“Just Live With It” – Changing The Conversation Around Urinary Incontinence During #BladderHealthMonth

By Jessica McKinney

November is here, and the quickly approaching holidays can send our already-busy lives into overdrive. There are lists to make, meals to plan and events to coordinate. It’s easy to get caught up in the frantic, festive pace and neglect to slow down and listen to what our bodies are telling us. For many women, our bladders are trying to get our attention, sending clear messages that something isn’t right. Since November is bladder health awareness month, now is the perfect time to talk about an important, but often brushed off, health topic for women.

When everything is functioning properly, it’s easy to take our bladder health for granted. We potty train as young kids and assume we’ll never have to think about it again! But as many women age, our bladders have a way of demanding our attention in new ways. Whether it’s during a workout, while laughing with a friend or simply being away from a bathroom for too long, many women start to experience bladder leaks. In fact, more than 20 million women in the U.S. and 250 million women worldwide are bothered by urinary incontinence (UI) – this isn’t a small issue by any means.

UI often begins as inconvenient or embarrassing. If ignored, however, it can progress and have a serious impact on women’s quality of life, mental health and relationships. While almost 30% of women in their 30s report bladder leaks, over 50% of women in their 50s and beyond report symptoms. Why? One reason is that the group of muscles responsible for controlling the bladder, known as the pelvic floor, tends to get weaker with age. Pregnancy, menopause and the general muscle loss associated with growing older all can contribute to pelvic floor weakness and UI. Despite the prevalence of UI, or alternatively, maybe because of how common and normalized UI is, most women “just live with it.” In a healthcare system not set up for routine UI screening, women often have to speak up and actively seek help, which can be hard to do. They often resign themselves to living with leaks and the $8 billion adult diaper and absorbent pads market continues to soar.

In an earlier GirlTalkHQ post, The Right to Live Without Leaks: Dismantling Stigma Around UI, I detailed several historical, cultural, societal and biological reasons why women don’t seek treatment for bladder leaks. I argued that a “human rights-informed approach to UI” should include health education about continence and incontinence, a fostering of discussion between women and healthcare providers and mechanisms for (1) letting women know about treatment options, and (2) access to such treatment if she chooses to treat it.  

There is good news! It’s never too late to treat UI by improving the health of your pelvic floor. And there are proven methods to do so. Avoiding or quitting smoking, limiting certain foods and caffeine, alcohol and carbonated drinks all can have a positive benefit. Achieving or maintaining a healthy weight, addressing constipation issues and incorporating exercise and movement into daily life also can help. But one intervention in particular can significantly improve UI symptoms: pelvic floor muscle training.

That’s right—just like any other muscle group, your pelvic floor can be exercised and strengthened! Even if you’re already experiencing bladder leaks stemming from a weakened pelvic floor, it’s not too late to intervene and improve this important part of your health. Pelvic floor muscle training—or PFMT—involves a program of exercises that women follow regularly for a period of several weeks or months. This type of program is much different than what many women do—perform Kegel exercises only occasionally and under no medical supervision; in fact, data show that as few as 25% of women can perform these exercises effectively on their own.

PFMT is most successful when women work with their healthcare providers on an individualized, monitored regimen. Some clinicians may oversee exercise programs in an office setting, but the evolution of digital health technologies now means that women can train their pelvic floor muscles right in the comfort of their own home! Digital devices paired with smartphone applications allow women to perform PFMT practice in just a few minutes each day.

It’s important to choose the right type of device for at-home use. Look for a discreet, user-friendly device that’s FDA-approved and backed by published data and clinical studies; it’s also important for a device to enable provider participation in a woman’s training. I’m partial to our device at Renovia—the leva® Pelvic Health System—because it has several features designed to support successful PFMT: it’s the only device that uses real-time visualization of movement during muscle contraction and relaxation as the primary way of delivering feedback, women can access optional personalized coaching sessions, review and track progress over time and share usage and symptom data directly with healthcare providers. 

Whether your goal is to prevent bladder health issues or to address problems you’re already facing, now is a good time to strengthen your pelvic floor. There are effective, user-friendly treatment options that don’t involve drugs or surgery. Getting started on the right type of program can be easier than you think and can have a positive impact on your health for years to come. This November, while you’re busy giving your time and energy to others, listen to your body. Speak with your doctor about improving your pelvic floor and bladder health. Remember: prioritize yourself this #BladderHealthMonth!

Dr. Jessica McKinney is a career-long women’s health provider (Physical Therapist), educator & advocate with current roles as VP, Medical Affairs and Clinical Advocacy at Renovia Inc., a digital women’s health company, as well as adjunct university faculty, & consultant in global/community women’s health with a focus on fistula care and physiotherapy for women’s health in low resource settings. She is founder and previously was Director of The Center for Pelvic and Women’s Health for Marathon Physical Therapy & Sports Medicine and non-physician faculty in the FPMRS fellowship at Mount Auburn Hospital, both in eastern Massachusetts, USA.
You can connect with and follow her on LinkedIn.

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