Don’t let a weak bladder stop you doing the things you love

As a continence nurse specialist, I’ve seen firsthand how overwhelming and upsetting incontinence can be. Patients visit me when things have gone too far – their behaviours change and they’re suddenly avoiding activities such as playing tennis, having sex or even going to the cinema because they’re worried about having to race to the toilet. When you start avoiding things you enjoy, it’s time to take action.

Urinary incontinence usually affects women (up to 45% of us) after childbirth, or during the menopause. Other factors include obesity, bladder surgery, hysterectomy or neurological conditions such as Parkinson’s disease or multiple sclerosis. It’s not just older people affected, either – even athletes are prone to incontinence. A Scandinavian study states that up to 80% of professional female trampolinists experience leakage. Men who have undergone surgery to treat prostate cancer can suffer, too.

Of course, leakage can be troubling at any moment, but during sex it’s particularly distressing (it tends to happen during an orgasm or because of the physical pressure). But the good news is, it doesn’t mean the end of your sex life. In fact, patients always say they wish they’d sought treatment sooner. Even if you don’t experience leakage, sexual sensation and satisfaction can be improved, too – and who wouldn’t want that? As well as increasing blood supply to the vagina and penis, pelvic floor muscle training (or “kegels”, as they’re also known), can improve muscle tone and maintain nerve activity, meaning better sex.

When it comes to treatment for accidental leakage, it depends on the type of incontinence people are dealing with. “Stress incontinence” is when we suffer leakage while doing things such as sneezing, coughing or laughing, and it’s common for women to experience this after having a baby, when the pelvic floor is weakest. Leaking during sports or sex falls under this category, due to weakened pelvic floor muscles. The other common type is an overactive bladder, or “urge incontinence”, which feels like you have to urinate suddenly and often.

Pelvic floor exercises can help in both instances, but it’s really important to make sure you’re doing them properly – speak to a women’s health physiotherapist or a continence specialist if unsure. They’re simple – just squeeze, lift and hold the anus and vagina, count to five and repeat five times. Improvement is fast – you’ll notice a change in six weeks if you do them regularly. There’s also a brilliant app called MyPFF, which reminds you to do your exercises.

Related: Peeing during sex? You're not alone. Here's what to do about it

If an overactive bladder is the problem, lifestyle changes are key – symptoms can be worsened by too much caffeine, alcohol, fizzy drinks, spicy foods and stress, for example. Certain medications can also play a part, as well as conditions such as constipation, urinary tract infections and vaginal atrophy. Bladder retraining is great – when you have an urge to pee, you teach yourself to hang on, which slowly expands your bladder capacity. It might also be worth avoiding high-impact sports until your pelvic floor is stronger, since too much exercise can make things worse. Medication and surgery could be considered with a specialist, too.

I definitely sense a change coming in the way we discuss women’s health issues and incontinence, and it’s great the conversation is becoming more open. There shouldn’t be any shame or stigma around it any more – this sort of condition affects so many of us. I hope people realise improvement is possible and that once the issue is tackled, it really can be life-changing. Recently, a woman visited me in my clinic and said that just having a treatment plan in place has made her feel better. It really is the very least we deserve.

As incontinence affects one in three women over 35, we should all be having more open conversations about this everyday condition that impacts women of all ages. Find out more at tena.co.uk/ageless