People often ask what made me write a book about incontinence when it is such a taboo subject. They wonder how I dared to describe wetting myself in Mothercare or smashing my wine glass on the floor to distract people from an accident at a Christmas party. Was I born with no embarrassment or shame?
It’s funny, because I did have shame about incontinence for a long time. But coming clean didn’t add to that – and in its own way, speaking up has made me feel powerful, rather than cowed. After years of treatments (with doctors, physiotherapists and specialist nurses) I became a confident advocate for myself, but I noticed something else – talking to other people, especially women, about their worries and secret concerns around continence, leaking and accidents could be empowering for all of us.
I had been brilliantly treated, so I was devastated to find out how many people do not get help for leaking, even when it disrupts their lives and wellbeing. It can take years for women to ask for support. As Alison Wileman, chair of the Royal College of Nursing Bladder and Bowel Forum, says: “Far too often women do not report due to embarrassment.”
I don’t blame people for keeping quiet. Incontinence is hard to talk about and it can be pretty isolating. It made me behave like two different people. One who was smashing it at life, adulting to the max. And one who was a shrunken ball of shame, self-hate and panic – panic that one day someone would see my mess or smell it and realise just how broken and disgusting I really was.
I felt very alone. I wasn’t though, which is why I’m so passionate now about talking about everything, even the most grim elements of knicker nitty-gritty that come out when we talk about losing bladder control. Studies suggest there are around 400 million of us with some sort of continence problem around the world, so maybe it is time to try and move beyond embarrassment and bring more issues out into the light.
In my case, I became incontinent after childbirth, but though lots of women with children experience some leaking, there are many other causes too, including menopause, neurological diseases, alcoholism, medication, trauma, being overweight, spinal injury or inherited conditions. It can happen after a caesarean section, any type of vaginal delivery, and to those who have not given birth. It can happen to women, men and non-binary people.
Some people have lifelong issues, others realise gradually. Many women have confessed key moments to me: ruined running tights, trampoline catastrophes, evenings of dancing where pads couldn’t cope. And most people have heard that leaking is common with ageing.
But, as Myra Robson, the UK physiotherapist and mind behind Squeezy, a pelvic-floor muscle exercise app endorsed by the NHS, says: “Just because something is common doesn’t mean it is normal.” And that’s the heart of it.
There is help out there, and embarrassing or difficult continence issues are often completely treatable, especially if you catch them early. The stumbling block is the need to start a conversation. As Wileman says: “Unless we do talk about it, far too many will be living with something they could get help with.”
So let’s get talking. There is a lot of good news. Around one in three women leak, but many bladder issues can be cured or massively improved. And there are plenty of apps, devices and digital ways to help you exercise and improve your bladder health.
There are lots of solutions too, and things you can do for yourself. Nobody has to accept being leaky just because they had a baby, hit the menopause or took part in high impact sport and exercises that seemed to affect their control.
Depending on your circumstances, some solutions are quite simple and quickly effective too. Like moving more, exercising your pelvic floor and core properly and regularly, losing excess weight, and avoiding food and drink that affects your bladder (like coffee, acidic drinks, alcohol). Be wary, too, of anything that makes you constipated, as that can impact on continence as well.
It is also possible to develop strategies that make you feel more confident while you manage continence and get help: find clothes that fit, are easy to change and dark coloured so leaks won’t show; use vinegar or other methods to remove smells from clothes and sheets; find liners, pads and underwear that work for you as you are waiting for treatment or help. And remember: like period products, some brands or shapes of liners, pads or incontinence underwear can fit better than others, and unlike the bulky mattress pads of the past, these days there is a much wider choice.
If you are worried about whether you are doing your exercises right, you aren’t alone. And if you aren’t improving after clenching and squeezing, it is always worth speaking to someone qualified, to make sure you are doing things right for you. Wileman says: “Pelvic floor exercises can help, but the most important thing to do is to seek medical advice. Speak to a nurse or GP, and do not suffer in silence.”
Specialist pelvic physiotherapists, such as Robson and Emma Brockwell (AKA @Physiomum), are clear that though there are lots of inventive gadgets, including pads, devices and postnatal exercise regimes available, it is important to make sure you are using the right equipment for your specific issues. So do get someone qualified to check you out.
Beyond the physical it is also worth remembering broken minds are as important as broken bladders. Having a tricky-to-talk-about health problem can be hard going – especially if there is a lot of silence or nobody has said there is help out there.
If incontinent people got together, we’d be the third largest nation on Earth, so if you are reading this and worrying about leaking, please remember: You really aren’t alone. And the more we smash the stigma the better we can all feel.
So take care. Squeeze well. And find help. You’ll get there. I promise.
Luce Brett is the author of PMSL: Or How I Literally Pissed Myself Laughing and Survived the Last Taboo to Tell the Tale (Bloomsbury, £12.99). Available to buy now
Many women experience light bladder weakness at some point in their lives. By exercising your pelvic floor muscles you can seriously reduce the risk of little leaks. To find out more, search “TENA My Pelvic Floor Fitness app” or visit tena.co.uk/ageless