Is enduring urinary incontinence the price women must pay to avoid social shame? Bladder leakage is such a taboo that women will suffer the consequences for an average of seven years before seeking help. Embarrassment, feelings of being broken or alone, and doubts about the legitimacy of the problem can all be barriers to getting the appropriate support. The good news is, the conversation around urinary incontinence in women has begun and is picking up pace.
Anya Hayes is a Pilates instructor who works with Pelvic Floor Patrol in the U.K. She explains, “It feels less challenging for women to approach me than it is for them to approach their doctor. My classes are safe spaces where I talk about the pelvic floor a lot, but still, women will wait and talk to me afterward, worrying that it’s ‘too much information’ to share.”
“One [woman] told me she’d suffered incontinence for 30 years after having children and thought it was just something she had to deal with. There’s a real lack of awareness and understanding, and I believe pelvic health should be discussed openly from the time of puberty. That way we can tackle root causes like posture and breathing patterns.”
Changing the Urinary Incontinence Narrative
It doesn’t help, however, that many women believe pelvic floor exercises are one more thing they have to do to stay in shape, says Anya. “This isn’t as sexy as toning muscles you can see in the gym. Engaging the pelvic floors does recruit the lower abdominal muscles, which leads to a toned tummy, but this feels like yet another toxic message.”
The aim is to tackle the toxicity of cultural messages that tell us we should be tiny and toned. We must also challenge the false information we’re fed about the importance of having a super tight vagina. “Pelvic floor muscles that are hypertonic are as damaging as muscles that are too weak,” Anya adds.
“We’re conditioned to not let go, but anxiety has been linked to pelvic floor hypertonicity. We need to know what it feels like to relax. If the diaphragm and pelvic muscles are in sync as you breathe, it activates your parasympathetic nervous system—or the rest and digest system.”
This is all the more important for women who experience urge incontinence post birth since they’re more likely to suffer from postnatal depression—but if they don’t know where to turn for help, how can they possibly relax?
Laughing About Leaking
“There seems to be a twofold reaction to incontinence,” says Anya, “Ignore it and suffer in silence or make inappropriate jokes about it on social media. Neither of these options benefits women. Mocking those ‘oops’ moments misses the point.” Yet humor based on empathy can serve to create much-needed support networks.
Elaine Miller is a pelvic floor physiotherapist who wrote a comedy show called Gusset Grippers. It was a sell-out at the Edinburgh Festival in 2018 and challenged the taboos and myths that surround incontinence in women. She’s acutely aware, however, that this kind of comedy walks a fine line.
“A woman told me that she’d wet herself in front of her neighbor and I knew I could use the story as material, but not in a way that shamed her. I use humor to explain how the pelvic floor works and the joke is always on me.”
“When someone’s bladder leaks, they’re reminded of being a child who wets themselves in front of the whole class. We can forgive this in very young people, but it’s not socially acceptable for adults to do the same. There’s something visceral about our need to be clean and dry, that’s why women with incontinence feel incredibly vulnerable.” They also feel isolated.
When it Comes to Urinary Incontinence in Women, Know You’re Not Alone
“A man approached me after the show to say he didn’t get the joke about panty liners,” Elaine adds. “But this was useful feedback since women really do feel alone in their experience of incontinence. That’s why I use comedy to bring us together and encourage those suffering to reach out for help.”
The Australian Continence Foundation carried out a study in 2010 that said just six pelvic physiotherapy sessions could cure up to 84 percent of stress incontinence. Yet only a quarter of women will actually turn to a physiotherapist in the first instance, choosing instead to do nothing or approach fitness professionals like Anya.
“This is due to the myth that it’s normal to experience incontinence after birth so it doesn’t feel like a real problem,” Elaine explains, “but no leaking is ever normal and you don’t have to put up with it. All it takes is the smallest tweak to change a woman’s life. What’s more, nearly a third of women I treat only have one appointment. All they needed was some education and reassurance that they’re not alone.”
Featured image by Johnny McClung
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