To ask for advice on incontinence

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Tried kegel etc but making no difference.

What now? Surgery? One of those wee machine things to improve the muscle?

Anyone any advice as my pad landfill will be declared an environmental hazard soon.

I'm in midst of menopause if relevant

If you do pelvic floor exercises properly 4 x a day you should notice improvements in around a month.
Ask your GP for a referral to a specialist womens PF physio and download the NHS squeezy app whilst waiting for an appointment. In order for the exercises to be effective, you need to squeeze your bum hole as well.

Google gusset grippers. She is a womens physio and has full instructions, and lots of advice, on her site.

What type of incontinence is it? If its cough/sneezing causing leaks then exercises are your best hope. If it's urgency problems then it could be overactive bladder. There is very effective medication for that - maybe speak to your GP ?

Following because post menopause I have the same problem.
Reading the replies I've realised I stoped PF exercises about 5 years ago so will restart these.

There is no way around the pelvic floor exercise but if you can afford it get a Contiform as well. Given me back my life.

If you live in a city, there might be a continence clinic that you can refer to, or ask your GP. Where I live, they asked me to cut down on coffee.

Try vaginal oestrogen, cream or pessary. Usually applied 2-3 times a week.

I'm on a treatment path for this post birth, mine is stress incontinence. The first step is pelvic floor exercises for about 6 months while under supervision of pelvic physio, download the squeeze app and get started, I did 3 times a day. As someone said upthread make sure you start clenching anus and then vaginally, and when you release keep it controlled not just instant let go. If after 6 months your pelvic floor has improved but you're still having issues you get referred back for more tests to see if it's stress or urge. There is a medication for urge, stress there is but weirdly it's also an anti depressant so has side effects. It is effective but is making me sleepy! There is a pessary device option that goes in the vagina and sort of holds things up that's meant to help. The next stage is intervention, there is a less invasive procedure that injects a bulking agent to stem the flow. This is 70% effective and done under local. The next 2 options are both more major surgeries under general, one involves stitches in the vagina and the other creates a sling from your own tissue to hold things up. These are more invasive but have high success rates. So there is a treatment pathway with increasing levels of intervention, but first stage get referred through to pelvic physio. Good luck, I hope you fins an option that works for you, its not something that's fun to live with.

Oh yes and coffee is one cup a day, wine isn't my friend any more, decaf tea.

Core exercise!
I had diastasis recti after my first big baby, I went on to have a second big baby. Had a bad tear too.

Wee often, not just coughing/sneezing/jumping, a sudden movement might do it.

I did start exercising regularly and was doing core exercise 3x a week and I noticed a huge difference! I could go running without having to wear a massive sanitary towel! It helped me massively. It didn't stop, but I'd say it was 50% better.

My husbands physio actually asked if I did core exercises and he asked him why he would ask specifically core. He said that a lot of women favour core when they've had children as it strengthens their muscles helping with jncontinence.

Referral to urogynae clinic.

Addenbrookes Hospital have a surgeon who specialises in treating women with incontinence. It was on that Surgeons On the Edge of Life programme on BBC2 couple of nights ago.

You’ve already had some good advice about how to start sorting it but in the meantime I find wearing period pants rather than pads helpful if it’s just a small ish bit of leaking (I’m generally alright but suffer occasionally if I get a cough / sneeze)

Why do I hate doing pelvic exercises sooooo much? It's just so uncomfortable and I can feel my whole face contorting and wincing whilst I'm doing it. I've never managed to do more than 3 in a row. Is there a machine that will do it for me? 😔

Go to a women's health physio. I recommend go private as you get a much better service. They will examine you internally, check for prolapses, check your existing strengths, check you are doing the exercises correctly, check you are releasing correctly, check for other contributing problems such as poor core strength, give you exercises at the correct level and hold you to account. Plus discuss any other issues and take into account other health problems.

Look up Mummy MOT to find someone in your area. (You don't have to have recently given birth, it's aimed an anyone who's had a baby,) Mine cost £60 for the first 45 minute session then £40 for each follow up. I needed 4 sessions in total and the difference was amazing. Money well spent. You do have to do the exercises though!

Surgery is a last resort, it doesn't have a great success rate and has associated risks

It sounds like you are doing it wrong..go see a physio!

Good advice, @SnackSizeRaisin . I will.

Has anyone come across a different sort of exercise?

You inhale slowly, hold it several seconds, exhale, keep exhaling, keep exhaling til there is nothing left in your lungs. Then consciously expand your lungs. You'll feel your lower parts sort of drawn up and then you clench them. You can only hold it a few seconds before you run out of breath, then slowly relax.

Rinse and repeat.

Kegels don't do much for me now, but this exercise has helped quite a bit. Don't know its name though.

when you consciously expand your lungs, hold your breath. It creates a sort of vacuum that pulls your lower parts up and you can concentrate on tightening them. It doesn't work if you have inhaled though.

There's two types of incontinence - urge and stress. I had both.

First off a urogynae appointment to rule out any medical issues. I was prescribed medication to help the urge incontinence as I had an overactive bladder. I only needed to take it for a month and that was enough time for the psychological issues to reset. I then got 'brain training' to help longer term.

Then a women's health physio to look at the physical issues - are you doing your kegals correctly, do you have a prolapse or diastasis recti, are your pelvic muscles in spasm?

My women's specialist physio practically saved my life. My incontinence made my life miserable, made me depressed and suicidal. She worked miracles. I'll never be 100% continent because I have nerve damage, but I can live a very normal life now.

Vagifem made a big difference to me, my gp didn't believe it was menopause related and insisted on giving me diuretics and sending me for a bladder test, I bypassed her and went to a menopause specialist who prescribed vagifem daily, it has absolutely changed my life, no more getting up in the middle of the night, no checking where the toilets are whenever I go out, being able to plan days out hiking without fretting about the loo.

Thanks to everyone for the very very helpful advice. Going to follow up on the private option as my GP won't see you if you're breathing. Seriously.