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Written by: Kathryn Danzey

If you leak when you cough, laugh, sneeze or exercise, you may have STRESS INCONTINENCE caused by weak pelvic floor muscles. Pelvic floor exercises to strengthen the muscle that controls the flow of urine – the pelvic floor may help you.

To do this:

1. Sit well back on a hard chair with thighs and feet well supported.

2. Imagine you are trying to stop yourself from passing wind. Feel the muscles around your back passage tighten. They should be moving inwards and upwards away from the hard chair. Let them relax and try again a few times to get the feel of them moving. Remember, your buttocks and abdominal muscles should be relaxed at the time.

3. The next step is to imagine you are sitting on the toilet passing urine and you want to stop the flow. Try really hard by pulling up with your muscles. You will be using the same muscles as in the first exercise but the movement will feel further forwards and will probably be a lot more difficult.

4. Now try to tighten at the front and back at the same time.

Once you are able to tighten your pelvic floor, continue to do the exercises as follows:

• Count to ten: Tighten your pelvic floor muscles slowly and hold whilst counting to ten. Let go and repeat five times. This is a slow pull-up. The exercise helps to improve the overall support provided by the pelvic floor muscles.

• Rapid-sequence: Now tighten your pelvic floor muscles as fast you can. Let go and repeat ten times. These are fast pull-ups. As your muscles become stronger you will be able to do more.

• Ten times every day do five “count-to-tens” and five “rapid-sequences”. As your muscles become stronger you will be able to do more.

Try doing the exercises whilst sitting and standing as you become more confident. It may be several months before you notice results – persevere!

TIP: Tighten your pelvic floor muscles before you LIFT, COUGH, SNEEZE or STAND UP.

More advanced exercises may be supervised by trained physiotherapists, including cone therapy, electrostimulation and biofeedback.

Urgency and urge incontinence

If you feel a frequent urge to go to the toilet or cannot always hold on until you get there, bladder retraining may help you. The purpose of the programme is to exercise and stretch the bladder so that it is capable of holding its full capacity.

• Record (on a chart if possible) when you go the toilet for 3-5 days to give you some basic information

• Hold on when you feel that urge to go and delay your visit to the toilet, even by a few minutes. Here are some tips to help you “hold-on”:

stand still or sit down
cross your legs
press on your pelvic floor
tighten your pelvic floor muscles as hard as you can
wait until the urgency passes (10-20 secs)
think of something else (your favourite things?!)

• Gradually build up to longer delays, e.g. 3-4 hours between visits to the toilet

• Drink approximately 8 cups (1-2 litres) of fluid a day. Cut down on fluids which make the problem worse eg coffee, tea, coca cola. Not drinking enough
concentrates the urine, which irritates the bladder. Drinking too much also makes you go often.

• Try not to go to the toilet `just in case’ especially if you are at home

• Check your progress by recording your visits to the toilet on the chart every 3-4 weeks

• If you get up in the night to empty your bladder, don’t drink after 8.30 pm
Physiotherapy may also help urgency symptoms which are often related to bladder muscle instability (detrusor instability)

Bladder function and hormone replacement therapy

The pelvic floor connective tissue rely on oestrogen to maintain their strength. At the menopause these tissues weaken resulting in prolapse of the bladder neck, and/or uterus (womb). This may, along with loss of muscle tone due to ageing, compromise the ability of the bladder neck to maintain continence. Oestrogen replacement therapy may help to reduce the impact of these changes and may be used in combination with pelvic floor exercises.

Prof T C Li
Consultant Gynaecologist
7 Williamson Road
Sheffield S119AR
Tel: 0114 2550365
March 2007

About the Author

Kathryn Danzey
I have a passion to bring to you what really works in the beauty industry, from a moisturiser to the latest advanced treatment for anti ageing. After almost 4 decades in the industry I'm packed with info to share but never tire of looking for new things and would love you to share your experiences with us too. We're here to help you find that treatment or product that will make a change for you. Can't do without My Collagen Shots and H3O Night Repair. Love a great serum and UV protection

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