Incontinent Ida - Just Jill

Just Jill is the creation of Jill Cohen Morris. Jill is an avid rambler and married mother of two from Toronto, Canada with a remarkable zest for life and a fabulous sense of humor. 

Dear Just Jill,

There are a lot of things I love about this stage in my life, but there is one that I just can’t come to terms with … I have become incontinent. To clarify, I don’t mean a trickle while doing a jumping jack or sneezing. I have accidents. I wet myself.

It is so embarrassing. I know there are much worse things. However, to me, this is devastating!!

The thought of having an accident in public is terrifying. Don’t get me started on the smell!!

I need advice from my wise Sole Sisters.

What exercises can I do to strengthen my pelvic muscles?

Any suggestions for leakproof panties or pads?

Any advice you may have would truly be appreciated.

What’s a gal to do?

Sincerely,

Incontinent Ida 

Sole Sister Advice & Comments

• Have you tried pelvic floor training? I wasn’t incontinent after my hysterectomy, but they suggested I go anyway to keep my pelvic floor in shape. Many others there were incontinent, and they offered exercises, nerve stimulation, etc, to help.
  
  
• A Pelvic floor therapist will help - a lot! Many women utilize “period panties” while they strengthen their pelvic floor muscles. They are also great for those times when you’re out walking/hiking, and there’s no bathroom. 
  
  
• I had surgery to place a hammock under my bladder. It keeps things up, and no leaking since.
  
  
• Kegel exercises for sure, plus I guess wear a period pad?
   
• Please make an appointment with a licensed Physiotherapist who specializes in incontinence. They are highly qualified and can be a huge help, but very few people know that this service exists. Just google' physiotherapists near me specializing in incontinence,' and you'll find some.
  
  
• I think solutions may vary depending on the cause. Some suggestions: yes, wear a pad. Swimming is one of the best activities, very good for incontinence...laps. For some people, losing weight helps. Drink more fluids...many people ramp down their fluids because of incontinence...which can exacerbate incontinence. It might help to drink more fluids. More fluids will make a toilette routine easier...start a toilette routine...regular routine so that you train your body to void at certain times of day...stick to it. A toilette routine means that you don't wait until you feel the urge...I am able to almost demand my body to void now…
  
  
• Definitely a pelvic floor specialist, and you should work with your HCP to ensure there isn't anything else going on...vaginal estrogen is beneficial for genitourinary issues with menopause if that is the issue. Good luck
  
  
• Yes to pelvic floor therapy, and there is also a thing called a pessary. It looks a bit like a sex toy.. and it’s inserted like a tampon, but the shape of it tilts your cervix up to block the urethra. It’s removable and washable and comes in several sizes. Needs to be fitted by a Doctor. Good for temporary use while exercising.
  
  
• First off, you are completely not alone. The good news is that you can improve and reverse the issue with pelvic floor training. You can wear pads or pants, too, but you’ll only get worse if you don’t tackle the issue now while you can. The longer you leave it, the harder it will be to build muscle tone again (a bit like any other muscle). 
  
  
• I suggest you get a referral to be assessed. I had a bladder sling put in a few years ago. I had two kids years before and couldn’t sneeze or cough without incident. When assessed they asked why I waited so long- I said I felt I was too young( 40s) and that I should be able to fix it with exercises and Kegels. The ob/gyn said all the Kegels in the world wouldn’t undo the trauma to the pelvic floor from those births ( lots of tearing). It’s been literally life-changing! I could run and ski again!
   
• Like several others have stated, I also had bladder sling surgery in my early 50’s, and it really was life-changing. My stepdaughter, who is in her early 40s, has had the same issues, and her doctor/insurance recommended Kegels and pelvic floor therapy, but it didn’t help. She was recently approved for urethral bulkamid, a minimally invasive procedure that allowed her to go back to work the next day and start working out that same week. She was so excited when she sneezed and didn’t pee herself!
  
  
• Pilates!
   
• I had stress incontinence, and it was so embarrassing. Sneeze, cough, laugh, and I was practically wetting my pants. I was just starting to get back into fitness, and I couldn't jump or run. And even the exertion of weight lifting was problematic. I tried Kegels, but it just didn't work. So, I opted for urinary sling surgery. What a difference! I run. I can jump and lift heavy. No leaks. Best decision I made.
  
  
• My doctor advised that a decline in estrogen levels during menopause can weaken the muscles and tissues in the pelvic area, including those that support the bladder and urethra. This weakening can result in urinary incontinence. I was prescribed an Oestrogen cream to be applied around the bladder opening, and this must be done with pelvic floor exercises
  
  
• Yes, pelvic floor physio. I am a physio, not a pelvic floor one. They have extensive training. Most women need to learn to relax their pelvic floor before they can become more aware of strengthening it. the old Kegel exercises are definitely out, and exercises and awareness are much more subtle and specific.
  
  
• Search Hypopressives on YouTube; my friend says they've really helped her. I haven't been incontinent, but since I've been doing more weight training, I've noticed more strength in my bladder, so stress incontinence (sneezing, jumping leaks) has disappeared.
  
  
• Perhaps locating a urogynecology practice near you that offers pelvic floor treatments with an Emsella magnetic chair would be useful to you. 
  
  
• I had a similar problem, and it was affecting my daily activities - always planning outings with toilets in mind, which was very restricting and time-consuming. I went to a Uro/Gynae (medical specialist) to see if I could get help. Some unpleasant testing of urodynamics and capacity, as well as cystoscopy, determined that I had a 'nasty' bladder. The solution was simple: Oestrogen pessary 3 times a week and a tablet every day. Oestrogen helps the tissue, and the tablet reduces bladder excitability. Another thing that helps is scrunching up toes and tightening buttocks, especially when you put the key in your front door - it avoids doorstep accidents and a mad rush to the toilet. I now have control back.
   
• It is possible to gradually reverse this issue. I joined an online yoga program, and in three months, I saw an improvement. Six months later, I did not need to wake up in the middle of the night to pee. Two things you can do: Kegels exercise as many times in the day as possible. But even if you do it every day for two minutes, it will help. And do the bridge pose with Kegel hold. All the best.
  
  
• I’m going to try out a new app. Buff muff! Physiotherapy may offer some solutions
  
  
• Hypopressive exercises. See a physiotherapist for pelvic floor exercises - more than just Kegels. Find an incontinence clinic that has a chair to contract the muscles. Incontinence can be cured!

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