SINCE I gave birth to my third child, I am struggling with leaking urine when I try to exercise or even cough. I find I am going to the toilet to pass urine more than ever. I sometimes feel that I need to dash to the toilet very quickly or I leak some urine. I am 32 and other than being overweight I am generally fit and active. Is there any advice you can give me?
Dr Louise Newson replies:
Urinary incontinence is a very common problem, especially in women. It means you pass urine when you do not want to – from a small dribble to a large amount.
Some studies have shown that around one in five women have some form of urinary incontinence.
It sounds as if you have a combination of stress and urge incontinence. Stress incontinence is usually caused by a weakness in your pelvic floor muscles. In situations when there is more pressure on your bladder (eg when you cough or sneeze) then these muscles are unable to hold the urine in your bladder. Stress incontinence is more common in women who have had several children. It is also more common in women who are overweight and its incidence also increases as you get older.
Urge incontinence is when you have an urgent desire to pass urine and if you do not get to the toilet in time you may leak some.
The most common reason women have this type of incontinence is having an overactive bladder in which your bladder becomes irritable and then needs to empty before it is full.
There are various effective treatments for both stress and urge incontinence. Pelvic floor exercises can be very beneficial for women with stress incontinence.
Lifestyle changes can also really help. These include reducing the amount of caffeine you drink (ie tea, coffee, cola, hot chocolate), trying to drink less fluids in the evening and losing some weight. Having a healthy diet which is high in fibre is also advisable to avoid constipation, which can actually worsen incontinence. Although some women try to restrict the amount of fluids they drink in the day, if you do this too much your urine becomes concentrated which irritates your bladder more.
There are lots of different tablets to improve symptoms of incontinence. If these do not work then some women benefit from surgery.
This would aim to tighten or support the muscles and structures below your bladder. For more information go to www.patient.co.uk