As a women’s health physiotherapist, I talk to people about wetting their pants quite a lot. I am always surprised how often I meet women who are putting up with all sorts of embarrassing symptoms and just putting it down to “but I had children; that’s what happens.”
This is how conversations with my pregnant and post-natal patients often go:
It’s normal to leak a little urine when you are coughing or sneezing right?
No.
But what about when you are pregnant?
No.
What about when your bladder is really, really full?
No.
It’s not normal. Not ever.
We need to make a distinction here. There is normal, and then there is common.
It is COMMON to leak urine when you are coughing or sneezing, but that does not make it NORMAL.
After childbirth you can develop what is called urethral hyper-mobility. This can occur from a laxity of the vaginal walls due to stretching during pregnancy and childbirth, which means the urethra (where your wee comes out) moves more freely than it did before. It makes it difficult to close off the urethra when a large amount of pressure comes down from above, like what is created when you cough or sneeze or lift something heavy. It’s kind of like trying to step on a hose to stop the flow while standing on a trampoline. And it occurs in 1 in 3 women after childbirth. That number is huge!
So, let me give you a quick fix for this.
A research study published in 2008 found that if they taught people to pull up their pelvic floor when they are coughing or sneezing, they IMMEDIATELY were able to significantly decrease the amount of leaking that they experienced. They did of course check that they were contracting their pelvic floor muscles correctly as well.
When you pull on the pelvic floor muscles, they pull on the fascia that sits between your bladder and your vagina, giving a firmer back support for the urethra, as well as increasing your ability to close off your urethra.
A pelvic floor contraction should actually come on automatically when you cough or sneeze to ensure you don’t leak. However, if you are leaking, it might not be occurring, so if you do it consciously, you might just find that you can stop those leaks from getting out.
Sounds simple, right? It is. To activate your pelvic floor muscles, squeeze and lift the muscles as if you are trying to stop the flow of urine. If you are not sure, visit www.gcphysioforwomen.com.au to download our instructions on how to check if you are contracting the muscles correctly.
And then try it. You might be surprised by the results.
