Waterworks
You are probably aware of the problems associated with a ‘weak bladder;’ and the impact this can have upon your life. Did you know that 1 in 3 women suffer from some form of ‘leakage’ or incontinence and this only increases as they get older. Many women don’t seek treatment because they believe it is an inevitable part of having children and they are too embarrassed. Left untreated, however these symptoms can influence the quality of life now and into the future.
Did you know...
60% of women in nursing homes are there because incontinence severely restricts their lives!
There is good news! Any form of leakage is not normal and should not be tolerated. With some simple exercises you can stop the situation from getting any worse and usually stop the symptoms altogether.
It’s important to understand how the waterworks system operates to see how we can improve the problem. Urine is stored in the bladder where it is emptied out through a small tube called the urethra. Urine does not just dribble out; it is pushed out by the bladder muscle.
What you can control are the pelvic floor muscles and the urethral sphincter. The pelvic floor muscles act like a sling supporting the bladder, uterus and bowel. The urethral sphincter is like a draw-string that can tighten to stop urine leaking from the bladder to the urethra, the tube that takes urine through the perineum ( the area between your legs).
Menopause and post-menopause is a time to ensure that:
- If you already have problems with leakage (during laughing, coughing or sneezing) going to the toilet frequently or a feeling of urgency, you do not let them get any worse;
- If you don’t experience any of these problems, you make sure that problems don’t surface in future years.
How do you know if you have a problem?
- If you have any sort of leakage that is not normal;
- You go to the toilet frequently (more than 8 times a day);
- Do you know every ‘ladies’ in town so you won’t get caught out?;
- Do you find yourself going ‘just in case’?;
- Do you often have feeling of urgency – where you feel that if you didn’t go you would wet your pants?
If you’re nodding your head, then chances are you are setting in place patterns that will make the problem worse now and in the future.
So, what can you do?
It depends upon your situation.
- If you do not experience any problems with leakage, frequency or urgency, then include pelvic floor exercises daily;
- If you are experiencing these problems, you will definitely benefit from these exercises. You will also benefit greatly from seeing a qualified physiotherapist or health nurse that specialises in urinary continence (believe me, they do exist).
PELVIC FLOOR EXERCISES
Basic Exercises – these are very important to get into the habit of adopting for a lifetime.
- When you go to the toilet, start to pass urine and then stop midstream by pulling the muscles (pelvic floor muscles) tight and upwards. This is also a good way of identifying these muscles. Start the stream again – and complete the emptying of your bladder.
- Train yourself to brace up before taking the strain! If you are about to cough, laugh, lift, push, sneeze or any action which causes a downward thrust, contract your pelvic floor (as above) and hold lightly until exertion is over.
Exercise program:
- Sit on a hard chair, feet on the floor with thighs and knees apart, lean forward with elbows on knees.
- Pull in the muscle tight and up as if to stop passing urine and at the same time pull in the muscle tight and up the back passage. You should be able to feel the perineum. Move upwards from the chair. Relax.
- Start by doing five of each exercise (2, 3 and 4), increasing by five of each, daily.
- Continue the same exercises in various positions.
- Do them in bed, lying on your back with your knees crooked up.
- Standing, leaning forward from the hips with knees bent and hands flat on a table.
- Kneeling on all fours like a dog.
This is a very important issue for all women, particularly during menopause and beyond. It’s a problem that can cause loss of self-esteem and confidence and really impact on your quality of life. If you are already experiencing leakage of any kind, seek further help. A trained physiotherapist or health nurse can guide you through each step and ensure that you are doing the exercises correctly.
Don’t accept urinary problems as a normal part of a woman's life, because it doesn’t have to be that way. Take control of it.
Source: The Menopause Made Simple Program, Anderson, D.& Graham, V. (2002)
Allen & Unwin, NSW.
Pages 103-107