How to talk about, tackle – and treat – this taboo in the lead up to Valentine’s Day

It is estimated that 1 in 3 women will suffer with stress urinary incontinence (SUI) at some point in their lives. SUI can occur at any age but is more common in women aged 35 to 60. The condition can have a significant impact on daily life, relationships and emotional well-being.

SUI can affect women who have been through pregnancy and child birth, but other contributing factors can include obesity, age and a family history of incontinence. A recent survey showed that around 9 out of 10 women living with SUI are likely to simply “put up with” the condition, rather than seeking treatment and advice, despite any negative effects on their life and relationships.

Many women who suffer from SUI may feel embarrassed and isolate themselves from social activities, including meeting and dating new partners. SUI can make you feel uncomfortable when getting to know a new partner or enjoying date night with your current partner.

“I was also in a new relationship at the time of my diagnosis and soon realised how badly incontinence was affecting my confidence – it sounds dramatic, but I felt “unclean”. There is literally nothing “sexy” about wearing a pad!” Debbie Dowd, from Croydon, who was treated with bladder neck bulking agent, (Bulkamid®) in October 2017, and says her successful treatment has ‘changed her life’.

As Valentine’s Day approaches, Mr Steve Foley, Consultant Urologist at the Royal Berkshire NHS Trust (Reading), offers advice to women who are worried about being intimate with their partner when suffering from SUI:

1. Speak to your partner – Discussing incontinence may sound embarrassing, but it is a crucial step to make sure it doesn’t affect a new or current relationship. Talking about your incontinence with your partner will allow you to be honest and open about how the condition is affecting you and highlight that it may happen during intimacy. By speaking to your partner, it will also help to relieve some of the stress you may be feeling.

2. Consult your GP about treatment options – Bulking agents are a minimally invasive treatment which means no cutting of the patient’s tissue or skin. They seem to have a lower profile than many of the major surgical approaches (some of which have attracted a great deal of controversy) but they are a safe and effective treatment which have been used for over 10 years, widely on the NHS. In my clinic, we use Bulkamid® a water-based gel that helps the bladder neck to close when needed to help prevent bladder leaks and has an 80% success rate when used as a first line treatment. Many of my patients have been surprised at how quickly they are able to return to their normal routines after minimally invasive treatments, such as bladder bulking, and have no more leaks when partaking in exercise, sneezing or even using a trampoline with their kids.

3. Try different positions – If you experience leaks when you sneeze, laugh or workout, then putting extra pressure on your bladder during sex will also cause leakage. Incontinence shouldn’t affect your sex life, although it may make you feel anxious and uncomfortable. There are many things you can do to prevent leaking during sex and one of the simplest can be changing your sexual position. Women who are concerned about leakage during sex should avoid positions that put extra pressure on the bladder, such as missionary.

4. Be prepared – Avoid bladder irritating foods and alcohol for a few hours before you plan on getting intimate with your partner. If you are worried that you have consumed too many fluids, then be sure to use the toilet before having sex. You can also be prepared by putting down towels or underpads down, so you don’t have to worry about a leak if it does happen.

5. Make sure you do your pelvic floor exercises – Exercising the pelvic floor muscles will improve incontinence in the majority of those who do them consistently and correctly. Isolating the correct muscle is difficult for some, especially if the muscles have become very weak. Having an exercise plan and sticking to it makes a difference in results. Exercise aides can assist with doing these exercises correctly.