Urinary incontinence in women: 5 common misconceptions debunked
Isabelle Reynaud talks to us about common misconceptions about incontinence in women.
The benefits of exercise are obvious, but they can also expose an issue that is as common as it is taboo: stress incontinence. However, certain sports (jogging, ball games, etc.) and physical activities (CrossFit, Zumba, Pilates, etc.) can reveal what is known as “pelvic floor disorder”, as among them stress incontinence. This disorder, which is not a disease, is particularly sensitive in nature—even embarrassing. It need not be an inevitability, merely a reality, assures Isabelle Reynaud, a physiotherapist who is specialized in pelvic floor education. Fortunately, there are effective and discreet ways that those with this disorder can continue to enjoy physical activity. The following paragraphs debunk common misconceptions and offer expert advice.
Isabelle Reynaud, founder of Sport et Spécificités Féminines, an association that addresses women’s health with regard to exercise, assists women who are active at every level and preventing pelvic floor risks during various physical activities. This includes urinary incontinence — a problem that calls for a personalized response.
„Urinary incontinence comes in several forms: stress incontinence, urgent urination, or a combination of the two.“
#1: Urinary leakage is preventable
“Incontinence is not unavoidable, but it is a reality that has a strong impact on people’s social life as well as on intimate relationships. Those affected need a quality response and feel properly supervised.” This is accomplished through an adequate understanding of the risk factors which are constitutional in nature such as the physical posture. This requires a good understanding of constitutional risk factors such as the physical posture. But the reasons why it gets worse are numerous (chronic coughs, harmful practices of sports training, obstetrics, hormones, etc.).
#2: Incontinence affects not just older women
“Many believe this is a condition that only happens to older women, even though it is found in women as young as 13 who are active and in good health. The common misconception that links incontinence to advanced age reinforces the notion that is taboo and an embarrassing discussion topic. This is why general practitioners, OBGYNs and midwives need to bring it up with women before they do, and perform tests in addition to their usual exams, such as having the patient cough, testing her ability to contract and relax the perineal muscles, etc.”
#3: Urinary leakage does not necessarily mean an end to exercise
“Exercise is good for the heart, joints, muscles and overall balance. With regard to urinary leakage, it is not so much the sport or physical activity that is the cause, rather the way in which a person trains, practices concerning duration, intensity and quality,” explains Reynaud. Some sports, of course, are riskier than others: track and field, basketball, handball, BMX, trampolining, horseback riding, running, etc. They usually expose an existing weakness which necessitates specific care. “It is not a question of stopping exercise but of adapting it to the characteristics of the female anatomy,” recommends Reynaud.
#4: Strengthening the perineal muscles and other “remedies”: Be careful!
“Some active women have well-toned perineal muscles and still experience leakage. The issue lies elsewhere. We also have to deal with intra-abdominal hypertension.” So watch out for any formatted advice. Also beware of trivialization —“as if it were normal to work out and experience leakage!”—as well as quick tricks: These “tricks” shared in the locker room are often unsuitable and, at worst, risky, such as using tampons to avoid leakage during workouts. Proper care is the best way to be able to exercise with peace of mind.
#5: Embarrassing solutions are not the only solutions
Many women still find it uncomfortable and embarrassing to use safeguards or “diapers”... The goal, according to Reynaud, is “not to reconcile everyday life, exercise and urinary leakage, but to be rid of it”. The earlier the treatment, the more preventive measures will generally suffice: learning good habits and what practices to forget, such as “crunch” exercises (lifting of the torso and/or legs), instructions saying to inhale, inflate the stomach, push to urinate, wait until the last minute before going to urinate, etc. When women wait too long to see a doctor, it really is detrimental to their health. “You do not need to admit defeat; there are always solutions” that you can consider before resorting to surgery. This is what Reynaud proposes at the sports preventive health workshops held by her association. “Doctors can also recommend an internal vaginal device,” which is a discreet over-the-counter solution designed to physically reduce the risk of urinary leakage.1
What is stress incontinence?
Stress incontinence is the unintentional loss of urine, not preceded by an urge to urinate, following physical activity or coughing.
- Around 25–40% of women suffer from urinary incontinence2; in France, this corresponds to around 3 million women.3, 4
- One in three waits five or more years after the first symptoms to consult a healthcare professional.5
- Primary causes: pregnancy and childbirth, menopause, obesity and tobacco use.2
Sources
1. Cornu J.N et al. 75NC007 device for non invasive stress urinary incontinence management in women : a randomized controlled trial. Int Urogynecol J (2012);23(12) :1727-1734.
2. Fiche Info-Patient : Incontinence urinaire de la femme. Mai 2012. Association française d’urologie. www.urofrance.org.
3. Pyramide des âges au 1er janvier 2014, France. https://www.insee.fr/fr/statistiques/1913143?sommaire=1912926.
4. Haab F. et al. Traitement de l’incontinence urinaire d’effort par colposuspensionpercutanée: une technique non satisfaisante. Progrès en Urologie 2001, 11:336-339.
5. Ballanger P. Épidémiologie de l’incontinence urinaire chez la femme, Progrès en Urologie (2005), 15, Supp. N°1,1322-1333.