Why your urinary incontinence is a condition that's both common and treatable
Liz Connor speaks to TV's Dr Dawn Harper about the health issue, and what you can do to help beat it
It affects more Brits than hay fever, yet you're far less likely to hear your friends bring this condition up over brunch or coffee. We're talking about urinary incontinence, which is believed to affect around 14 million people in the UK, in some form or other.
Despite this, a new survey by Boots Staydry reveals there's still a huge taboo around the topic - and it's having a significant effect on people's lives and confidence levels.
In a poll of 1,000 women living with bladder and incontinence issues, 79% said they avoid enjoyable activities for fear of wetting themselves, while more than a third don't talk to anyone about the condition, so are currently not getting the support they need to help them enjoy life to the full again.
However, they're by no means alone. Urinary incontinence is one of the most common health conditions GPs get asked about, while celebrities like Kris Jenner and Katy Perry have spoken openly out about their experiences with it.
"I've always been a champion of eliminating stigmas associated with so-called 'embarrassing' health conditions, and this is one that I am keen to bring into the open," says Dr Dawn Harper, from TV's Embarrassing Bodies.
"As a GP, I know just how common this condition is in women, especially after childbirth, which causes a weakened pelvic floor, and the impact that it can have on their confidence is huge. Women tend to feel embarrassed and become isolated as they keep it a secret, instead of talking with their friends and loved ones. If they did start sharing, they would probably find many of their peers are experiencing similar symptoms."
Here, Harper talks about the causes and treatments of urinary incontinence and why women shouldn't ever feel embarrassed to talk to their doctor about it...
What are the causes of urinary incontinence?
"There are two main types of incontinence. Stress incontinence and urge incontinence," Harper explains.
"The first is generally more common in women than it is in men, particularly after childbirth, where a woman may have stretched their pelvic floor muscles."
Harper explains this is the type of incontinence you get when you cough, sneeze, run or jump, although for some, reaching up to get something off the top shelf might be enough strain for their pelvic floor.
"The other really common form of incontinence is something called 'an overactive bladder', or a sensitive bladder," she adds, explaining that people with an overactive bladder feel like they need to go to the toilet right away when they feel the urge to pee.
"I've had patients who only leave the house when they know exactly where every toilet is, so they know they can comfortably get around," says Harper.
While many people experience just one type or the other, Harper says it's also possible to experience both stress and urge incontinence together.
Other causes include a blockage or obstruction of your bladder, where your bladder may fill up as usual, but as it's obstructed, you won't be able to empty it completely. You can also get incontinence secondary to nerve damage and conditions like MS.
What can you do about it?
"The first thing to do is to ask yourself what sort of incontinence you think you have," says Harper.
If you aren't sure, a GP can sometimes do tests to help confirm, but if you're someone who leaks during activity, it's likely to be stress incontinence. If this is the case, Harper says the first course of treatment is pelvic floor exercises, to help strengthen the muscles around your bladder, vagina and back passage.
"Three-quarters of ladies who have stress incontinence can actually improve, if not cure, their condition with pelvic floor exercises alone. I usually refer patients to an incontinence specialist or a physio with a special interest, where they can learn to do the exercises correctly," she adds.
"I've had some women who religiously do their pelvic floor exercises, but aren't doing them correctly, so they're making matters worse.
"I would encourage anyone to go and have at least one session, to make sure that they know exactly what they're doing."
If you're not sure how to properly exercise, the NHS has an information page on its website (visit www.nhs.uk and search for 'pelvic floor exercises').
What else can help?
For any form of incontinence problem, Harper says losing weight (if you are overweight) can help, as it takes some of the pressure of the bladder. It's also important to stay hydrated.
"If you have an urge problem, the tendency can be to cut back on drinking water, and that might seem logical, but actually it reduces your bladder's capacity, so you can actually make things worse," says Harper. "I would encourage people to drink enough to keep their urine straw-coloured.
"Unfortunately, alcohol, caffeine and fizzy drinks can irritate the bladder, so cutting back on those might be useful. Smoking also causes the bladder to be more sensitive, so if you've got urge problems, I would encourage you to try to give up smoking - or certainly cut back."
Harper also advises those experiencing urge incontinence to try bladder training, where you teach your body to hold more urine. When you feel the urge to pass urine, don't immediately go; instead, try to distract yourself for five to 15 minutes from the time you get the first urge.
"Ultimately, we have medicines, too," says Harper. "There are prescriptions that GPs can offer to treat both forms of incontinence, and there are now a whole host of different operations. If we've tried lifestyle measures and a patient is a healthy weight and has tried bladder retraining and dietary measures, then it's something that can be explored."
Why does it still cause so much embarrassment?
"Women are much more comfortable talking about their sex lives and their periods - and I think it's partly because virtually all women have periods and most of us have sex. It's normalised," says Harper.
"I think there is a perception that incontinence problems are the domain of the elderly, so if you're struggling as a younger woman, then you likely feel like you're on your own.
"There's an awful lot of misinformation out there, because I see lots of teenagers and very savvy women in their 20s, 30s and 40s who are suffering with incontinence; it's a very common problem that can affect all ages."
Harper's advice for any woman suffering in silence is to speak to your GP, as there are lots of options available.
"There's so much we can do to help, but we need to know it's a problem before we can.
"Boots Staydry (www.boots.com/staydry) also have a careline (0800 0723 899), which is manned by fully-trained experts, who can give you advice on lifestyle measure, and perhaps, the confidence to go and speak to your doctor."