Strengthen your pelvic floor to resolve incontinence

Q: After I gave birth to my first child, things have never been the same “down there”. When I sneeze or even laugh, I let out some urine. It is so embarrassing. Can you help?

A: What you have is called stress incontinence. It is when leakage occurs either when you exert yourself or when you laugh, cough, or sneeze. (There is another type of incontinence called urge incontinence, where the need to use the washroom is frequent and urgent.)

While stress incontinence is more common in women who have had children, it is not necessarily for the reasons you might think.

Most people assume that this happens due to stretching and tearing of the pelvic floor and other tissues during childbirth. However, recent research suggests it is more complicated than that.

While it is true that women who have had a C-section are less likely to develop stress incontinence than those who have given birth naturally, they are still more than one-and-a-half times more likely to develop this condition than a woman who has never had a baby. It seems that pregnancy, not just the giving birth bit, appears to do the damage.

PEE JUST INCASE
As for urge incontinence, one factor that tends to make it worse is the tendency for women (and, for that matter, men too) to pee “just in case” — emptying their bladder before leaving the house even when they do not need to, something we regularly encourage our children to do.

While this in itself is unlikely to cause urge incontinence, it can make things worse by reducing bladder capacity.

Whatever the cause of your incontinence, there is plenty you can do before you turn to medication and surgery, which might not even work.

Pelvic floor exercises may seem overrated, but they work wonders for mild stress incontinence.

However, they do need to be done properly to be effective (see sidebar below). You can also train your bladder by waiting longer between trips to the bathroom, to try to stretch the bladder wall, thereby increasing capacity.

This is great for urge incontinence. Medication can also help to improve bladder control if these measures do not work.

Weight loss can also help. According to a study published in The Journal of Urology, women who lost on average of 35 pounds reduced their incontinence episodes by 60 per cent compared to just 15 per cent in women who did not lose weight.