Modern Western society is fast running out of taboos, but there is one thing that made our foremothers squirm that has exactly the same effect on us.
Embarrassment over continence issues remains universal. NCT has found that almost 4 in 10 (38%) women said they were self-conscious speaking about the problem with a healthcare professional.
It is timeless too, the Egyptians recorded how to make incontinence pads in 1500BC. Presumably laundering all that lovely cotton weave by hand in the Nile was tough going, so ancient Egyptian women figured that protective pads were a must.
Most people think it's only the very old, the very young or the infirm who can't manage their bodily functions. To lose bowel and bladder control is to worry about one day becoming the "smelly old lady", and no one aspires to be her when they grow up.
A survey of terminally ill people found that the things these people feared the most were:
2. Needing a breathing machine
3. Needing a feeding tube
4. Needing care all the time
Incontinence and psychological wellbeing are well known to be intertwined. Depression and anxiety are major mental health issues associated with having poor control over your bodily functions, but other issues like loss of self-esteem, shame, and concerns about cleanliness are all negative feelings that put pressure on relationships and intimacy. So, people either keep their bladder problems secret, or make light of it: "Don't make me laugh, the tears are running down my leg". And this is all confirmed by NCT's recent research.
Diseases of inactivity like heart disease kill many women every year, but we know very little about how many women give up running, or exercise classes because of incontinence. It can impact on parenting too: "Oh, sweetie, look, Daddy wants to run/wrestle/trampoline with you. Mummy can't!"
Management of incontinence adds to the burden of planning family life with lots of women making sure they have clean underwear packed for themselves, as well as their toddler. The "giant mum bag" is continually in vogue for very good reason.
The reality is that leaking is very common. In fact around 1 in 3 women leak when they laugh, cough or sneeze. To put it into perspective, it is more common to leak than it is to have the common cold. This might be why there's a misconception that incontinence is an inevitable consequence of ageing or motherhood. It's not, leaking may well be common but it is never, ever inevitable.
Most bladder problems respond well to physiotherapy, medication or simple lifestyle changes. However, the challenge is encouraging women to seek help in the first place. It can take an average of seven years before someone will actually discuss their incontinence with their GP.
Of course it can be embarrassing discussing incontinence - most personal and intimate problems are - but you're highly unlikely to be the first person in clinic with incontinence. Probably not even the first person that afternoon.
Here is a "Doctor, I have an embarrassing problem" sheet to help. Circle what applies to you and slide it wordlessly across the table. Job done!
Meanwhile, consider how much caffeine you drink and see if you can reduce it. Decaff though? Ugh, it's like brown sadness water.
Pelvic floor exercises really help, but can be tricky to get the hang of. If you want to fix your bingo wings you've usually got a good idea about what your arm is and what it does - but, undercarriages? Not so much.
The job of your pelvic floor is to hold your guts up, keep your holes shut when you want them to be and then relax to allow peeing, pooing and penetration. Their action is to squeeze and lift.
Imagine you are in polite society and trying really hard to stop a rank gas emission escaping from you. Like, really nasty. It'd be mortifying if that one was dropped. In front of your boss. In a lift with all your in-laws. And the tactless friend. Now add a squeeze towards the front around your vagina and bladder, as if you're stopping yourself from weeing. That squeezing and lifting you are doing (right now as you think of being in that scenario) ... yep, that's you working your pelvic floor.
So how do you do pelvic floor exercises correctly? Firstly, you've got to keep breathing while you do them, or they simply won't work. A pelvic floor isn't fixed - it moves up and down as you breathe, so holding your breath means it can't contract properly.
Okay, let's do them together.
Take a deep breath in, sigh out, squeeze and lift for a count of 10 seconds. Relax.
Do 10 quick flicks in a row. Relax in between each one.
Then, squeeze, squeeze harder and squeeze harder still. Relax.
That gives you a hold for 10, 10 flicks and 3 squeezes. That's 10, 10, 3. Now, sing with me "We won't pee with a 10, 10, 3!"
Do these three times a day, every day, for three months. Stop if you get pain, go and get a referral to physiotherapy instead. And, if you faithfully do your exercises and nothing changes, don't put up with it, see your GP!
I'm sure that laughing in the face of leaking will help break down the taboo surrounding continence. So, know that you are not alone, that help is available and you don't need to put up with it.