Treating Bladder Problems, Empowering Women

Bladder leakage is a significant problem for Australian women and is an issue that needs to be taken more seriously.  It is more common than you may think and the impact of it can have a ripple effect through many aspects of a woman’s life and her sense of wellbeing.  There are over 5 million Australians who experience bladder leakage and 80% of these are women.  Urinary incontinence also affects 1 in 3 women who have ever had a baby.   The physical, emotional and social impact that this can have on a woman’s life cannot be underestimated.  Whilst bladder leakage is very common, it is also very treatable - pelvic floor muscle training is the number one recommended treatment world-wide¹.

 

We often assume bladder problems only effect women who have given birth or gone through menopause.  Yes, these are the two most common times a woman will experience these symptoms, however it is also extremely common in women who exercise - including those who haven’t had children.  It is particularly common in women who do sports involving running and jumping such as netball, high intensity gym training, and high impact sports, including 50% of tennis players and 62% of long distance runners!

 

With the rise of females in community sport, particularly with the popularity of the AFLW, we are hearing more and more about how widespread bladder problems and other pelvic floor issues are in our community.  However, we don’t want people just to put up with it!  

 

No Amount Of Bladder Leakage Is Normal

There are different types of bladder leakage.  Some people will leak when they cough, sneeze, jump or laugh.  This is known as Stress Urinary Incontinence.  Others will leak when they feel an overwhelming urge to go to the toilet that they can’t hold on to.  This is known as Urge Urinary Incontinence.  Some people can have a combination of both types of incontinence.  For all types, the amount of leakage can vary greatly, with some leaking a drop or two, others a spurt and some may lose complete control.  Regardless of whether it is a drop of urine or a complete flood, no amount of bladder leakage is normal. 

Exercise is medicine.  Research tells us that the effect of exercise on our physical and emotional health is profound.  This is why we need to acknowledge and promote the fact that bladder issues do impact our ability to experience the benefits of exercise.

 

A study in Norway reported that bladder leakage was the cause of two out of three women dropping out of exercise².  An Australian study also found that urinary incontinence was the number one barrier preventing women participating in exercise³.  Although bladder leakage itself is not a life-threatening condition, being sedentary is a known risk factor for many chronic health conditions, such as heart disease, diabetes and cancer.  If bladder problems are stopping women from exercising, then this becomes a more significant health issue. 

 

The Emotional Toll Of Bladder Leakage

Can you imagine if you loved going for a run with your friend every morning but this started to cause you to leak?  You might feel embarrassed and ashamed and eventually stop doing this morning ritual that used to bring you joy.  Not only does this have impacts on your physical health and fitness, but it may also impact your mood and emotional health as well as reducing your opportunity for social engagement. 

We also often hear how bladder leakage can cause women to withdraw from intimacy.  It can also reduce self-esteem and confidence to leave the house or be around other people.  The emotional toll can be far reaching and more significant than many people may realise. 

The good news is, bladder leakage is treatable and reversible.  Pelvic floor muscle training (PFMT) is the number one treatment recommended world-wide for bladder leakage¹.  Experts have proven that it is the first treatment option that should be offered to women (ie before medication or surgery).  PFMT works by improving the strength and control of the pelvic floor muscles and sphincters around the base of the bladder, and by improving support of the urethra and bladder.  For people who have to rush to the toilet or have trouble getting there in time, pelvic floor contractions can help calm the bladder and control strong urges².   However, for pelvic floor exercises to work, you need to have:

·       the RIGHT TECHNIQUE: 1 in 2 women are often doing the wrong thing!  An assessment with a Pelvic Health Physiotherapist is important to ensure that you are contracting your pelvic floor muscles correctly.

·       the RIGHT INTENSITY:  you need to be working your muscles hard enough to achieve an improvement in muscle physiology and function

·       the RIGHT AMOUNT OF EXERCISE: your exercise program needs to be progressed over time and include functional training during situations when each woman experiences her symptoms (eg learning how to automatically contract PFM whilst coughing or jumping). 

·       the RIGHT LENGTH OF TIME: best results are often seen after 4-6 months of supervised training under the guidance of a Pelvic Floor Physiotherapist.  

Women with bladder problems are too often told to ‘wear a pad and learn to live with it’, however this is not the only solution!  We need to empower women to stay active, healthy and live their best life, and for many, improving bladder control can be a key ingredient that enables them to do this.   

1. Milson I, Altman D, Cartwright R, Lapitan MC, Nelson R, Sjostrom S.  Epidemiology Of Urinary Incontinence (UI) and Other Lower Urinary Tract Symptoms (LUTS), Pelvic Organ Prolapse (POP) and Anal Incontinence (AI).  7th International Consultation of Incontinence 2023

2. Brown, W. & Miller, Y. (2001). Too wet to exercise? Leaking urine as a barrier to physical activity in women. Journal of Science and Medicine in Sport, 4(4), 373-378.

3.  Dakic JG, Cook J, Hay-Smith J, Lin K-Y and Frawley H.  Pelvic floor disorders stop women exercising: A survery of 4556 symptomatic women.  J Sci Med Sport. 2021; 24(12): 1211-1217.

 

June 2023