Incontinence: Talking about the thing we don’t talk about

Did you know that more than half of all women affected by incontinence in Australia are under 50 years old? If you’re anything like us, you’ll be stunned by that figure.

When we think of ‘incontinence’, we might picture those cautiously-worded ads aimed at women much older than fifty, resigned to a life of sterile white pads that promise the ultimate in ‘protection’ and ‘absorption’.

A glamorous picture it is not. And as the stats suggest, it isn’t accurate either.

So, why isn’t it normalised yet?

Incontinence is a medical condition like any other. It’s common, too. About 4.8 million Australians are incontinent. That’s close to one fifth of the entire population.

But think about the things you read and consume on a daily basis – your social feed, news sites, newspapers, radio, books, magazines. How often do you read or hear people talking about incontinence? For women in particular, if we’re picking our way through the health and wellbeing sections of online sites, we’re far more likely to read an article on the effects of adult acne.

From a young age, the act of going to the toilet is treated with humour. ‘Peeing’ and ‘pooing’ are often considered childish terms, most likely because they’re topics of conversation that commonly occur between parent and child in the early stages of life.

Once that educational period is over, however, we often struggle to communicate on these topics without falling back on this approach, and specifically, leaning on humour to navigate what feels like an undignified conversation for an adult.

A survey of 1,000 Australian women aged 30 and over conducted by Pure Profile in March found that 60 per cent of women are talking about incontinence with their friends.

For a topic that isn’t so easily navigated, that’s a comfortingly high percentage. And yet, 80 per cent of the same group hadn’t sought treatment for their incontinence.

“Instead of laughing off the issue, women could be doing something every day to improve their situation and regain control,” says Continence Foundation chief executive, Rowan Cockerell.

With this in mind, the foundation has recently launched a campaign titled ‘No laughing matter’, encouraging women to take incontinence seriously and view it as a health problem requiring treatment.

“Pelvic floor muscle exercises can be done anywhere, at any time,” says Rowan. “Once you know how to do them correctly, they can easily be incorporated into daily life.”

If you’re a woman, you’ve probably given it a go at some point. A little clench or lift to test the waters, so to speak. But continence and women’s health physio, Alice Craigie explains that this really isn’t the way to go – you need expert advice to make sure you’re on the right track.

“You have to make sure you’re doing it correctly, and follow a specific program,” she explains. “If you just do bits and pieces it’s not effective. That’s what so many people do, and I did it myself. Until you get a proper program you don’t see those improvements.”

Alice’s experience is part professional, part personal. Working in the field for many years she has hands-on experience in treating and coaching women to manage incontinence.

Yet, it was only when she fell pregnant, gave birth to her son Milton, and experienced bladder weakness herself (first when sneezing, then while dancing at a friend’s wedding), that she realised the full importance of a treatment program. She now encourages women to approach their GP or continence physio as soon as they realise it might be an issue.

“A few drops here and there turn into a few drops most days, and then a few drops most days turns into wearing a pad, and wearing one pad a day turns into two pads a day, and we see some women and men who won’t leave the house anymore,” she says of her experience at work. “They feel like they can’t go out and socialise with their friends, they’re worried they smell of urine. It really is impacting their quality of life.”

Personally, Alice was acutely aware of the impact the issue could have had on her mental health.

“I love running, that’s what keeps me sane. Especially postnatally, that was my big thing to make sure I didn’t get postnatal depression – I had to make sure I could exercise. If I was wetting myself, I’d lose my outlet. Mentally, I would have struggled a lot more.”

“It’s the follow-on effect,” she points out. “A little bit of wee, you can brush it off and laugh about it. But it leads to other issues.”

From her experience, and from dealing with the issue professionally, Alice sees a shift in the way people are talking about incontinence – especially among the younger generation.

“There’s that idea that they’re not going to just accept it,” she says. “Previously, you would have just accepted it and put a pad in. These days, a lot more people are going, ‘No, I’m not going to put up with something. I want to be able to run, so I’m going to make this better.’ Now you can do something about it, and fix it.”