Do you leak when you laugh, sneeze, cough or jump? If so, you are not alone: it’s estimated that one-in-three of us suffer from urinary incontinence. So what are the main causes and what can help improve this embarrassing condition?

“Incontinence is the primary reason why women end up in care homes,” shares intimate health expert, Dr Shirin Lakhani. While it’s estimated that a third of us are suffering from the condition, the figure is likely to be much higher as it’s believed many people fail to report it to their doctor, wrongly thinking that it’s ‘normal’ or ‘just what we women have to put up with,’ especially with high-profile advertising of incontinence products normalising a medical issue that can be treated.

It’s certainly a topic we should be discussing more, especially as, according to the charity Bladder Health UK, 80 per cent of cases can be cured or improved. This is something that Mr Vivek Nama, Consultant Gynaecologist at The Door, supports. “Women’s wellness is quintessential to the wellbeing of society,” he says. “Now with increasing awareness, more women are seeking help and are able to talk about it.”

What are the types of incontinence?

Stress and urge incontinence are the main types, and as women grow older it’s not uncommon for women to suffer from both. Stress incontinence occurs when you leak when laughing, sneezing, coughing, or straining. It can strike at any age, with high impact sport, constipation and being overweight all risk factors. Urge incontinence is a sudden and often uncontrollable urge to pee, and often you leak before you reach the toilet. This type of incontinence is also called an overactive bladder (OAB).

Why does it happen?

“Your bladder, bowel, vagina and uterus are held in place by a hammock of muscles called the pelvic floor,” says Dr Lakhani. “Weak muscles can’t hold up these organs and that can cause your bladder to leak.” The most common causes of a weakened pelvic floor include pregnancy, childbirth, obesity, constipation and the menopause, so strengthening the pelvic floor is key.

What treatments are available?

Fortunately, there are several effective non-surgical, minimally invasive in clinic treatments available to improve a weak pelvic floor and incontinence.

Ultra Femme 360

Dr Lakhani frequently prescribes a course of three sessions of this radio frequency treatment which involves a small probe being repeatedly and gently inserted in and out of the vagina for eight minutes by the practitioner. Reassuringly, patients report it is pain-free. “It’s a fast and effective treatment for vaginal laxity, tissue quality and continence, and is one of my most in-demand treatments”, says Dr Lakhani.

Emsella Chair

We all know we should be performing kegel exercises every day–that is consciously clenching and relaxing our pelvic floor muscles–but they are tedious and easy to forget. However, the Emsella Chair, also known as ‘The Kegel Throne,’ promises the equivalent of 11,400 pelvic floor exercises in just 28 minutes, plus it’s totally non-invasive and easy to perform–it involves sitting fully clothed on a chair. Using an electromagnetic field, the chair stimulates the pelvic floor and strengthens 100 per cent of the muscles, rather than the 40 per cent which kegel exercises promise. The treatment is painless, although you might feel a slight tingling in your genital region.

Empower RF

Another option is Inmode’s Empower RF, which uses a combination of radio frequency microneedling to stimulate collagen and elastin, and V-Tone which uses electrical stimulation to strengthen the pelvic floor muscles and improve circulation. Mr Nama believes it can help women avoid complex surgeries. “Vulvo-vaginal rejuvenation is a rapidly expanding treatment”, he says. “It’s designed with women’s wellness at the forefront and allows us to treat both collagen and muscle to improve vulvo-vaginal health.”

The O Shot

This is a specific type of PRP (platelet rich plasma) injection designed to lessen the symptoms of incontinence and sexual function. It involves taking a small sample of blood, which is spun in a centrifuge to separate the plasma that is then injected back into areas of the vagina. The PRP helps stimulate the production of collagen and elastin and increase sensitivity in the area, as well as lessening symptoms of incontinence. Most women report an increase in their sexual responses, along with greater lubrication and better bladder control. “It restores vaginal tissue and improves stress incontinence, as well as reducing dryness,” confirms Dr Lakhani.