‘I wish I could find a way to make it fashionable to do your pelvic floor exercises,’ says Jane.
‘We need to treat them like something we wouldn’t dream of not doing, like cleaning our teeth or having a shower.’
‘About 50% of people do the exercises wrongly,’ says Jane.
‘This is often because people are not locating the right muscles.’
How to locate your pelvic floor
1. Sit on the arm of a chair or on a hard surface with your feet flat on the floor.
2. Lean slightly forward with your vulval area in contact with the hard surface.
3. With your hands on your thighs, try to lift that area away from whatever you’re sitting on.
Sit up straight on the toilet with your knees apart.
Try to stop the flow of urine by contracting your muscles up and inwards.
Squeeze, lift and hold for a moment before letting go again.
Start by lying on your back with your knees bent and your feet flat on the bed or floor.
1. Draw up all the muscles at the same time, squeeze, lift and hold for a count of five seconds.
2. Let go and count to five.
3. Repeat five times, ideally three times a day. Work up to 10 seconds, which may take a few weeks or longer. Both men and women can do this.
Once you have the hang of it, you can do these exercises any time of day (standing, sitting, lying down).
Make them part of your routine by associating them with something you do every day, like getting out of bed, putting on the kettle or brushing your teeth.
Jane says, ‘Think of the benefits it will bring – no more pads, better sex, and you can do the sport you want.’
Can it be cured?
Cure rates are impressive.
Studies show 73% of women who do three sets of eight to 12 decent pelvic floor squeezes two to four days a week for five months are totally cured, while 97% show some improvement.
The younger you are the easier it is – yet Jane has seen patients in their 60s and 70s who have cured themselves.
Do we need gadgets?
It is possible to exercise the muscles without the use of gadgets, but Jane recommends them because she believes it will help people to carry on with the exercises.
She likes the Squeezy app, £2.99, designed by NHS physiotherapists, which sends you phone reminders of how and when to do the exercises, and reviews your progress.
She also rates the Elvie trainer, expensive at £170, or vaginal weights, vastly cheaper but rather medieval-sounding.
What about Pilates?
Jane says Pilates doesn’t help unless you are specifically doing pelvic floor exercises in the routine.
Sit-ups and other exercises can harm a weak pelvic floor.
– Jane Simpson is the author of The Pelvic Floor Bible, available HERE.