Amanda* first noticed bladder weakness, manifesting as urinary urgency and frequency, after the birth of her first child. At the time she thought it was just something she had in common with several of the women in her mother’s group. “This is when I started the ‘I better go just in case’ routine because I didn’t want to be out and wet myself,” says Amanda*.

Two years later and after the birth of her second child, Amanda* noticed the problem had become worse. After confiding in her sister, she discovered there were treatment options for women, one of which was an artificial compression device, also known as a balloon, which is used for mild to moderate stress incontinence. This had been “the best thing ever” according to Amanda’s* sister, so Amanda* decided it was time to consult a urogynaecologist.

Following a diagnosis of stress urinary incontinence (SUI), Amanda's* urogynaecologist recommended an operation was a better option for her than a balloon. Amanda* went ahead with the procedure and experienced a good outcome with no further continence issues for many years. And then, she hit menopause….

With the onset of menopause, Amanda* noticed she had continence issues again. “I was experiencing what I know now was urge incontinence,” says Amanda*. “My keys would literally just be in the front door, and I was like get out of my way and bolting to the toilet. We used to laugh about it but then I realised I didn’t actually have to put up with it.”

Amanda* decided to again consult her urogynaecologist as she wondered if the previous operation was no longer effective. She was asked to complete a bladder diary, which revealed she urinated more frequently than normal and was now experiencing urge incontinence (UI). Her urogynaecologist advised Amanda* she had three options: see a pelvic floor physiotherapist, consider Botox treatment, or take medication. Amanda* went for option number one and headed off to see a pelvic floor physiotherapist who assessed her pelvic floor muscle function and prescribed an exercise programme to retrain these muscles.

Amanda* says one of the key factors in retraining her pelvic floor muscles has been to focus on techniques which divert her brain from responding to the urgency need. Her physiotherapist advised her not to ever run to the toilet, but stop first, stand, walk slowly, and delay the process as long as reasonably possible. Other diversionary techniques she has found useful include curling her toes and tapping when she feels the need to urinate, again distracting the brain from the urgency signal.

Amanda* finds she can now ‘hold on’ for a lot longer and has stopped going to the toilet ‘just in case.’ Whilst remembering to do her pelvic floor muscle exercises daily requires ongoing self-discipline and commitment, Amanda* has definitely experienced improvement. “I feel like I have a better understanding that there are two types of incontinence and I get the difference between the causes of them,” she says.

*Name has been changed to protect privacy.