Female incontinence - the last taboo?
I did a regional radio day this week to raise awareness about what I see as one of the last taboos - incontinence among women. It should have ticked all the boxes - a common problem which may affect as many as one in three women, so relevant to any producer's listeners; new statistics showing how much impact it has on their lives; and good news about effective treatments. Yet while most radio days I do attract up to 25 shows wanting interviews, very few people jumped at the chance to talk about it. Why? Because in an age where celebrities bare their souls, bodies and everything else at the slightest opportunity, nobody seems prepared to put their head above the parapet and admit they have incontinence. And as long as that goes on, a huge proportion of the 12 million women affected will continue to suffer in silence.
The most common cause of incontinence among women is stress incontinence, where you lose urine when the pressure inside your abdomen goes up, because your pelvic floor isn't strong enough to keep the bladder opening closed. Coughing, laughing, sneezing, running or even having sex can cause you to leak. The second most common kind, urge incontinence, is caused by a mismatch of the messages between nerves and the bladder muscle, making the bladder oversensitive and causing it to contract at unpredictable moments.
A new survey of women suffering from incontinence shows just how much impact it's having on lives across the country. Almost two thirds of women feel embarrassed, anxious or nervous most of the time; 70% worry that they might smell; 60% say it affects their sleep and more than a third admit that it has caused relationship problems with their partner.
With so many women too mortified even to think about it, most don't seek help from their GP and two thirds aren't using products designed to help with sensitive bladder, through embarrassment, lack of clarity on which products work best or lack of satisfaction with the products they have used. Over half 'make do' with sanitary products, which aren't designed to prevent urinary leakage and smell, or just regular changes of clothes.
Then there's the vicious cycle. While there are lots of women suffering from stress incontinence who aren't overweight, increasing weight does tend to make stress incontinence worse. Hardly surprisingly, 43% of sufferers found that exercising made their symptoms worse - but worryingly, almost one in five of them had given up exercising completely as a result. With so much evidence of the importance of regular exercise not only on general health but on keeping weight within a healthy range, there's little doubt that feeling unable to exercise would contribute to a vicious cycle of increasing weight and worsening symptoms.
The tragedy is that if only they would take the first step to seeking help, there is often a solution. For women with stress incontinence, proper pelvic floor training can cure, or significantly improve the problem in six out of 10 patients. There are many clinics across the country, accessed by direct referral from the GP, where specialist physiotherapists can help with pelvic floor exercises or use a variety of other treatment options. For urge incontinence, medications can be effective or physiotherapists can help you with bladder training where you 'teach' your bladder to hold gradually larger amounts of urine. But to get access to these effective treatments, you need to seek help. And to make sure more women do seek help, we have to break this last taboo.