#WeNeedToTalkAbout is a series by Clio aimed at breaking unnecessary taboos around women's health. This month's featured article about incontinence is by Melissa, a physical therapist passionate about women's pelvic health.

One in four women is affected by incontinence, and yet most of us wait an average of seven years to seek help for our condition. If you are that unlucky woman wetting her pants like I was, you likely understand it is not JUST about wetting your pants. Incontinence effects your social life, mental health and your sex life.

I know, I know; women who pee their pants tend to be humbled by it and may even develop a self-deprecating sense of humor about it. I’ve been part of many conversations that begin something like, “I was jumping on the trampoline with my kids when pee started streaming down my leg,” or “I can’t run anymore without peeing my pants.” You know what I am talking about, ladies. If you haven’t been the one saying it, you’ve heard your friends talking about it.  And, as enticing as it may be to laugh it off or try to ignore it, I encourage you to get help. The sooner you get help, the better chance you have to recover—and, bonus!  You will likely have more pleasure with sex!

My goal is to educate and empower women to take control of their pelvic health, and I don’t mean by putting a pad in your pants or going to the doctor to get a bottle of pills. The market for incontinence pads is approximately $10 Billion, and the National Library of Medicine predicts that incontinence drug spend will reach $4.9 Billion in 2020, despite the low efficacy rates and SAEs (significant adverse effects).  I would also love to save you some money on pads and pills.

My hope is that by women understanding their bodies better they can avoid developing incontinence or pelvic pain or at the very least learn how to train their pelvic floor muscles to recover from incontinence. 

What is Incontinence? 

There are three common types of incontinence: stress incontinence, urge incontinence (also referred to as overactive bladder or OAB) and mixed incontinence, which as you might have guessed, is a mix of stress and urge incontinence.

Stress incontinence is leaking while doing activities such as jumping, running, coughing and sneezing. This type of incontinence is often the result of an injury while giving birth. Urge incontinence is just like it sounds; you feel a strong urge to go to the bathroom, and can’t control urine from escaping before you reach the toilet. Mixed incontinence is a combination of these two things.

Causes of Incontinence

There are many causes of incontinence, the most common include pregnancy, childbirth and hormonal changes resulting from menopause. During pregnancy, the weight of the baby can put stress on the bladder and cause leakage. The process of childbirth can stretch or injure the pelvic floor muscles. The decrease in estrogen production during menopause can weaken the bladder and pelvic floor. Other causes of incontinence include bladder irritants, as well as certain medications and infections, such as urinary tract infections.

Risk Factors

Women are more likely than men to develop incontinence. Prevalence is significantly less in men with studies indicating anywhere from 3-11% of the male population with urge being the predominant symptom. Advanced age is another significant risk factor; the incidence of incontinence goes up to 50% for postmenopausal women.  Smoking, being overweight and family history are some of the other risk factors.

Managing Incontinence

Patients can manage their incontinence in many ways, including surgery, pharmaceuticals, pessaries (prosthetic device), incontinence pads, diet and fluid management. But in many cases women can improve their incontinence through exercise and retraining the pelvic floor muscles to work like they should. Most of us have heard of Kegel exercises. Maybe you have been told by your doctor to do Kegel exercises at home. For many of us with incontinence, it is not enough to just go and do our Kegel exercises. If you are able to perform a Kegel exercise that is great; keep up the good work. But if you are one of the folks who have tried with little to no success, do not lose hope! 

Stay Tuned, Ladies!

Please stay tuned for a more detailed approach to managing your incontinence and pelvic pain. In future articles I will help you learn how to re-train your pelvic floor muscles to perform like a rock star and enjoy better sex. I also hope you learn how to strengthen your core the easy way and how to avoid bladder irritation without giving up your favorite foods and drinks.  In addition, I will give you great tips on how to keep your vagina safe while going to the bathroom, and many other things you you didn’t know about your pelvis! (I would be remiss if I made it through the writing of this article without mentioning the very important vagina, and its connection to maintaining good pelvic health.)

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Written by:
Melissa E.
Melissa is a writer and physical therapist, with a focus on women’s health and pilates. She lives in Minneapolis, Minnesota with her husband, three teenagers, one sheepadoodle and two chickens. During evenings and weekends, Melissa may be found at the ice rink or basketball court, watching her children play sports. In the off-chance she has some time to herself, she enjoys running, walking the dog, and sharing the remote and a bowl of popcorn with her teens.