You cross your legs when you sneeze.
You map the nearest bathroom is whenever you go.
You avoid jumping on the trampoline with the kids (or jumping in general).
You turn the key in the door and have to run straight to the loo.
Sound familiar?
It could be incontinence.
Bladder leakage, urgency and other continence concerns are incredibly common among women, particularly during pregnancy, after birth and throughout menopause. In fact, 1 in 3 women in Australia will experience at some point in their lives.
Talking about incontinence can feel awkward, but it’s treatable, and it’s worth talking about.
What is incontinence?
Urinary incontinence is the involuntary loss of urine. In simple terms, it’s when you leak urine when you don’t mean to.
For some women, it might be a few drops when they laugh or sneeze. For others, it can involve a sudden, overwhelming urge to get to the bathroom or leaks that impact daily life.
Understanding the type of incontinence you’re experiencing is the first step towards finding the right treatment.
Here we break down the four most common types of incontinence.
1. Stress Incontinence
This is the most common type we see at TWB. Stress incontinence is a leak that happens when there’s increased physical pressure on your bladder.
You might notice leaks when you:
- Sneeze
- Cough
- Laugh
- Run
- Jump
- Lift something heavy
It’s often related to pregnancy, birth, a weak pelvic floor, or sometimes prolapse.
Tip to try:
Practice “The Knack” a simple pelvic floor squeeze just to use just before and during a pressure-causing movement (like a sneeze or cough). Leaking during exercise? A vaginal pessary for incontinence might help — learn more about pessary’s here.
2. Urge Incontinence
That sudden, intense, gotta-go-right-now feeling? That’s urgency, and can lead to urge incontinence. It happens when your bladder contracts suddenly and you leak. It’s less about bladder strength, and more of a miscommunication between bladder and brain.
You may find yourself:
- Rushing to the bathroom
- Not making it in time
- Needing to urinate frequently throughout the day
- Waking multiple times overnight to use the bathroom
Sometimes even hearing running water or putting the key in the front door can trigger the urge.
Tip to try:
Cut down on bladder irritants like coffee, fizzy drinks, and citrus. And avoid “just in case” trips to the bathroom — this habit can train your bladder to misbehave. Bladder training and gentle pelvic floor relaxation can help.
3. Mixed Incontinence
As the name suggests, mixed incontinence is a combination of both stress and urge incontinence.
For example, you might experience leaks when exercising but also struggle with sudden urgency throughout the day.
This one needs a bit more detective work to figure out your triggers, so it’s best to talk to a women’s health physio.
Tip to try:
Track your symptoms in a bladder diary for a week. Jot down what you drank, when you peed, and when you leaked. This info is gold for your physio! From there we can spot patterns and create a personalised treatment plan for you.
4. Overflow Incontinence
Less common, but still important to know about. Overflow incontinence occurs when the bladder doesn’t empty completely, causing frequent dribbling or leakage (aka overflow) later.
You might notice a constant dribble or a weak stream. It can be linked to nerve issues, prolapse, or certain medications.
Tip to try:
If you’re noticing changes in your ability to empty your bladder, or you’re experiencing leakage with no obvious cause, reach out to your GP or women’s health physio.
Why Does Incontinence Happen?
There isn’t always a single cause.
Bladder leakage can occur due to a combination of factors, including:
Pregnancy and Childbirth
Pregnancy places increased pressure on the pelvic floor muscles, while vaginal birth can stretch and weaken the structures that support the bladder.
Menopause
Changes in hormone levels during menopause can affect the bladder, pelvic floor tissues and urinary tract, contributing to symptoms.
Pelvic Floor Dysfunction
The pelvic floor is a group of muscles that support the bladder, bowel and reproductive organs.
When these muscles are weak, overactive, uncoordinated or not functioning optimally, continence issues can occur.
Chronic Constipation
Straining over long periods can place additional pressure on the pelvic floor and contribute to bladder symptoms.
High-Impact Exercise
Activities involving repetitive running, jumping or heavy lifting can increase pressure through the pelvic floor, particularly if underlying dysfunction is already present.
Previous Surgery or Medical Conditions
Certain surgeries, neurological conditions and other health factors can also influence bladder function.
What Can Help?
The good news is that many forms of incontinence respond well to conservative treatment.
The first step is understanding what’s contributing to your symptoms.
At The Wellness Boutique, our women’s health physiotherapists take the time to assess your pelvic floor function, lifestyle, movement patterns and symptoms to create a personalised treatment plan.
Depending on your needs, treatment may include:
- Pelvic floor assessment and rehabilitation
- Individualised pelvic floor exercises
- Bladder retraining strategies
- Lifestyle and fluid intake guidance
- Constipation management support
- Return-to-exercise advice
- Pessary fitting and management where appropriate
- Pregnancy and postpartum care
It’s also good to understand that pelvic floor exercises aren’t always as simple as “doing your Kegels.”
For some women, the pelvic floor may actually be overactive or lacking coordination, which is why an individual assessment can be so valuable.
When Should You Seek Help?
If bladder leakage, urgency or changes in your bladder habits are affecting your confidence, exercise routine, social life or daily activities, it’s worth seeking support.
You don’t need to wait until symptoms become severe.
In fact, early intervention often leads to better outcomes and can help prevent symptoms from progressing.
You deserve to feel confident in your body
Bladder leaks can be frustrating, inconvenient and sometimes embarrassing. But they’re also incredibly common, and in many cases, highly treatable.
Whether you’re dealing with occasional leaks or more frequent accidents, there are ways to make it better.
You deserve to feel confident in your body, whether you’re exercising, laughing with friends, chasing after your kids or simply getting through your day without worrying about where the nearest bathroom is.
If you’d like support, our women’s health physiotherapists are here to help.
Learn more about incontinence and World Continence Week at www.continence.org.au.
