Humour can be a great way of dealing with embarrassing scenarios. This is certainly true for Elaine Miller, whose incontinence provided great material for her stand-up comedy routine – such as her ‘Dribbly Doorstep Disaster’…
“Doorstep piddling wasn’t unusual for me – you know how you’re OK right up until you get the key in your lock? Well, my poor neighbour caught me as I was wresting small kids and shopping with a post-coffee-bladder. She chatted away as I tried to disguise that I was bursting. Our relationship was mostly based on exchanging gardening tips and accepting parcels for each other. So, washing her down the driveway in a giant tsunami of my urine was a bit, y’know, socially awkward…”
But, there’s a serious side. While laughing at life’s cringe-inducing mishaps can be extremely therapeutic, bladder incontinence can also have a significant detrimental effect on people’s lives.
An estimated 12 million women in Britain have experienced some form of adult incontinence (AI), and more than half (51%) have also struggled with depression. Forty eight % say they often feel bad about themselves and 65% feel embarrassed, according to Always Discreet’s Quality of Life study. Two thirds are also likely to suffer disturbed sleep, and many said it impacts on their confidence and the relationship with their partner too. The findings are part of Always Discreet’s campaign to break the taboo surrounding the topic, and encourage women to be aware of what can be done to help.
MORE COMMON THAN WE THINK
Incontinence may be a taboo topic that isn’t talked about much, but it’s actually very common.
“Millions of women of all ages experience bladder leaks when they’re dancing, laughing, exercising or just going about their daily lives,” explains GP Dr Sarah Jarvis. “This is just one of the conditions that make up sensitive bladder, which affects one in three women aged 18-75. In women over 40, it affects more than 40%, so you’re certainly not alone.”
There are lots of types and causes of AI, and often bladder weakness or sensitivity occurs after childbirth.
“Any form of bladder leakage is a form of incontinence but there are obviously different levels of severity, from light leaks to much heavier ones,” says Dr Jarvis.
“Sensitive bladder actually includes two types of incontinence. The most common is stress incontinence – the result of a weakness in the pelvic floor muscles, where leakage can be triggered by pressure on the bladder with activities like dancing, laughing, exercise or just going about your daily life.
“Urge incontinence or overactive bladder, where you experience a sudden overwhelming urge to pass water and can have a large accident if you don’t get to the toilet quickly enough, is the second most common kind.”
Some women have a mixture of both these types, she adds, and while it’s very common to worry that the problem will get worse and eventually lead to complete loss of bladder control, this usually isn’t the case.
Sometimes the symptoms will be due to a temporary cause, like alcohol and caffeine intake, or certain medications.
“It can also be caused by an easily treatable medical condition, such as a urinary tract infection or constipation,” notes Dr Jarvis.
DON’T JUST PUT UP WITH IT
Being common doesn’t mean it’s inevitable, though, or something women should just put up with.
“There’s a perception that bladder weakness is so common that it’s normal, but no leaking is normal,” says Miller.
“There’s also an assumption that it’s just part of ageing, or part of becoming a parent, and it’s not. But it can be addressed, and that’s the important thing.”
Miller, 42 from Edinburgh, knows from experience how easy it is to bury our heads in the sand about niggling problems of this nature, especially ones which are embarrassing, personal and tricky to talk about. And she was probably better placed than most women to do something about her incontinence, as she’s a physiotherapist, and therefore very aware of the effectiveness of things like pelvic floor exercises.
A recent Netmums poll revealed that the majority of women who develop leakage problems after giving birth don’t tell anybody, or seek any help for the problem. Shame may be a factor, but so too is simply not realising the difference it can make to take control of the symptoms – and taking control is usually easier than you think.
“It’s so easy not to do anything about it, particularly where post-pregnancy incontinence is concerned, because you’re just so busy,” says Miller.
“Women aren’t very good at putting themselves first, I’m definitely guilty of that. You’ve got a long list of things to do and sometimes you think, ‘Oh, I’ll leave my pelvic floor exercises until tomorrow’, then tomorrow comes and you don’t get around to doing them.”
GETTING YOUR LIFE BACK
It was only after a series of incidents, including wetting herself during the mums’ race at her kid’s school sports day, when the penny finally dropped for Miller and she decided to sort it out properly with daily pelvic floor exercises, which have made a world of difference.
Now when she looks back, she can see just how much the leaking was affecting her; it was a constant worry at the back of her mind, she’d started drinking less and going to the loo more, for fear of having an accident.
“Addressing it has made a major difference to my general wellbeing. I’m a lot happier. It’s also because you can get back into exercise, and we know that exercise is a big mood-enhancer, but if you wet yourself when you go to Zumba, you don’t tend to go to Zumba, so that makes a big difference as well.”
WHERE TO START?
How AI is treated depends on the cause; where a more complex prolapse or hernia is concerned, surgery may sometimes be required and, in some rarer cases, symptoms can’t be reversed. But for the vast majority of women, this isn’t the case and significant improvement in symptoms is usually very possible.
Dr Jarvis and Miller both agree that speaking to your GP’s a good place to start, as they can help identify the exact underlying causes, advise on appropriate treatments, and refer you for physiotherapy for guidance on exercises. Take along a diary of your symptoms – “You may uncover a pattern, or other information that will be helpful,” says Dr Jarvis – and a list of the questions you want to ask.
The main thing is, taking action is always better than taking no action at all.
“The exercises are easy to do once you get the hang of them,” stresses Miller.
“And the impact it has on your life – being in control of your bladder – is worth the effort.”