Leaking? Nothing to be ashamed of

March is always busy for women — woman becomes the buzzword, and all issues surrounding the female species arise because of International Women’s Day celebrations. Women empowerment is always a major focus, and empowerment not only in the professional level, but also with understanding one’s self and body.

Over coffee last week with a group of women, we began to discuss issues that make women “disempowered” and ashamed. One of my coffee mates was Dr. Jennifer Marie Jose, head of the Urogynecology and Incontinence Center at the Makati Medical Center. She voiced out the issue of incontinence and how this has made so many women ashamed and embarrassed to talk about it. Many often feel helpless and think they are aging.

Incontinence is the experience of suddenly leaking urine, of “going at the wrong time” and suffering great inconvenience. The medical term name is stress urinary incontinence where one in three women will experience a sudden leakage of urine at one point in their lives, especially among those aged 35 to 65. Many of them were laughing, coughing, or doing strenuous activities when the leaking happened.

Incontinence happens when the pelvic floor (which supports the urethra or the tube where the urine passes through) muscle weakens. Normally, the pelvic floor keeps the urethra in place until the person urinates on purpose. When the pelvic floor muscle is weakened, however, the diaphragm’s movements can exert pressure on the bladder, causing the involuntary release of urine. 

Many factors can weaken the pelvic floor muscle. Multiple childbirths and pelvic surgery contribute to the weakening of these muscles. Hormonal changes accompanying pregnancy, childbirth and menopause are another factor. Incontinence can worsen during the week before the menstrual period when lowered estrogen levels may lead to lower muscular pressure around the urethra, increasing chances of leakage. The incidence of incontinence increases following menopause, similarly because of lowered estrogen levels. Age, too, is another consideration. In fact, involuntary urine leakage is a common problem of women aged 80 and above.

Beyond embarrassment and inconvenience, urinary incontinence can lead to bigger psychological problems such as depression. These problems depress the quality of one’s life. Self-esteem issues may also arise, and many have seen their sexual relationships affected by the condition. Urinary incontinence is also an occupational hazard. Many among the elderly have fractured their bones when they slipped as they rushed to the bathroom.

Dr. Jennifer was telling me that incontinence should not be considered a normal part of aging but is actually preventable. We have heard of Kegel exercises to keep the muscles of the bladder strong, or trying to “lift the pelvic floor,” and feel that slight contraction near our “puson” area. This behavioral and muscle therapy is the more conservative approach.

The more problematic cases can be treated by tension free vaginal tape placement. This is a synthetic mesh tape that prevents urine leakage during sudden movement and while exercising by reinforcing the ligaments and tissues that support the urethra. And all it takes is 30 minutes for an out-patient procedure to put attach this mesh tape. So, for women with this problem, say goodbye to nightmares of those adult diapers because there are treatments available around!

“Being silent about this condition decreases our self-confidence and quality of life,” adds Dr. Jennifer. “The best thing to do is to consult your doctor.”