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Guest post: Stress incontinence - 'Fallen fanjos are a feminist issue'

259 replies

MumsnetGuestPosts · 21/05/2014 10:55

Doorstep piddling wasn't unusual for me - you know how you're okay 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 (standing on your tip toes works by the way, for a time).

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 steaming piss was a bit, y'know, socially awkward.

And I had no excuse. I knew exactly what pelvic floor exercises were, how to do them, and why I should bother because I'm a physiotherapist.

No excuse, but, there was a good reason – I was awfully tired. I lived with hundreds of tiny kids who were always trying to maim themselves, and each other, in ever-more inventive ways. I could barely remember my children's names, let alone remember to clench my nether regions.

But the great Dribbly Doorstep Disaster was the motivation I needed.
"Make it a habit" is the advice, so, I did them every time I shouted at my kids' (effective), every time I craved a glass of wine (remarkably effective) and every single time I thought an evil thought about my husband (dry in three months).

Here's the sciencey bit:

One in three women aged 35-55 wet themselves, and, about 50% of women over 55.

70-80% of stress incontinence can be cured with pelvic floor exercises within four months.

Read that again. At least a THIRD of your peers use pads, and MOST of them can be cured.

The exercises are cheap to teach, free to do and don't have any side effects. Unless you count toe curling, panting, blaspheming orgasms as a side effect (ask me how I know).

And it bloody MATTERS. Incontinence quietly disempowers women by interfering with every single thing they do, and yet, few complain. It matters because wetting yourself in the front row of Zumba, means you are unlikely to go back to Zumba (again, erm, ask me how I know), and we know that diseases of inactivity kill people. It matters because being "a bit leaky" is a big deal that can have a huge impact on your long-term well-being.

We silence ourselves. It’s as if we are so ashamed of having less bladder control than our toddler that we'd rather continue to suffer in silence than seek help. I suggest we try being angry and vocal instead, because that’s how taboos change.

Even more silent are the one in ten people who leak poo, or the 50% of women over the age of 50 who have vaginal prolapses. Some wait until they are practically dragging their cervix behind them before seeking help.

It's common to be a bit disengaged with your "down below" because, well, you can't see it. We know that many women find the exercises difficult to do correctly, and that energetic eyebrow wiggling is not an effective alternative.

So, set the scene: You're in a tiny lift with your boss, your MIL and someone you've got a massive crush on. Imagine you can feel a fart brewing. A really nasty one. You know that bum-ole squeezing you do to hold in the mortifying toot? That's you working your pelvic floor. Hold it for a count of 10. When you let go you should feel a "drop" down into your pants. Or you could do 10 quick flicks and relaxes in a row - try doing them in time to the beat of music.

The important thing is to keep breathing and to relax your muscles in between the exercises. Do these three times a day, every day for four months, and then, once a day, every day, until you die. If you get pain, stop and take your bits to a GP or pelvic physio.

And, I'll even remind you via twitter - when I tweet, you twitch your twinkle. Midwives and physios are collaborating with #squeezeandlift. If you see it, do it!

Basic lifestyle changes – like reducing caffeine, citrus and alcohol (so, at least cut out the 'slice' from your rum and coke), controlling hayfever or asthma coughs and (even small amounts of) weight loss can make a huge difference to the amount of leaking you experience.

As with all things, the best place to start is with good information – there are brilliant blogs out there, like Evidently Cochrane, and lots of useful stuff from the CSP and the Bladder and Bowel Foundation. Or, you could even watch me, on a really bad hair day, doing about pelvic floors.

The bottom line is that any leaking at all is abnormal. It is not an inevitable consequence of ageing or parenthood, and you don't need to put up with it.

Watch Elaine's alter ego Gussie Grips take the Edinburgh Festival by storm over on the - and don't forget to subscribe - lots more brilliant videos coming very soon.

OP posts:
cardamomginger · 26/05/2014 23:46

The chat and the joined up thinking is starting. There's an MDT group that meets in London centred around hypermobility that includes ob/gynae, rheumatology, immunology, gastric, neuro-vascular.

And there is a lot of anecdotal chat about it all. But it's still pretty removed from the level of care that most of us would get, certainly on the NHS.

Research is needed. Papers. I spoke to 4 gynae surgeons and, whilst all of them were anecdotally up to speed with hypermobility and increased risk of birth injuries, none of them could point to a single paper that investigated the link. I did an internet search through an academic search engine. And again, nowt. So it's great if you get to see the person who has taken a professional interest in the area and has thought about the things they have seen and has had the 'right' sort of conversations with colleagues. But not much help otherwise.

gussiegrips · 26/05/2014 23:57

You able to PM me a link to the group, Cardmom?

If you want to be totally depressed, do a pubmed search for anything to do with womens' pelvic health.

You are right. Everything you say is right.

cardamomginger · 27/05/2014 00:11

That's true!! Am PMing you.

Longrun · 27/05/2014 00:57

Great post Gussie! I’ve learnt a lot, had no idea that hypermobility is a risk factor for PF weakness.

Slightly off topic, I wear pads but often have a hard time keeping them in place. There is purpose made underwear for the job but it reminds me of the net bags you get onions in. Not sexy.
For those of us who do wear pads, what is everyone using? And how are you making them stay put?

nooka · 27/05/2014 04:02

Hi gussie, just to say that my GP was very sympathetic and suggested a urine test to check if there was any infection going on. Weirdly though since my smear I've not leaked at all. Is it possible that she moved something around inside me that got things better aligned (I had incomplete emptying after peeing). She did a internal to check my ovaries and uterus felt OK (apparently routine here in Canada) so there was a bit more rummaging than normal.

BunnyPotter · 27/05/2014 10:03

IT'S ON WOMAN'S HOUR TODAY!!!

gussiegrips · 27/05/2014 12:39

I just caught it, Bunny! Fan-bloody-tastic, the CSP and RCM's collaboration is really important and deserves to be on WH!

Here's the link for those of you who missed it BBC iplayer link

What did you guys think of the article? (I'm a fan)

GarlicMayonnaise · 27/05/2014 12:41

Longrun - control pants ... No wonder I have thrush every few weeks Blush

gussiegrips · 27/05/2014 13:01

Long Yep, hypermobility's a big problem. Just means you're naturally stretchier than the average bear, so, resisting gravity and intra-abdominal pressure is harder for your elastic tissues. #doyerblardyexercises will help, and, really, I'd advise you to look at using a pessary like incostress or a contrelle if you are a runner guessing that from your name

So, firstly, usual party line - any leaking of any sort is abnormal and so needs to get checked out. But, some people will, sadly, be reliant on pads, and you raise something really important - the pads are rubbish!

They move, they unstick themselves (and re-attach elsewhere, which can be a bit nippy) and they can be too bulky for ordinary knickers to keep in the right place.

Big, close fitting pants will help. I came across these guys at a conference recently enso Nice kecks, no seams, won an award. They also make clothes to accommodate stoma. Anyway, I've not tried them but, they are sexier than the onion bag versions

gussiegrips · 27/05/2014 13:03

nooka you get a shiny for going

Some people have a urethra (pee tube) that kind of kinks. Wonder if that's it?

Glad you had a good experience of care, so good to hear.

gussiegrips · 27/05/2014 13:06

Garlic yep, spanx are one I see people using. But, they're not comfy for everyday use and, there's a train of thought that because they alter your breathing pattern from diaphragmatic to heaving-bosom, that they can actually worsen incontinence.

I haven't seen any research on that, it's anecdotal, but, here's an article Huff Post link about the evils of control wear

GarlicMayonnaise · 27/05/2014 13:20

Hmmm! I don't wear them all the time, just when I'm feeling - er, insecure. I have noticed, though, that the pressure makes me pay more attention to my pelvic/tummy muscles which is probably a good thing. I buy ones that fit, not the sort that push your entire belly up to your bra strap Grin

Another friend uses cycling shorts.

gussiegrips · 27/05/2014 13:45

Me too, I squeeze myself into them whenever I need to wear a frock. wonders about a corset

GarlicMayonnaise · 27/05/2014 14:16

Well, Gussie, there's quite a crowd of retro underwear fanatics on MN! I'm sure they'd be happy to help you find your preferred instrument of self-torture Wink

gussiegrips · 27/05/2014 14:18

Hmmm, "retro" or fewer tunnocks teacakes....

tough choice.

Pull my stays, Garlic?

GarlicMayonnaise · 27/05/2014 14:49

Sure, G, just clench ... tighter ...

PacificDogwood · 27/05/2014 20:05

Get a room, you two Grin

Thanks for the link upthread - will read later.

PacificDogwood · 27/05/2014 20:05

Or 'watch' rather… Blush

Nevermind PFE, I need dementia meds (get in there early… Hmm)

PacificDogwood · 27/05/2014 20:06

Oh crap, listen - 'tis radio

PacificDogwood · 27/05/2014 20:07

Did I forget any senses?
Could I feel WH? Or smell it? Hope not

Laughing about myself, so others laugh with me, not at me….

gussiegrips · 27/05/2014 23:46

Arfed at the thought of sense of smell and WH.

How about a big health promotion campaign in glossy magazines with a "scratch and sniff" bit on the #doyerblardyexercises as a motivational tool. But, then I felt a bit bad about it. Sometimes, I take things a little too far (that would totally work though)

Meerka · 28/05/2014 08:22

I used to get leaks as a teen (blush) thank heavens the worst one, on the hockey field, I happened to have a towel in cause I was expecting the monthlies. Lived in fear of another leak after that though.

Post second vaginal delivery a few weeks ago I'm finding things notably worse than first time around, sneezing and coughing is really embarassing.

Thanks for putting up the stuff about -how- to do the exercises gussy. Hadn't heard about the lift one before. Now adding that to me 5 x dailly exercises.

Does being prone to bladder infectoins make it worse?

flowersinthewind · 28/05/2014 19:34

I use a electronic toner which is brilliant solved alot of problems for me

PacificDogwood · 28/05/2014 21:42

Well, gussie, I am once again so inspired by you that everybody who stands still long enough in my (professional) presence, will be offered advice of PFE these days Blush - I discussed them with an elderly demented lady and her daughter today, including written instructions and diagram and the lot. Little did they know that I was sitting there actually doing them while I was talking about them. Why is it impossible to talk about them without actually clenching….?

Meerka, congrats on your new baby.
It is my understanding that a weak pelvic floor can predispose you to urinary tract infections, rather than the other way round (gussie will know the evidence).

gussiegrips · 28/05/2014 23:20

Meerka if you have problems when you are young then you're more likely to have them later on.

That's interesting about the bladder infections, there's an element of cause and effect there. If you have a kink in your urethra, or incomplete emptying of your bladder, well, bugs like that. Equally, pf sagginess can mean the urethra's wobbling about and not beign supported which increases risk. Had it checked out?