Tag: bladder leakage

After a Traumatic Vaginal Birth, I Live with Bladder Leakage



This educational resource was sponsored by Poise, a brand of Kimberly-Clark.

As told to Nicole Audrey Spector

I’m small in stature. But you wouldn’t guess that I’m a petite woman if you went only by my sneeze, the sound of which resembles the war cry of a goose. And observers don’t get to hear just one sneeze. They’re met with at least a few — one after the other. A proper gaggle.

My mom has the same loud sneeze, and as a kid, I’d make fun of it — not so much the chandelier-rattling sound that went with her achoos, but the side effects of her sneezing.

Every time my mom had a sneezing fit, she peed herself. It wasn’t a secret.

“Oh, god, I peed!” she’d scream, then gallop to the bathroom, laughing. The same would happen when a coughing fit befell her. “I peed!!!”

She never seemed to be embarrassed, but I was embarrassed for her.

Now, at 41, I can relate to what my mother has been going through.

When I sneeze or cough, I often pee a little. Sometimes more than a little, if I already “have to go.”

Bladder leakage is a fairly new issue for me. It started after I gave birth to my son, Timothy, in 2022. It was my first time carrying a pregnancy full-term. And my first time having a creature with a head in the 100th percentile vacuumed out of my birth canal, after said head got stuck.

After having Timothy, it took a couple days for me to pee on my own. For the first day, I had a catheter. The second day, I walked to the bathroom by myself and sat on the toilet for what felt like a million minutes, unable to feel anything south of my belly button. It was important, a nurse said, that I pee on my own, without the catheter. When I finally achieved this, my nurse clapped for me. I cheered along, even though I really couldn’t feel the urine coming out, and surely couldn’t turn the stream off and on like I’d been able to before.

When I was released from the hospital after the standard 48 hours, I was sent home with a stockpile of hospital-issue mesh underwear and pads seemingly designed for elephants.

I thought the pads were just there to capture the discharge that would spill out in the first few postpartum days, but it turned out they were catching urine, too, as many a too-late, too-soiled trip to the bathroom revealed.

“A little urinary incontinence after a vaginal birth is normal,” my OB-GYN told me in an email, after I pinged her about two weeks later. I’d emailed her asking about whether the bladder leakage was to be expected.

I told my friend, Sophie, a yoga teacher who does a lot of great work with pregnant and postpartum women about the bladder leakage.

She told me I probably had a pelvic floor injury and she told me to go to a pelvic floor therapist “sooner than later” to address the problem.

Instead of consulting with a pelvic floor therapist as she advised, I did nothing.

Looking back, I think I was really just too tired to believe that anything was wrong or unusual. What’s more, I didn’t feel like “me.” I felt like an alien had taken host in my body. I was a total mess, and I just didn’t want things to be messier than they already were by bringing some certified expert into the mix to be like, “What a mess!”

This was nearly two years ago. The bladder leakage has lessened from what it was right after giving birth, but it’s not gone away. Not at all. What has gone away, however, is my shock about it. I’ve gotten used to peeing a bit when I sneeze, cough or even, sometimes, laugh.

Though I never leak to the extent that I saturate myself completely, I do dribble, and this is enough to motivate me to bring a spare pair of underwear in my bag when I go out. If I leak, I usually just throw out the soiled pair and change into the fresh ones.

It’s not an ideal solution (it’s bad for both the planet and my wallet), but I have yet to come up with something better. Unlike my mother, I don’t find peeing myself particularly humorous. It’s embarrassing, especially when I’m out in public.

And I still wonder, “Is this normal?”

I’ve talked with other moms who’ve had vaginal births, and they all say they can relate. They usually pee a little when they sneeze, cough or laugh a lot, too. Additionally, I recently learned that up to 1 in 2 women experience urinary incontinence.

Does the fact that bladder leakage is so common among women make it “normal”? Is there anything I can do to make this stop? I’ve tried Kegels, per the advice of Sophie and many mom blogs, but I have no clue if I’m doing them correctly and they have yet to make any difference that I can feel.

I’ve reached a breaking point: I need to know if bladder leakage is just a way of life for women like me. Right now, I’m looking for a pelvic floor therapist, and, honestly, wishing I’d done so sooner.

In the meantime, I’m going to explore products like pads or disposable underwear to make urinary incontinence less of a hassle. Throwing panties out in restaurant bathrooms isn’t a good long-term solution — nor is feeling bad about myself all the time

*Names have been changed for privacy.

Resources

National Association for Continence

Poise Incontinence Pads

This educational resource was sponsored by Poise, a brand of Kimberly Clark.

Have your own Real Women, Real Stories you want to share? Let us know.

Our Real Women, Real Stories are the authentic experiences of real-life women. The views, opinions and experiences shared in these stories are not endorsed by HealthyWomen and do not necessarily reflect the official policy or position of HealthyWomen.


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After Living with Postpartum Bladder Leakage, I Was Able to Treat It


This educational resource was sponsored by Poise, a brand of Kimberly-Clark.

As told to Nicole Audrey Spector

After giving birth, vaginally, to my first child, I experienced bladder leakage. It happens, I was told by my medical team. It would likely go away. And it did. But after the birth (also vaginal) of my second child, the bladder leakage came again. Only this time, it didn’t go away.

At first, I wasn’t concerned because I’d been told that postpartum bladder leakage is a common experience. But this just wouldn’t stop, and, what’s more, it was quite intense. I would pee whenever I coughed, sneezed or laughed. Often, it was a lot more than just a dribble. I relied on pads every day. I stopped wearing dresses and skirts and started wearing black pants to hide the leakage when it got bad — and I could never predict when it would get bad.

I’ve always been a very social and active person. I love hiking, running, swimming and going out with friends. Living with bladder leakage held me back from all the activities that made me feel alive. Who wants to have an accident while jogging? Or be at a party and have to dash to the bathroom without warning to avoid an accident?

Worst of all, I couldn’t show up for my kids the way I wanted to. I wanted to run and jump with them at the playground, but was too worried I’d have an embarrassing accident.

Out of fear of embarrassment, I became isolated, withdrawn and a stranger to myself. No, I realized, this is not something I have to just accept! Oh, and I tried Kegels. So many Kegels. But those only seemed to make the leakage worse.

After more than two years, I decided to take action. I was a physical therapist, and in my practice, I was committed to the understanding that everything in the human body is connected. So, I thought to myself, “I treat people using a whole body approach. I need to use that approach on myself.”

Lindsey showing a skeleton of a pelvis2023 (Photo/Shane Geddes)

It took me several months to piece together an understanding of bladder leakage, its causes and how to best treat it. I did a ton of research on my own. It was a huge journey, and I relied heavily on my medical background to make sense of it all. Something I realize not everyone else can do.

I considered a few injuries I’d had in my past — nothing too serious, but still enough to affect how my body and bladder functioned. For example, I’d hurt my knee and my tailbone, and afterward, had adapted to some unhelpful posture and moving strategies. I believe the force from these injuries acted on my pelvis, bladder and pelvic floor, ultimately leading to bladder leakage.

I realized that it wasn’t that I had loose pelvic floor muscles, as I’d previously suspected (and what women usually think is the cause of their bladder leaks). It was the opposite. I actually had overactive pelvic floor muscles that were holding on for dear life all day long. Many people don’t know this: Tight muscles are not efficient or even necessarily strong muscles. Relaxation is key to building strength, and overactive muscles don’t allow for that relaxation.

I retrained my pelvic floor muscles, focusing on lengthening and strengthening and incorporating whole body exercises. I also used methods to manage pressure and stress, like stretching, mindfulness and breathing exercises. By focusing on both the physical and emotional parts of my condition, I found a complete solution that finally brought relief.

The pelvic floor and bladder are affected by emotional stress. And as a mom of two little ones with a partner who was often traveling for work, I was under a lot of stress. And that can show up as overactivity in those muscles, as well as sensitivity in the bladder.

After just a few months of doing theappropriate exercises, looking beyond the pelvis, balancing my stress and calming my bladder, my leaks lessened and soon stopped entirely.

Now, I don’t recommend that others go down the rabbit hole I went down to resolve my bladder leakage. Instead, I suggest they seek out a pelvic floor therapist who considers the whole body — not just the pelvis. It’s never too late. I lived with bladder leakage for more than two years before I got the help I needed. To manage my leaks during that time, I relied on pads, which provided much-needed comfort and reduced the fear of embarrassment or needing to change my clothes.

Once I finally overcame my bladder leakage, I wanted to help others who are going through what I went through. Now, I work as a pelvic floor physical therapist and am honored to be in this space, helping to empower other women of all types.

I encourage my clients to use pads, or leak-proof underwear as a practical solution for managing leaks while we work together to address the root cause. I also urge women experiencing bladder leakage to get help from a professional and not feed the myth that long-term bladder leakage is acceptable. It’s common after childbirth (even Cesarean moms can experience it), yes, but that doesn’t mean it’s something to be ignored.

I’ve noticed that bladder leakage is rarely talked about in most circles. The bladder is a taboo part of the body. Even with our healthcare providers, we may be ashamed or embarrassed to talk about leakage, especially if we aren’t doing the Kegels we’ve all heard we “should do.”’ We may think it’s our own fault that we’re living with bladder leakage. And so, we clam up, and by doing that, we increase the stigma.

But the pendulum can swing too far in the other direction, too. We may laugh it off with our mom friends, assuming it’s just how things are after giving birth. But again, bladder leakage may be common but that’s not the same as “normal” — and it shouldn’t be accepted as a permanent side effect of having had a baby.

We must shatter the stigma around bladder leakage. If you live with it, let the people in your life know what you’re going through. Most importantly, get the help you need. It’s out there and waiting for you.

Resources

National Association for Continence

Poise Incontinence Pads

This educational resource was sponsored by Poise, a brand of Kimberly-Clark.

Have your own Real Women, Real Stories to share? Let us know.

Our Real Women, Real Stories are the authentic experiences of real-life women. The views, opinions and experiences shared in these stories are not endorsed by HealthyWomen and do not necessarily reflect the official policy or position of HealthyWomen.

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Menopause and Bladder Leakage – HealthyWomen



This educational resource was sponsored by Poise, a brand of Kimberly-Clark. Other Kimberly-Clark brands include Depend and Thinx for All Leaks.

My friends and I knew the hot flashes were coming for us. And we’d heard the chatter about sleep disturbances and mood swings. Women are now more likely to be openly discussing the menopause symptoms previous generations weren’t even whispering about. But there remains one exception to this openness. Lurking in the dark corner of menopause conversations among friends is the symptom few want to discuss: bladder leakage.

But it’s too common to ignore. More than half of postmenopausal women experience some sort of urinary incontinence, the medical term for bladder leakage. If you’re like me, you may be asking: doesn’t menopause take enough, even without the bladder leakage? Menopause has claimed our sleep, our moods, our ability to control our facial sweating. Can’t menopause just let us keep our ability to sneeze, laugh and cough without fear?

We should be so lucky. “We see sharp increases in bladder leakage during the menopause transition and during the menopausal years,” said Lauri Romanzi, M.D., a urogynecologist and member of HealthyWomen’s Women’s Health Advisory Council. “Aside from estrogen deprivation in the bladder and urethra, we don’t truly understand why this spike at and around menopause occurs. And it’s difficult to sort out whether it’s caused by menopause, aging issues or delayed onset impacts of childbearing.”

In the search to narrow down a culprit, estrogen loss from menopause looks reasonably guilty. Estrogen is a hormone that affects far more than the reproductive system, and most types of bladder leakage during menopause have links to estrogen loss.

Estrogen loss can weaken the urethral closure, which causes a type of bladder leakage triggered by pressure on the bladder and urethra. Changes in pelvic floor strength have also been linked to estrogen loss, and this issue is more common among women who have given birth. However, Romanzi said, women who have not given birth aren’t necessarily guaranteed a lifetime of fear-free sneezing, coughing or laughing.

Another type of bladder leakage, overactive bladder (OAB), causes urinary urgency, which is when you don’t have much warning before you have to pee. It can also trigger urinary frequency and nighttime urination, with or without a sense of urgency. The loss of estrogen receptors in the bladder because of menopause can cause overactive bladder, Romanzi said.

Bladder leakage may be common, but you can manage the symptoms

While bladder leakage from menopause is common, it should not be accepted as a “new normal.” Possible solutions depend on the type of bladder leakage you’re experiencing and how bad it is, but they all should begin with a conversation with your healthcare provider (HCP).

“Be your own advocate,” Romanzi said. “Start by speaking with your primary care physician or gynecologist. Ask for a referral to a urogynecologist or urologist specializing in women’s bladder problems.”

Your healthcare provider might also suggest lifestyle changes or seeing a physical therapist that specializes in pelvic floor therapy. A pelvic floor physical therapist can help you strengthen your pelvic floor muscles through physical exercises, such as the Kegel technique. They might also help you retrain your bladder using biofeedback and electrical stimulation techniques. Many women perform Kegel exercises incorrectly, so it can be a good idea to talk to a professional to make sure you’re doing them correctly.

Using bladder leakage pads, like Poise pads, or underwear designed for bladder leakage, like Depend or Thinx for All Leaks, can be helpful in offering you protection and peace of mind. Bladder leakage pads are designed to control odor and wetness from urine unlike sanitary pads made for periods.

Avoiding certain foods can help improve bladder leakage symptoms for some women. Some foods to avoid are:

  • Caffeinated drinks (such as coffee, tea and some energy drinks)
  • Carbonated drinks (such as soda and sparkling juice)
  • Citrus juices and fruits
  • Tomatoes
  • Chocolate
  • Alcohol
  • Spicy foods

What irritates your bladder might not irritate someone else’s, so it’s a good idea to try to figure out what you personally can and cannot eat and drink by keeping a journal of what you’ve eaten and drunk. If you have overweight or obesity, your healthcare provider might suggest weight loss to reduce pressure on the bladder and pelvic muscles.

If these changes don’t work, medicine might be an option. If menopause is causing your bladder leakage, topical estrogen that goes inside the vagina can be helpful. It comes as a cream, tablet or vaginal ring.

There are also FDA-approved medications to treat urinary incontinence. Some of these medicines can cause side effects such as dry mouth, which can actually make things worse by making you drink more. Although it may seem odd, drastically limiting fluid intake to control bladder leakage is not recommended. In fact, staying well hydrated (but not overly hydrated) and emptying the bladder regularly may help retrain and strengthen the muscles around the urethra and bladder.

If these treatments don’t work well enough, there are other treatments available, but they’re considered more invasive. These include Botox injections to the bladder, or a weekly treatment called percutaneous tibial nerve stimulation (PTNS). PTNS delivers electrical stimulation through a needle inserted into a nerve in the ankle.

According to Romanzi, a device that resembles a pacemaker can be implanted in women with severe OAB or urge incontinence that doesn’t respond to other treatments. These devices are inserted in the lower back and deliver electrical pulses. Weakened urethras can be surgically strengthened with a urethral sling. Urethral bulking is a similar surgical procedure that strengthens the urethra by injecting it with silicon.

Data show that only 1 in 3 people experiencing bladder leakage try to get treatment. But shame, fear or embarrassment should not silence you into needless suffering.

To get treatment, let your healthcare provider know you’re having this common menopause symptom. You may feel like you’re the only one having bladder leakage, but you’re definitely not alone. And your HCP can help you find solutions.

Resources

National Association for Continence

Poise Incontinence Pads

This educational resource was sponsored by Poise, a brand of Kimberly-Clark. Other Kimberly-Clark brands include Depend and Thinx for All Leaks.

Poise and Depend are registered trademarks of Kimberly-Clark. Thinx for All Leaks is a trademark of Kimberly-Clark.

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