Millions of women experience stress incontinence and while the problem is known to increase with age, many young women suffer too. They have the additional stress of the stigma around incontinence and the fact that it is generally perceived as an older woman’s problem. It’s no wonder most feel too ashamed or shy to talk about it.
The definition of incontinence is “having no control over urination or defecation”.
We are born without control and much is made of “potty training” so that we can wee and poo on demand and be weaned out of nappies. This may explain the roots of the humiliation attached to the involuntary loss of control. But with many studies reporting the prevalence of stress incontinence as one in four of young female adults, the problem is as huge as it is hidden.
Would an average schoolgirl tell her friends that she wets her panties on the trampoline? How about a sexually-active young lady in her 20s working her way up the corporate ladder? Would she tell her friends the real reason why she doesn’t drink much when she is out with them? And how freely can she talk to her boyfriend about the little leakage during intercourse?
Related factors to stress incontinence
- Genetic factors
- Heavy physical work
- High impact physical training – although other forms of exercise have been shown to protect against or lessen the symptoms of stress incontinence
The relationship between pregnancy and childbirth remain controversial but let’s put this aside a moment and consider the list above – what here explains the occurrence of stress incontinence in teenage girls and young women? Any ideas as to what is missing?
Pelvic floor – supportive function
Also known as effort incontinence, stress incontinence is essentially a functional problem where the pelvic floor muscles fail to provide adequate support for the bladder. The result is the leakage of small amounts of urine during activities which increase abdominal pressure such as laughing or even shouting, lifting and running.
Think of the bladder like an upside down balloon. From being empty, it gradually fills with urine which filters down from the kidneys – here it is stored until we empty the bladder again.
When the bladder is full any physical activity or exertion will require the supporting structures to work harder. They have to support the body of the bladder as well as the sphincter (circular muscle) at the base of the bladder that relaxes open to let the urine flow out.
Additional factors in stress incontinence
- Posture: Most of us have a default posture, one we tend to adopt unconsciously. In general, those who stand with their bottom tucked under – butt grippers – will tend to have a tight pelvic floor and those who stand with an exaggerated arch in their low back will have a stretched and therefore weak pelvic floor.
- Dysfunctional Breathing or Breathing Pattern Disorders: Poor breathing patterns such as chronic breath holding have been shown to create problems not just for the diaphragm but also the pelvic floor.
- Stress-related postural changes:Compare how you stand when you are anxious or irritated compared to happy and relaxed!
- Stress-related physiological changes – the stress hormones affect our heart rate and how we breathe
- Abdominal pain e.g. Period pain: Pain has been shown to “switches off” our postural muscles including the pelvic floor
- Back pain: Like abdominal pain, switches off the postural muscles
Yoga and the pelvic floor
Yoga and similar practices are a wonderful way to address these additional factors. They can teach you how to become aware of physical tension in your body, specific techniques promoting a letting-go as well as breathing techniques that leave you feeling relaxed and often revitalised. With regular practice these can help re-establish and maintain a normal, healthy and functional pelvic floor.
We also recommend using the Buttafly in supine to help the spine unwind from its habitual postural patterns – ideally prior to yoga or your rehabilitation exercises. In our experience this exercise alone can help you feel calm and centred.
Seek help early
Stress incontinence is a distressing problem that has a profound impact on a woman’s quality of life regardless of her age.
Left untreated the early symptoms of occasional leakage, just a few drops here and there, can progress all too quickly.
The more opportunities we can create to talk about the pelvic floor in general, as just another group of muscles, the more women, young and old can feel confident about what is “normal” – and comfortable enough to seek the help they need.
Ideally this will include an assessment by a specialised women’s health physical therapist to establish the cause(s) of the problem as well as to provide appropriate treatment and advice.