Bladder leakage: fact versus fiction

Let’s clear up the confusion when it comes to bladder leakage.

Here we speak to the experts and give you the facts straight-up, because wetting yourself – either a little or a lot – happens to many women, so isn’t it time we got to the bottom of it?

Bladder leakage and urinary incontinence are the same thing

A little bit of leakage – say when you cough, laugh or exercise – is normal for women, right? It’s just a bit of ‘LBL’ (light bladder leakage) and nothing to worry about? Not so, says Jean Hailes pelvic floor physiotherapist Janetta Webb.

However you slice or dice it, leakage or the accidental passing of urine (wee) is actually urinary incontinence. It’s important not to shrug off this problem, put up with it or hope it’ll go away on its own.

This type of urinary incontinence is very common. And unfortunately, it can get worse over time. It’s important to know there are effective ways of managing and even curing it, so speak to your GP.

Bladder leakage doesn’t have to be part of getting older

As we get older, we might think that leakage is just one more thing we have to deal with – part of the package along with an extra wrinkle or two. But Janetta explains, this certainly doesn’t have to be the case.

The risk of urinary incontinence does rise after menopause. This is due to a drop in the hormone oestrogen, which can impact bladder control. But there is much you can do to keep your ‘plumbing’ in tiptop shape into your 70s, 80s, 90s and beyond. (Spoiler alert: it’s called exercising your pelvic floor, but more on that later).

Bladder leakage affects younger women too

Dr Payam Nikpoor, a Jean Hailes specialist, says that up to 20-30% of women aged 18-45 experience urinary incontinence. “It is also a condition of the young,” he says. “We need to create greater awareness about it.”

Pregnancy and childbirth can increase the risk of incontinence cropping up, but there are other risk factors such as having a chronic cough, and drinking too much caffeine.

Watercolour illustration of a blue sunspot orchid.

There are different types of urinary incontinence

If you get a sudden and strong need to urinate but often can’t make it to the toilet in time, this is known as ‘urge urinary incontinence’.

If you leak when you sneeze, laugh, cough, exercise, this is known as ‘stress urinary incontinence’. Both these types of incontinence can also happen when you have sex.

“If you are leaking when exercising, it’s your body saying ‘I’m not strong enough in the pelvic floor to do this exercise’,” says Janetta. “So modify your program so that you don’t leak and get some help so that you can soon return to your exercise.”

There are many other types of incontinence, but the advice is the same – see your GP for advice.

Leakage is often caused by a weak pelvic floor

Our pelvic floor muscles support the bladder, bowel and reproductive organs – holding them all in place. These muscles are the main players when it comes bladder (and bowel) control.

It’s important for all women – including those who have never been pregnant or had a baby – to keep their pelvic floor muscles strong. Also, being able to relax these muscles is key.

When our pelvic floor is not as strong as it should be, we can experience symptoms such as incontinence.

It’s important for all women – including those who have never been pregnant or had a baby – to keep their pelvic floor muscles strong. Also, being able to relax these muscles is key.

You can improve leakage, it’s never too late

Pelvic floor exercises are an important part of improving leakage (if you have urge urinary incontinence, bladder training is also key). However, many women perform their pelvic floor exercises incorrectly.

So if you’re doing your exercises but not seeing any improvement, it might be time get the help of a physio. A pelvic floor physiotherapist can provide expert advice on how to correctly exercise these muscles and create a program to improve your symptoms.

Search for one by visiting the Find a physio webpage on the Australian Physiotherapy Association website and selecting ‘Pelvic Health’ as the special interest area. If you’re experiencing leakage, you can also speak to your GP who can help work out the best approach.

Bowel health affects bladder health

Being constipated is a common cause of urinary incontinence, particularly in girls and young women.

A bowel that’s overfull puts added pressure on the bladder, so you may feel the need to go to the toilet often and in a hurry. What’s more, repeated straining can weaken your pelvic floor muscles.

Keep your bowels healthy by staying hydrated, eating a diet rich in fibre and whole foods – such as vegetables, legumes, nuts, fruit and wholegrains – and exercising regularly.

Investing in your pelvic floor might improve your sex life

Many women report that strengthening their pelvic floor muscles leads to greater pleasure from penetrative sex and more intense orgasms.

The vaginal walls are layered with the pelvic floor muscles. Exercising these muscles can increase blood supply in this area, which – in theory – can all lead to greater pleasure.

Words by Jess Gleeson. Illustrations by Tam Bower.

Published September 2022

This article is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your medical practitioner.

Jean Hailes for Women’s Health gratefully acknowledges the support of the Australian Government.

© Jean Hailes for Women’s Health 2022

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