WHAT’S
YOU R T Y PE?
‘There are two main types of bladder
weakness,’ says Elaine. ‘One is stress
incontinence, caused by weak pelvic
floor muscles where you may leak
when you lift, run, jump, cough, laugh
or sneeze, while the other is called
urge incontinence where, as well as
leaking, you also have an intense
urge to urinate.’ Bladder weakness
may occur after childbirth
(through stretching or
damage to the muscles and
ligaments that support the
pelvic floor), menopause
(oestrogen loss weakens
muscles), damage to the
bladder, as well as some
neurological conditions
(such as multiple sclerosis).
WHY YOU NEED
TO SEEK HELP
‘They may not be life-threatening, but
research shows that bladder problems
can have a profound emotional impact
on your life,’ says Dr Megan Arroll,
who is the co-author of What’s Up
With Your Bladder? (Hammersmith
Health Books). ‘There is still a lot of
stigma attached to incontinence, and
many women associate it with a loss
of dignity.’
Don’t let embarrassment stop you
from talking to your GP – you might
also benefit from counselling or
CBT (cognitive behavioural
therapy), alongside the
correct treatment for
your specific condition.
Urgently need to go?
‘Overactive bladder (OAB)
is where you feel an urgent
need to go to the toilet more
than eight times a day,’ says
Elaine. ‘Often it’s to do with
feeling anxious about having an
accident, so you start to go to the toilet
more often. After a while, your bladder
capacity reduces and the bladder
muscle becomes overactive and
contracts when you don’t want it to.’
Ask your GP for possible medication
options and to refer you to a pelvic-
physiotherapist for bladder training.
IS YOUR DIET
MAKINg IT WORSE?‘You may find that certain types of food
and drink can make symptoms worse,’
says Dr Arroll. Keep a diet diary to help
you notice any correlation between foods
and symptoms. Spicy food, acidic fruit
like citrus, caffeine and fizzy water have
been found to make symptoms worse.ARE YOU UP
ALL NIgHT?‘While we sleep, our bodies
produce an antidiuretic
hormone (ADH),’ says
Elaine. ‘This allows you to
retain more fluid during the
night. If levels of ADH are
low at night, you may find
yourself waking up to go to
the bathroom. Once a night is considered
normal. Needing to go more than twice is
called nocturia.’ Sound like you? Consult
your GP – apart from causing sleep loss,
nocturia may also be a symptom of
bladder prolapse, diabetes, heart- or
even liver problems.WH AT YOU R
DOCTOR WILL TEST‘It’s important to know what’s wrong,
as it could get worse, or require medical
treatment,’ says Dr Mel Wynne-Jones.
‘You’ll need a tummy and internal
(pelvic) examination. Your
doctor will test your urine
for infection, blood,
diabetes, and kidney
damage, and perhaps
take blood for tests. She
may ask you to measure
how much urine you pass/
leak and how often to see
how your bladder behaves,
arrange an ultrasound scan, or
refer you to a specialist for a cystoscopy
( bladder telescope examination) or
X-rays to measure urine flow.’THE NExT STEPS
If you have severe pelvic floor weakness,
surgery may be needed. ‘The urologist orgynaecologist can explain the pros and cons
of different operations for your particular
situation,’ explains Dr Wynne-Jones. ‘An
overactive bladder often improves with
bladder training (learning to “hold” on
for longer) or medication to stabilise your
detrusor muscle (you may need to try more
than one brand). Oestrogen cream used in
the vagina or HRT medication can remedy
hormone deficiency.’ But even if urinary
incontinence can’t be cured, your doctor
can provide lots of advice and practical
aids/support to help you cope.COULD SURgERY
H EL P YOU?Bulking agents can be used to improve
closure of the urethra in the case of stress
incontinence. To treat urge incontinence,
Botox can be injected into the bladder walls
to help stabilise muscle contraction. But it
all depends on the type and severity of
incontinence suffered so it’s important
to consult a doctor about your
specific symptoms and needs.heaLTh | report
did you
know?
women are twice
as likely as men to
suffer from some
form of bladder
complaint.‘Bladder
problems have
an emotional
impact on
sufferers’
THE 5-MIN FIx
Pelvic floor exercises can help
strengthen weak muscles that lead
to urinary incontinence – you should
see results within three months.- Lie down on your back on a firm,
flat surface. - Squeeze the muscles you use to
stop urine flow for two seconds, then
relax for another two seconds. - repeat 10-15 times a session,
at least three times a day. - each week, add one second,
until you are able to squeeze for
10 seconds.
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