Four Myths About Incontinence
Around 50 per cent of women will suffer some degree of incontinence in their lives, but few of us ever talk about it. And while there is still a lot to discover about the condition – a recently-published study found that women with urinary incontinence have different urinary microbiomes compared with continent women – too many of us don’t understand the basics. This is not something you need to live with: there are many successful treatments and seeking help is the first step to a better quality of life.
Tonic asked Dr Caroline Dowling, clinical director of the Urology Unit at Eastern Health, Melbourne, to clear up some of the most common myths around incontinence.
Myth Only women who have given birth experience incontinence
Stress incontinence – leaking when you cough, run or jump – is caused by the weakening of the supportive tissues around your urethra (the tube that empties urine from the bladder). While stress incontinence is associated with childbirth, it is not just vaginal delivery that puts you at risk. A New Zealand study has shown that while a caesarean birth might reduce your risk of severe bladder control problems from 10 per cent to 5 per cent, things even up after multiple caesareans. A second type of incontinence, urge incontinence, occurs when the bladder is overactive. This common condition is often more distressing than stress incontinence, because it causes a strong urge to pee at unpredictable times. The link between urge incontinence and childbirth is less clear.
Myth Waking up to pee in the night is perfectly normal
If you are over 50, waking up to pee once a night is normal – but waking up more often is not. It’s important to realise that the problem may not be your bladder capacity. There can be other causes, linked to how your heart and brain work to process fluid through your kidneys. If this is worrying you, keep a bladder diary for a few days and take it to your doctor to discuss possible causes.
Myth My weight has nothing to do with it
Unfortunately, bladder leakage can be added to the list of conditions, from high blood pressure to diabetes, that is exacerbated by carrying extra weight. A study published in the New England Journal of Medicine in 2009 found that losing 7.8 kilograms can decrease incontinence by a whopping 47 per cent.
Truth Menopause can make it worse
There is a definite link between declining oestrogen levels – a natural process associated with menopause – and pelvic floor disorders such as incontinence, which may be explained by the number of oestrogen receptors in the urogenital tract. What has not yet been determined is the respective roles of oestrogen levels and other age-related tissue changes. Many women find their menopausal symptoms improve with oestrogen-replacement therapies such as vaginal creams and pessaries.
Myth Orgasms can fix the problem
Yes, the pelvic floor contractions that occur during orgasm exercise your pelvic floor, but not enough to have any lasting effect. For that, you need to practise Kegels, pelvic floor exercises which are often recommended to women post-childbirth. It is also worth noting that a weak pelvic floor is associated with lower levels of arousal and poorer sexual function. Pelvic floor exercises improve blood circulation in your vagina and pelvic floor, which can help increase sexual arousal and make it easier for you to reach orgasm. Pelvic floor exercises and rehabilitation are important and successful treatments for both stress and urge incontinence.
If you want to talk about incontinence consult with you doctor, phone the National Continence Helpline on 1800 33 00 66 or go to continence.org.au
Words_ Patricia Sheahan
Photo_ Mitchell Luo/UnSplash