Urinary incontinence: 7 simple steps for urology awareness

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Urology awareness

It’s hard to believe, but round one in three women over 40 have stress incontinence. Yes ladies, it’s a fact that urinary incontinence becomes increasingly common with age, mainly due to the effects of childbirth and the menopause. The NHS estimates that between 3 and 6 million people in the UK have some degree of urinary incontinence.

 
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Urinary incontinence can be distressing, yet it’s totally treatable. Often the worry of having an embarrassing leak stops women going out or joining in with social or physical activities. Left untreated, it can increase the chance of infections, kidney injury and may lead to depression.

We’ve been advised by women’s health physiotherapists and pelvic floor health campaigners, #pelvicroar, that urinary problems such as incontinence are never normal and women should not suffer in silence.

Understanding the signs and solutions are the first steps to raising awareness of urinary incontinence.

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Know the symptoms of urine infection

Symptoms of a urine infection include

  • a frequent and urgent need to pass urine

  • pain or burning when you pass urine (cystitis)

  • pain in the tummy (abdomen), back or sides

  • blood in the urine

  • a high temperature, chills and feeling sick

Know the causes of incontinence

Incontinence is an uncommon symptom of low sex hormone levels (oestrogen and progesterone.) It is much more likely that there’s another underlying cause, such as a urine infection or swelling caused by friction during sex. But incontinence can sometimes be due to a combination of factors, including low oestrogen levels.

Oestrogen helps to keep the wall of the urethra, (the tube that carries the water we pass, away from the bladder), elastic and the pelvic floor muscles healthy. When oestrogen levels fall, muscles can get weaker and the urethra becomes less elastic, leading to incontinence or infection.

Reduce the risk of incontinence

Simple steps to reduce urinary incontinence

  • drink plenty of fluids (about 2 litres a day)

  • empty your bladder before and after sex

  • reduce vaginal dryness - vaginal dryness can cause irritation in the area of the urethra especially during and after sex. This could increase the risk of infection and pain when passing urine. Check out our symptoms section on Vaginal Dryness for treatment options

(Cranberry juice is thought by many to help reduce the symptoms of cystitis but this is not backed up by research).

What are the treatments for incontinence?

Treatments can include:

  • pelvic floor exercises; you can download apps such as Squeezy App. NHS recommended pelvic floor exercisers include vaginal weights and cones and electronic pelvic toners such as Kegel8 that automatically tone and strengthen the muscles, ligaments and fibres in your pelvic floor.

  • a referral to a women’s health physiotherapist who will carry out an initial assessment and then recommend a personalised treatment place

  • prescription medication

  • vaginal oestrogen

  • in extreme cases surgery.

Research has found that using vaginal oestrogen helps to reduce the need to pass urine often and urgently. It comes in two forms:

  • cream

  • tablet (pessary) that you place in the vagina which gradually dissolves

If you have had a hormone dependent cancer such as breast cancer, Cancer Research UK say they “don’t yet know how safe it is to use vaginal oestrogens. Your body absorbs some oestrogen from vaginal oestrogens but the amount is very small. Research suggests that using vaginal creams or pessaries doesn’t increase oestrogen levels in the blood enough to stimulate breast cancer. More research is needed to find out how safe these products are to use after breast cancer.” (As always, seek medical advice to see what is appropriate for your own situation).

Urinary problems through cancer treatment

Certain cancer treatments lower sex hormone levels in women. Low levels of sex hormones sometimes cause urinary problems in women, including infections and incontinence.

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Increased risk of urine infections?

Some women have an increased risk of developing urinary tract infections (UTI), Cancer Research UK say the number of women who have had breast cancer and then develop UTIs or cystitis, is between 5 and 8 out of 100 (5 to 8%). Women with diabetes, where the bladder doesn’t empty as well as it should, or who have a prolapsed bladder, have a higher risk of developing a UTI.

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Coping with urine problems

Get help from your doctor. Research shows that some women wait up to years before seeking medical help. Whilst some women may feel reluctant to talk about this, in most cases this can be resolved, with the right support.

(As a way of starting the conversation with your doctor, keep a diary for a short period, recording how much fluid you drink, and how often you need to go to the loo).

We give a full explanation of womens continence issues and suggestions to prevent, or improve problems, in our symptoms section

Incontinence.

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