Urinary incontinence is definitely a less fun topic to chat about with your girlfriends than the latest series we all loved… and yet it can really disrupt your life. So yes, ladies, it needs to be talked about! The urinary leaks in women are a bit like periods: we all experience them directly or indirectly. L'incontinence should no longer be a hidden taboo because of age. The good news is that it is not inevitable. Effective treatments exist to help you regain control of your body and a great level of confidence.
In this blog post, we’ll cover 3 key points:
- The impact of everyday habits: Simple daily adjustments to change your habits, significantly reduce the risk of incontinence and relieve pelvic discomfort.
- Pelvic floor strengthening: An essential step to deeply tone the pelvic floor muscles.
- Incontinence treatments: Discover a wide range of advice and methods, such as using the pelvic floor trainer Emy Trainer at home.
What are the causes of incontinence and its symptoms?
According to official data from Assurance Maladie, urinary leaks result from a mechanical dysfunction during the bladder filling phase. Normally, the muscles of the bladder wall relax to store urine while the urinary sphincter remains closed. An abnormality in this system leads to three main types of incontinence in adults:
- Stress urinary incontinence : It is defined as an involuntary loss of urine without any urge to urinate beforehand, triggered during physical activity, a sneeze or laughter. It results directly from weakening of the pelvic floor muscles (which support the urethra) or from a deficiency in the sphincter.
Its main factors in women are pregnancy, childbirth, menopause and prolapse. - Urgency incontinence (overactive bladder) : Linked to bladder overactivity, it appears as a sudden urge to urinate caused by an involuntary contraction of the bladder muscle. It can be triggered by a urinary tract infection, urethral narrowing, radiotherapy, bladder cancer or a neurological condition.
- Mixed incontinence: It combines the symptoms of stress and urgency incontinence in an associated way.
The overall risk of incontinence is greatly increased by contributing factors: excess weight, chronic constipation, smoking-related cough, drinking bladder irritants (coffee, tea, alcohol) or certain medications. To identify the exact cause of incontinence, completing a bladder diary is essential before seeing your healthcare professional.
What medical answers are there for urinary leaks?
Dr Marine Lallemant, a obstetrics and gynaecology resident specialising in pelvic-perineology, explains.
In treating urinary incontinence, the first step is to address contributing factors. Healthcare professionals will encourage weight loss, limiting tea and coffee intake, doing suitable physical activity, treating constipation and supporting smoking cessation.
After menopause, a local vaginal treatment with oestrogen may be prescribed. It improves the quality of the vaginal mucosa and indirectly urinary continence.
Whatever the type of urinary incontinence, pelvic floor training is the first-line treatment. It helps train the pelvic floor muscles, strengthen the abdominal muscles and improve lumbopelvic stability.
Learn more about my pelvic floor
Anal prolapse and pelvic weakness
When distension of the pelvic floor muscles becomes widespread, other anatomical disorders can unfortunately be associated with urinary leaks. This is the case with anal prolapse (often confused with rectal prolapse), which is characterised by the abnormal descent and relaxation of the rectal walls through the anus.
Just like incontinence, this mechanical discomfort often has its source in repeated straining due to chronic constipation, obstetric trauma or tissue ageing.
Early management through targeted muscle strengthening and a reassessment of lifestyle is essential to restore the supporting structure and avoid more serious deterioration.
Natural treatments for urinary incontinence in women
Adjusting your lifestyle
One of the first pieces of advice for people with incontinence is to adopt a healthy, balanced diet. The goal is to avoid developing chronic constipation or being in a state of excess weight.
These are situations in which significant pressure is placed on the pelvic floor. This can therefore encourage the появition of urinary leaks.
It is also important to do physical activity regularly. Healthcare professionals also recommend quitting smoking. Indeed, cigarettes can lead to a chronic cough that creates excessive pressure on the pelvic floor.
Regulating your drink intake
Some drinks such as coffee, tea or alcohol are bladder irritants. When you consume them, they increase urine flow into your bladder and encourage urination. They are natural diuretics. It is better to limit your intake.
If night-time urination bothers you, try drinking less fluid during the few hours before bedtime.
Strengthening your pelvic floor through pelvic floor training
Urinary leaks can occur in a woman’s life for many reasons. For example after pregnancy and childbirth (vaginal or by C-section), or during menopause, due to tissue ageing.
To prevent urinary incontinence, it is important to strengthen your pelvic floor.
If you are suffering from urinary leaks, pelvic floor training sessions will always be prescribed as a first-line approach. They will help you to tone your pelvic floor.
Treatment for stress urinary incontinence
In stress urinary incontinence, pelvic floor training is carried out by a physiotherapist or a midwife, usually after childbirth.
Between training sessions, the patient needs to continue self-training at home to improve results. This is easy to do with the Emy Trainer pelvic floor trainer.
Treatment for urgency incontinence
In urgency urinary incontinence, training is combined with a cognitive-behavioural treatment to retrain urination habits. In combination with, or following, failure of behavioural treatment, medications to calm bladder contractions may therefore be prescribed.
To treat the urge to pee, there is also a medical device that stimulates the tibial nerve. It involves placing 2 electrodes on the skin at the ankle for 20 minutes a day.
Alternative treatments for urinary incontinence
Many natural alternatives exist, such as sophrology, acupuncture, reflexology, homeopathy or even hypnosis. Should they be ruled out, or do they offer additional avenues worth exploring?
At present, there is no scientific evidence for the effectiveness of alternative methods in the management and the treatment of urinary incontinence.
In addition, sophrology or hypnosis can be used. These methods help patients manage the anxiety linked to this condition and regain confidence. Millions of women suffer from urinary incontinence but few talk about it: let’s break the taboo!
Can all forms of urinary incontinence be treated?
When all first-line treatments have failed, surgery may then be considered.
Slings for stress incontinence
In the case of stress urinary incontinence, surgical treatment is recommended. This may include the placement of a suburethral sling (support for the urethra during exertion), the placement of an adjustable balloon that compresses the urethra, injections of bulking agents around the urethra, or the placement of an artificial urinary sphincter.
Botulinum toxin for urgency incontinence
Healthcare professionals will suggest surgery as a last resort to treat urgency incontinence. It involves injecting botulinum toxin into the bladder walls. A neuromodulation device may also be implanted under the skin to stimulate the sacral nerve.
In all cases, to avoid reaching the point of surgery, pelvic floor training remains the best preventive treatment for urinary incontinence!
What you need to remember about treating urinary incontinence
- Prevention is essential: Changing your lifestyle, losing weight and avoiding constipation reduce pressure on the bladder.
- Training is your best ally: Strengthening the pelvic muscles through pelvic floor training remains the most effective first-line treatment.
- Medical support is essential: Seeing your GP helps identify the cause of incontinence, explore the medications used to treat urinary incontinence and introduce Emy Trainer at the right time to prevent the condition from getting worse.
FAQ: Everything you need to know about treating urinary leaks
Why do I have urinary leaks?
Urinary incontinence is mainly linked to weakening of the pelvic floor muscles. This relaxation usually happens after childbirth, at the time of menopause, with natural ageing, or following intense sport. Other factors such as chronic constipation or a urinary tract infection can also be the cause.
What are the real causes of urinary incontinence?
Incontinence is not a disease in itself, but a symptom of a physical dysfunction. It is mainly caused by:
- Pelvic floor relaxation: Following pregnancy, childbirth, or due to natural ageing, the pelvic floor muscles relax and no longer support the bladder properly.
- Hormonal changes: At menopause, the drop in oestrogen weakens the tissues of the urethra and bladder.
- Repeated abdominal pressure: Excess weight, chronic coughing (linked to smoking for example), frequent constipation or high-impact sports (running, crossfit) place continuous pressure on the body that tires the pelvic floor.
- Overactivity of the bladder muscle: In urgency incontinence, the bladder muscle (the detrusor) contracts abnormally, creating a sudden and uncontrollable urge, sometimes linked to stress or neurological factors.
Who should you consult for an incontinence problem?
You can first talk about it with your GP or your gynaecologist. Depending on your diagnosis, they will refer you to a pelvic specialist: a urologist for further tests, or a physiotherapist / midwife to start appropriate training.
What is the best natural treatment to stop leaks?
The reference natural treatment is pelvic floor strengthening through biofeedback. The connected Emy Trainer smart pelvic floor trainer makes it possible to do this active training at home.
This medical device offers playful exercises on your smartphone to effectively strengthen your pelvic floor, with visible results from as early as 3 weeks.
How can I reduce urinary leaks in everyday life?
To reduce the impact of leaks day to day, you can adopt a few simple habits:
- Limit bladder irritants such as coffee, tea, alcohol and fizzy drinks.
- Avoid holding on too long or, on the contrary, going to the toilet “just in case”.
- Brace your pelvic floor (contract it voluntarily) just before exertion, a sneeze or a cough.
Are there effective medications for incontinence?
Yes, medication treatments (such as anticholinergics) exist, but they are mainly prescribed for urgency incontinence (overactive bladder). They help relax the bladder muscle to calm urgent urges. They can sometimes cause side effects and do not treat pelvic floor muscle relaxation.
When should surgery be considered?
Surgery (particularly the placement of suburethral slings) is considered as a last resort when stress urinary incontinence is severe and deeply affects quality of life.
It is only offered after pelvic floor training has failed and following a full urodynamic assessment with a urologist or gynaecological surgeon.
Sources:
- Urinary incontinence: mechanisms, prevalence and causes, Assurance Maladie (Ameli), February 2024, Information sheet - link
- Prospective evaluation of the connected biofeedback EMY Kegel trainer in the management of stress urinary incontinence, Jochum F et al., February 2022, Journal of Gynecology Obstetrics and Human Reproduction 51(2):102280. - link
- Pelvic Floor Muscle Rehabilitation Using Biofeedback, Diane Kaschak Newman, July 2014, Urologic Nursing 34(4):193-202. - link
- Rehabilitation in the context of post-partum, Haute Autorité de Santé (HAS), December 2002, Clinical practice recommendations. - link
