Feel the squeeze

One in four women suffers from bladder control problems. If you're one of them, here's what you should know (and what you can do)

The number of people – not just women but men too – who suffer from bladder control problems is tricky to calculate, since nobody knows how many are affected but are too embarrassed to admit it.

But to give you a rough idea of the scale of the problem, a MORI poll suggests more than 5 million people over the age of 30 have experienced it.

So who exactly is at risk? For women, the main causes of bladder weakness include pregnancy, childbirth and menopause – or, rather, the hormonal and physical changes that take place in your body at those stages during your life. These changes can affect and weaken the pelvic floor muscles, that is the muscles that support the bladder and control urination.

But that's not all. If you have a medical condition such as diabetes, for instance, or if you suffer from dementia, multiple sclerosis, Parkinson's disease or a brain injury, or if you have had a stroke or suffer from frequent urinary infections, you too could suffer from bladder weakness as a result. Some medicines can also cause bladder problems – if this has happened to you, talk to your pharmacist about possible alternatives.

What's your type?

Of course not all bladder weakness problems are the same. There are indeed several types of incontinence, including:

• Stress incontinence: Caused by exercise, coughing, sneezing and laughing. Stress incontinence is the most common type among women and is caused by weakened pelvic floor muscles. Strengthening your pelvic floor muscles has been shown to help in 70 percent of mild-to-moderate cases of bladder weakness.
• Urge incontinence: You may have urge incontinence (also called an overactive bladder) if you get a sudden urge to go to the loo and at the same time leak a little urine without warning. The average person goes to the toilet between four and eight times a day, so if you're going lots more than that, you may have urge incontinence.
• Overflow incontinence: People who feel they never completely empty their bladder, and who feel they need to go to the loo again soon after urinating, may be suffering from overflow incontinence.
• Nocturia: If you need to urinate more than a couple of times during the night, the condition is called nocturia. This is often associated with getting older, but may also be caused by a medical problem.

Floor work

If you suffer from stress incontinence the good news is that doing a few simple, discreet exercises just two or three times a day can help you control your bladder. Called pelvic floor exercises, they target the muscles that support and control the bladder. Not sure where your pelvic floor muscles are? Here's how to find them:

• Sit comfortably, and imagine you're passing urine but want to stop the flow. The muscles you use are your pelvic floor muscles.
• Don't use your tummy muscles, tighten your buttocks or squeeze your legs together – simply isolate those muscles that control the flow of urine.

The great thing about exercising your pelvic floor muscles is that nobody can tell you're doing it, which makes it easy to have a few squeezes every now and then. So here, courtesy of the Bladder and Bowel Foundation, are a couple of exercises to get you started:

1. Slow contractions

Slowly tighten and pull up your pelvic floor muscles as hard as you can and for as long as you can, then rest for four seconds and repeat. Build up your stamina until you can do 10 slow contractions at a time, holding them for 10 seconds each with rests of four seconds in between.

2. Quick contractions

To get your pelvic floor muscles into shape so that they can react quickly to sudden stresses, such as coughing, laughing or exercising, practice drawing in the muscles quickly, holding them for just a second before relaxing. Build up to 10 quick contractions in succession.

Practise these exercises several times throughout the day – get into the habit of doing them while you brush your teeth, for instance, or while you're waiting for the kettle to boil. Then as you get stronger, you can tighten your pelvic floor just before or while laughing, coughing, sneezing or lifting heavy objects.

Reduce the pressure

As well as doing pelvic floor exercises, there are some other things you can do to help yourself where bladder weakness is concerned…

• Don't stop drinking –drinking less may actually aggravate your bladder and make the problem worse.
• Do drink less tea, coffee and alcohol, as these act as diuretics (which increases the amount of urine you produce).
• Eat high-fibre foods to avoid constipation, since constipation can put a strain on your bladder.
• Lose weight if you need to – being overweight is associated with bladder control problems, so ask your pharmacist for advice on how to shed excess pounds.
• Give up smoking (though it's not the smoking itself that causes bladder problems, if you have a smoker's cough, it can put pressure on your bladder).
• Practise Pilates, an exercise method that stresses the importance of strengthening the pelvic floor muscles
• For further relief, visit your local pharmacy where you can buy a range of incontinence aids, including freshen-up wipes, pants, pads, bedding and pelvic floor toning products. If your problem is moderate-to-severe, your GP can help by prescribing medication or offering other treatments.

For further advice visit the Bladder and Bowel Foundation's website at www.bladderandbowelfoundation.org