Do you leak a bit when you sneeze or cough? Do you have to run to the bathroom before your trainer or group class has you jump? Maybe you avoid those exercises altogether for fear of peeing all of the floor.
Leaking urine is common. It’s nearly two times as common in women than in men (30% – 50% of us women leak urine). We treat it as a normal part of aging or the effects of childbirth. We put on our Poise and hope for the best. Contrary to our belief, leaking urine is not normal, and there are things you can do to improve your situation without relying on a pad or adult diaper. Let’s explore a why we leak and what we can do about it.
WHY DO WE LEAK URINE?
There are several reasons why we may leak urine. For this article, I will focus on two: Stress Urinary Incontinence (SUI) and Urge Incontinence (UI).
- Stress Urinary Incontinence (SUI)SUI happens when there is an increase in abdominal pressure. Leaking when we sneeze, cough, lift heavy things, or jump are examples of this. Many times this is because our pelvic floor has weakened from stress (pregnancy, trauma during childbirth, extreme lifting of heavy weights, etc).
- Urge Incontinence (UI)UI, also known as overactive bladder (OAB) is the inability to hold in the urine long enough to get to the bathroom. The urge comes on and you can’t get to the bathroom or get your pants down quick enough. Another symptom of UI is needing to pee 3 or more times during the night.
Incontinence can happen because of a weakened pelvic floor.
WHAT IS THE PELVIC FLOOR?
The pelvic floor is the group of muscles at the bottom of your pelvic area that create a sort of sling. This sling of muscles hold in your pelvic organs (uterus, bladder, bowels). When these muscles weaken, the neck of the bladder may not stay closed when stressed. When this happens, we may leak some pee.
The decrease in estrogen as we age and enter menopause may also be a contributor to a weakened pelvic floor, causing us to have UI. Ugh. Aging is so much fun.
If the pelvic floor weakens too much, we may experience pelvic organ prolapse. This is when one or more of our pelvic organs begins to descend down and basically out of our vagina or anus. If this happens, and we let it go too long, we may need surgery to correct it.
WHAT CAN I DO TO HELP MY SYMPTOMS OF UI OR SUI?
If you are leaking or have urgency, fear not. There are things you can do to help. First, remember that Kegel exercise? It’s an oldie, but goodie. The Kegel can help strengthen the muscles of the pelvic floor and should be an important part of your workout routine. To perform a Kegel, sit on a hard surface or on a stability ball. Make sure your feet are flat on the floor and your hands are on your thighs. Lean forward a little so that you feel that your vulva area is in contact with the ball or hard surface. Lift and squeeze the muscles in the area around your vagina and your anus away from the surface your are sitting on. Hold these muscles for 5 seconds, then relax. Repeat this for a count of 5, working up to a count of 10.
If you are not sure if you are doing the Kegel correctly, try to Kegel while peeing. Hold the pee by lifting the muscles from the vagina to the anus. If you can stop the flow of pee, chances are you are doing the Kegel correctly.
I also recommend getting the Squeezy app for your phone. This app will remind you to do your Kegels, as well as time them for you (you can set up the repetitions and hold/release times). Another great feature of this app is the ability to link it with your doctor, who can then set a program for you to follow.
WHAT IF LEAKING URINE GETS WORSE OR DOESN’T IMPROVE WITH KEGELS?
If leaking continues to be or becomes a bigger issue, I suggest you seek the help of a pelvic floor specialist, either a doctor or a physiotherapist. You may want to find out if you are leaking because of a tight pelvic floor, rather than a weakened pelvic floor. You may also want to make sure your are not having a pelvic organ prolapse. The pelvic floor specialist can determine what the cause of your leaking is and treat you accordingly.
The Pelvic Floor Bible by Jane Simpson
Voices for Pelvic Floor Disfunction
NAFC (National Association for Continence)