Urinary leakage: what you need to know

The pelvic floor is a group of muscles located at the base of the pelvis. It supports the lower digestive tract, the urinary tract, and the genital organs — which is why it is essential to look after it throughout your life. Yet it is often neglected, and life's events can put it under a great deal of strain, especially for women.

Exercise, pregnancies, and vaginal deliveries can all weaken the pelvic floor. It is common for women who have recently given birth to experience urinary leakage — known as stress incontinence.

The pelvic floor is not always solely responsible for urinary leakage

Urge urinary incontinence is a bladder condition characterised by an uncontrolled contraction of the bladder.

When combined with a weakened pelvic floor, this is referred to as mixed incontinence. Mixed incontinence is the most common cause of urinary leakage, and it primarily affects older women.

I'm experiencing urinary leakage: what should I do?

If you are experiencing involuntary urine loss outside of normal urination, the best course of action is to make an appointment with your doctor for an assessment.

In the first instance, they will likely refer you for pelvic floor rehabilitation with a midwife or physiotherapist. If you have recently given birth, 10 pelvic floor rehabilitation sessions, fully reimbursed by social security, will be prescribed.

If you are menopausal or approaching the menopause, your doctor may prescribe local oestrogen treatments.

When non-invasive treatments prove ineffective, your doctor may suggest surgery. The insertion of a mid-urethral sling helps reinforce the support of the pelvic floor.

Whatever your doctor's prognosis, while waiting for the chosen treatment to take effect, it is important that you feel comfortable and are not bothered by the sensation of dampness. Washable sanitary towels can absorb urine leakage whilst their microfleece lining ensures a stay-dry effect. When you are away from home, you can store your reusable intimate protection in a waterproof pouch: discreet and slim, it will slip easily into your handbag and effectively protect your belongings from moisture and odour.

How to prevent urinary leakage?

The best way to prevent urinary leakage is to preserve your pelvic floor so that it retains all its elasticity — starting from a young age, by maintaining a healthy lifestyle and a balanced diet!

Indeed, urinary leakage is more common in people who are overweight, suffer from constipation, or smoke.

Furthermore, certain sports — such as running, step aerobics, or basketball — are particularly hard on the pelvic floor and should be avoided if you suffer from urinary leakage. Intense exercise in general tends to put strain on the pelvic floor.

This is why, even if you don't suffer from incontinence, it is important to adopt a proper posture by tilting your pelvis when exercising. If you are working your abdominal muscles, which can be particularly demanding on the pelvic floor, make sure you engage your pelvic floor by drawing in your stomach at the same time.

Also, make sure you engage your pelvic floor when lifting heavy objects or when coughing.

Finally, it is important to become aware of your pelvic floor and to exercise it with small daily exercises.

Why am I experiencing incontinence since my pregnancy?

The increase in the size and weight of the abdomen puts additional pressure on the pelvic floor. It is estimated that nearly one in two women experiences incontinence by the end of their pregnancy. To limit the pressure exerted on the pelvic floor, a moderate weight gain is recommended during pregnancy.

Birth is also traumatic for the pelvic floor. The muscles and nerves may become stretched, particularly in the case of a long or assisted delivery.

For all these reasons, it is recommended to begin pelvic floor rehabilitation 10 weeks after the birth of your child. In the meantime, to live as comfortably as possible, you can opt for panty liners or washable sanitary towels, which will manage leakage and reduce the sensation of dampness.

Signs that your pelvic floor may be weakened

You may not experience urinary leakage immediately after the birth of your child, but it may develop months or even years later. To prevent potential incontinence issues, we invite you to be alert to the following signs:

You feel a heaviness in your pelvis, similar to how you felt during pregnancy.
You may feel discomfort, again in the pelvic area, when walking.
Your menstrual cup or tampon is no longer staying in place properly.

If you notice any of these symptoms, we recommend speaking to your doctor or midwife.

How to look after your pelvic floor during pregnancy and childbirth?

First pregnancy, then childbirth — both place enormous demands on the pelvic floor. To ease baby's passage during delivery and prevent tearing, it is recommended to perform perineal massage with a massage oil from the 8th month of pregnancy onwards, right up to the birth. The massage should last between 3 and 5 minutes per day.

Please be aware, however, that perineal massage is not recommended if you are experiencing painful contractions before 37 weeks of amenorrhoea.

Antenatal preparation classes can also help you protect your pelvic floor. By being more relaxed, breathing better, and pushing more effectively during the pushing stage, you will place less strain on your pelvic floor and reduce the risk of requiring an episiotomy.

Choosing a physiological birth position (on your side, squatting, on all fours, etc.) will also reduce the risk of tearing.