We need to talk about peeing when we sneeze.
I never expected to be thinking about a leaky bladder in my thirties, but there I was, peeing myself whenever I ran, jumped, or sneezed.
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I
had two children in my mid- and late-thirties (“young for a New
Yorker,” my obstetrician told me). For a while I was juggling the
bathroom issues of a barely potty-trained toddler, a newborn son with a
propensity towards urinating on me during diaper changes, and
myself—wearing panty liners around the clock to catch leaks. I’d be
buying diapers for my kids, wondering if I should be doing the same for
me.
Stress incontinence is not just an issue for moms, though.
The Mayo Clinic
defines stress incontinence as urine that leaks when you "exert
pressure on your bladder by coughing, sneezing, laughing, exercising, or
lifting something heavy."
Kay Hoskey,
M.D., a urogynecologist with Anne Arundel Medical Center, tells SELF
that “although childbirth is a well-known cause for this problem,
pressure on the pelvic floor from chronic cough, obesity, high-impact
activity, and poor pelvic muscle strength can all lead to stress urinary
incontinence.”
[post_ads]Though I joke about
peeing when I laugh or cough, it’s really not funny. If I feel a sneeze
coming on as I’m walking, I need to stop and clench my pelvic floor
muscles to try to stop the flow of urine that would be forced out with a
sneeze. Before kids, I could run and jump without incident. Now, after
just a minute on the treadmill, a puddle of pee soaks through my track
pants. I stopped going to the gym after work because even voiding my
bladder right before working out didn’t stop the urine from leaking out.
I hated having to craft a workout schedule around my bladder.
In
hindsight, I wished I had asked my doctor more about what changes to
expect after having kids. I realized I might never be the same weight or
shape as I was before pregnancy and childbirth, but I certainly didn’t
expect my bladder to be permanently affected. The absence of information
and discussion on this topic deepened the shame I was feeling. Was I
the only thirty-something woman who kept changes of underwear in her bag
at all times?
In my case, incontinence worsened with my second child.
Fara Bellos, M.D.,
a urologist at Ohio State University Wexner Medical Center, says, “The
greater number of children women have, the greater the chances are of
developing stress incontinence.”
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So,
why aren't we talking about it? It’s certainly not something I was
discussing with my friends. My doctor never even asked me about
incontinence at my postpartum check-ups. And I assumed if my medical
practitioner didn’t bring it up as a common symptom for women who have
had multiple children, what I was experiencing was just not supposed to
be happening. I didn’t have infections or pain or abnormal bleeding. I
just had bursts of urine.
This spring,
I hit my limit. I could no longer deal with my incontinence issue and
live my best life, or even a somewhat active life. My 7-year-old son
became obsessed with soccer this year, and begged for me to kick the
ball around with him. So I did—at the risk of leaking urine while
running around at the park. But playing with him was anxiety-inducing,
as I feared a wet spot growing between my legs with all the neighborhood
kids looking on. I might be able to live it down, but would he?
I
knew I needed to make a change if I wanted to keep up with my active
kids. So I secured a new primary care physician and gynecologist. It had
been seven years since I had last given birth, and Kegel exercises were not getting the job done. Turns out, “women do Kegels incorrectly 50 percent of the time anyway,” Stephanie Kielb, M.D., urogynecology and pelvic reconstruction surgeon at Northwestern Medical Group, tells SELF.
Finally, I summoned the courage to ask my doctors what I could do about my leaky bladder.
My gynecologist, who has a specialty in urology, suggested that I try bladder supports.
Inserted just like tampons, they work by putting pressure against the
urethra, supporting it from the other side of the vaginal wall. The
insert doesn’t absorb any urine and must be removed after 12 hours.
[post_ads]My
doctor recommended I try a sizing kit, which contains two inserts of
each of the three sizes available. It was trial and error, starting from
the least-wide insert, and moving up in size until I was leak-free. The
smallest size didn’t do much for me. I coughed or sneezed and leaked,
albeit not as much as before. So I moved on to the next size up, which
seemed to do the trick. I went all in on these inserts. And at a dollar a
piece, it was quite an investment. But I could sneeze freely, and laugh
without incident, so how could I put a price on that?
But
there are a few downsides, like the fact that I can't use them during
my period. So, for one week a month, I'm back to dealing with both
bladder leaks and menstrual cramps. And the cost of these products is
significant: about $280 per year, if I use just one a day. Plus, they’re
not biodegradable; both the plastic packaging and non-absorbent insert
need to be thrown away after use. I’m not too keen on how my
incontinence is impacting the environment, but there has yet to be an
ecologically sound, non-surgical option for women like me. So the search
for relief continues.
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“Thankfully
there are many treatment options for stress urinary incontinence,
including pelvic floor physical therapy, procedures to narrow the
urethra, and surgery to support the urethra,” Dr. Hoskey says. Now, I'm
considering a more permanent surgical option (like a vaginal sling,
which supports the urethra to help keep it closed when you cough,
sneeze, run, etc.) to hopefully get relief from bladder leaks
year-round. While I don’t love the idea of undergoing surgery, I also
don’t want my kids to look back on their childhood and see me on the
sidelines of their lives. After seven years of sitting out soccer games
and missing my runner’s high after a treadmill session, I’m ready to
jump back in.
And I'm ready to get
over this embarrassment and talk about my leaky bladder. “It’s amazing
how little women talk about this," Dr. Kielb says. Maybe if we're more
honest about stress incontinence, we’ll find ourselves in increasingly
good company, and the stigma can get flushed away for good.
