(intro) Alex Lopes is a pelvic health physiotherapist, the director of Pelvic Health Melbourne in Altona North, and past national chair of the Australian Physiotherapy Association’s Women’s Men’s and Pelvic Health Group.
Up to 38 per cent of Australian women experience bladder leakage. Whilst bladder leakage for women is common there is help.
As a pelvic health physiotherapist, the most common questions I get asked are – what is the cause of my bladder leakage and how can I fix it?
The main causes of bladder leakage can vary depending on your stage of life. In young women the cause can often be high intensity training. In peripartum women increased loads above the bladder or weakness below is often to blame. In perimenopausal women hormonal change can affect bladder strength.
Why do I leak?
Bladder leakage can be caused from too much pressure above the bladder or not enough support below.
The best way to describe the first phenomenon is to imagine your bladder is like a balloon filled with water and held below with an elastic band.
Sometimes the pressure above the balloon is too great for the elastic band to hold. This could be due to constipation, high abdominal weight, a chronic cough or repeated heavy lifting.
Alternatively, you could have a problem with the elastic band below. It may have been stretched with childbirth or hormonal change with menopause where the connective tissue within the elastic band weakens.
Or you may have a problem with the bladder itself otherwise known as bladder urgency.
Do you go to the toilet more than your friends, are you often ’busting to go’ or rushing to the toilet and sometimes there is hardly anything there?
You may have bladder urgency or an overactive bladder. This is not due to weak pelvic floor muscles but a problem with the bladder itself. An overactive bladder is normally a genetic condition where you have always had an issue with going to the toilet more often than normal (up to 7 times per day) and often with urgency.
Or you may have developed an urgency problem associated with triggers. Possible triggers that may be causing a problem for you could be caffeine, fizzy drinks, artificial sugars, or alcohol. For some of you it is more what you do, possibly thinking about drinking, washing your hands or running water, walking to the toilet or even driving home or that key in the door.
So how can I fix my leakage?
Well of course it depends on the cause, so getting help to diagnose the cause will address all the factors that are contributing to your leakage.
If it is a pressure imbalance, physiotherapists like myself work on the loads above the bladder and the support below. If you have an overactive bladder there is strong evidence that Transcutaneous Electrical Nerve Stimulation (TENS) can calm the bladder and stop the sensation of urgency or the contraction of the bladder.
If you have triggers, then holding the urge whenever you feel urgency helps break the cycle on those triggers.
Your pelvic health physiotherapist, GP and/or urologist will be your support team in assisting you to better bladder health.
