Bladder leakage – or urinary incontinence – is more common than people realise, with research from incontinence products manufacturer Tena claiming one in three women over 35 in the UK have experienced bladder weakness.
The condition additionally affects one in 10 men over the age of 60, estimates Kimberly Clark, manufacturer of the Depend range.
People can experience various types of incontinence, including stress incontinence (leakage when they cough, sneeze or exercise), urgency (where they have to rush to the toilet), frequency (visiting the toilet more than eight times a day), or stress and urgency incontinence at the same time, known as ‘mixed symptoms’.
Short-term incontinence is also common and can occur for various reasons such as infection, constipation, or taking medication that has side effects. More often than not, however, incontinence is viewed as a natural sign of ageing.
Despite being so common, incontinence is still a source of distress, embarrassment and inconvenience and can be very difficult to discuss. Pharmacy teams should be able to spot and engage those suffering and provide them with the right advice, support and self-help strategies.
So, what are the main types of incontinence, their symptoms, differences, and the self care, treatment and product advice available that can help?
Types of incontinence
Obesity and bladder weakness
Some risk factors for incontinence can’t be avoided, but obesity is often connected to bladder weakness and is something pharmacy teams can encourage and support customers to do something about.
Having a high body mass index (BMI) is one of the most commonly seen causes of incontinence, according to continence product supplier Allanda, who estimates that each five unit increase in BMI is associated with an incontinence prevalence risk of up to 50 per cent.
This is usually due to the fact that excess weight in the abdominal area puts pressure on the bladder which can weaken or damage pelvic floor and urethral structures, making bladder leaks more likely. People with type 2 diabetes who are carrying extra weight can, similarly, also experience urinary incontinence.
Pharmacy teams are therefore in the ideal position to advise overweight or obese customers that they can reduce their chances of bladder leaks if they can maintain a healthy weight.
What about the menopause?
Most people are familiar with common symptoms of menopause such as hot flushes and mood swings, but bladder weakness is less discussed, despite data from Tena suggesting up to 50 per cent of post-menopausal women experience urine leakage every now and then.
Bladder weakness usually starts in the perimenopause stage as levels of oestrogen levels start to fall, and pelvic floor muscles weaken, commonly leading to stress urinary incontinence and overactive bladder. Once again, pelvic floor exercises can help with muscle control, and customers can also talk to their GP about medication or further referrals for other treatment options.
Pharmacy teams should also encourage women to talk to their GPs about the benefits and risks of hormone replacement therapy (HRT), in order to work out if it will relieve their menopausal symptoms, and access it if they want to. In the meantime, staff can recommend a wide range of discreet continence products, which are more appropriate than the sanitary pads some women choose to use. Although continence products can cost more, they’re much more effective and comfortable.
With pharmacy teams at the forefront of professional healthcare advice, they are ideally placed to provide discreet and appropriate information, support and break down the taboos surrounding this sensitive issue.