Emma Bardwell | Reports & expert advice
Breaking the taboo around urinary incontinence
Urinary leakage is not a topic we often talk about. Yet it is a problem that affects many women, especially during menopause and postmenopause stage. Fortunately, there are many things you can do about it: From exercises to nutrition strategies and avoidable toilet habits.
MoliCare® teamed up with inspiring women like the registered nutritionist Ms. Emma Bardwell who offer an emotional and professional support for women experiencing urinary leakage. In this article, she shared her tips to manage bladder weakness.
There are many ways to manage your bladder weakness and live the life you are used to.
Do you leak when you laugh?
If you answered yes, you’re not alone. According to research, 40 percent of women in the UK1 have some kind of urinary incontinence. In reality this figure is likely to be much higher because women are often embarrassed by symptoms and don’t report them to their GP. There’s still, unfortunately, a ‘this is part of being a woman’ mentality around leakage, which prevents women getting help.
Urinary leakage can happen to any woman at any age, but it’s particularly common around perimenopause and menopause, mainly due to depleting levels of sex hormones2. As our oestrogen levels drop, the muscles that support our pelvic floor can weaken and the lining of the bladder and urethra can become thinner and more sensitive. Women commonly exercise less during the menopause transition and experience increased weight and abdominal fat, which when combined can cause an overall weakening in pelvic floor muscles.
The good news, however, is that just because urinary leakage is common, it doesn’t mean you have to put up with it. Here’s what you need to know.
The topics in this article:
The different types of incontinenceThere are a few different types of incontinence. Knowing which one or ones you have can really help you to pinpoint how to talk about and address your symptoms.
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Build muscles everywhere
Increasing your overall cardiovascular fitness and strength around your glutes (buttocks), adductors (inner thighs) and abdominal (belly) region can have significantly positive effects on your pelvic floor strength5. Interestingly a study in women showed a link between hand grip strength and the likelihood of having stress incontinence, so being physically fit is definitely a goal worth pursuing. Opt for low impact activities that allow you to build muscle mass. Changes in overall strength and conditioning take about six to eight weeks so do try to be patient and don’t give up if you don’t notice improvements straight away.
My favourite tip for stress incontinenceThis is what I call the ‘pre-sneeze squeeze’ and it works a treat! When you know you’re going to cough or sneeze, activate your pelvic floor quickly beforehand (using the method outlined in the step by step guide above) to help withstand the pressure. Lift and hold your pelvic floor muscles to brace for impact, then relax once it has passed.
Lifestyle and nutrition strategies
- Limit alcohol and caffeine as not only can they irritate the lining of the bladder, they’re stimulants and can encourage the kidneys to produce more urine.
- Drink plenty of water. This sounds counterintuitive, but if you’re not drinking enough water, your urine gets more concentrated, which can irritate the bladder. Your urine should be a pale straw colour, dark yellow is a sign you might be dehydrated.
- Avoid getting constipated as bearing down can really exacerbate pelvic floor issues. Eat plenty of fibre (wholegrains like oats, as well as beans, lentils, vegetables, nuts and seeds) and stay well hydrated.
- A tablespoon of psyllium husks added to a smoothie or porridge in the morning can really help move things along!
- Spicy food, citrus fruits and fizzy drinks can all cause the bladder to spasm, which increases urge and frequency. Try keeping a diary to see if they affect you.
3. Toilet habits
- Try resting your feet on a raised foot stool (or even a small bathroom bin) when sitting on the toilet - so your knees are higher than your hips
- This puts you in more of a natural squatting position and can help make passing a bowel movement easier and prevent you bearing down and further weakening pelvic floor muscles.
4. Weight loss
- Women who are carrying some extra weight may find losing some body fat has a positive effect on symptoms.
- Weight maintenance can feel harder around perimenopause and menopause. If you need help and accountability, talk to a registered nutritionist or weight loss specialist.
- Pilates and yoga moves that work on your core strength can also be helpful for building pelvic floor strength and bringing awareness to the area in general. Many women around perimenopause and menopause seem to lose the mind-pelvis connection.
6. Things to avoid
- Avoid very heavy lifting, this includes large toddlers!
- And try not to do too much high impact exercise until you get your symptoms under control - swap running on hard pavements for running on grass or use a treadmill if you can, which lessens the impact on your pelvic floor.
- Repeated coughing can also impact your pelvic floor, so if you smoke this is a good time to quit.
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About the author - Emma Bardwell
Incontinence and bladder weakness are often a common consequence of the hormonal change that occurs during the perimenopause. For many women, going through this phase can feel like their world is being turned upside down. As a registered nutrionist and a women´s health specialist, Emma Bardwell is here to guide you through the perimenopause – by sharing evidence-based advice as well as her own personal insights.
Emma´s interest in the topic began when she started experiencing perimenopause symptoms herself more than 10 years ago. Because she quickly noticed there just wasn’t enough evidence-based nutrition information around, she soon began to educate herself and, in the process, became an expert on the topic. Today, Emma blends nutritional science, diet therapy and behaviour change on her website and her Instagram page. In addition to her recently published book “The Perimenopause Solution”, she also hosts workshops and regularly appears on podcasts.
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