Lifestyle habits

The Tät® app has been evaluated through several research studies at Umeå University. Women who leaked urine upon exertion and who performed exercises for three months with the help of the app, experienced reduced leakage and increased quality of life, compared with a group that did not use Tät®. These improvements were maintained when the women were followed up after two years. One study also showed that improvements were greater the more frequently the women used the app and the more often they performed the exercises. The app treatment includes information about the pelvic floor, stress urinary incontinence and lifestyle habits that affect incontinence, as well as a programme for pelvic floor muscle training. Among pregnant women who used the app for preventive training, 7 out of 10 retained continence after three months.

References

Drinking

Most women urinate between one and two litres per day. The amount of fluid one needs to drink depends on how much one exerts oneself, how warm it is and how much one sweats. If you urinate less than one litre per day you could try to drink more. On the other hand, if you urinate more than two litres per day, you could try reducing your intake of fluids. For people with incontinence problems, leakage is actually more likely with a full bladder. For healthy people, nothing indicates that it is harmful to drink a lot, but on the other hand, nothing says that it is healthy.

What you drink can also be significant. Alcohol can increase the amount of urine and coffee and tea can create an urge to pee.

Hu JS, Pierre EF. Urinary Incontinence in Women: Evaluation and Management. Am Fam Physician. 2019;100(6):339-48.

Milsom I, Altman D, Cartwright R, Lapitan MC, Nelson R, Sjöström S, et al. Epidemiology of Urinary Incontinence (UI) and Other Lower Urinary Tract Symptoms (LUTS), Pelvic Organ Prolaps (POP), and Anal Incontinence (AI). In: Abrams P, Cardozo L, Wagg A, Wein A, editors. Incontinence. 6th ed. ICI-ICS. International Continence Society, Bristol, UK2017. p. 4-142.

Incontinence is more common in women with constipation than women who are not constipated. If you suffer from constipation, try treating that and seeing whether it eases your urine leakage problems.

Lian WQ, Li FJ, Huang HX, Zheng YQ, Chen LH. Constipation and risk of urinary incontinence in women: a meta-analysis. Int Urogynecol J. 2019;30(10):1629-34.

Physical activity

Generally, all exercise is good for the body. Some research shows that regular physical activity can help to reduce the risk of urine leakage. This is probably because the pelvic floor muscles get stronger when you are active. Yoga and core stability training in particular have been shown to be very good forms of exercise. If it is difficult for you to exercise for any reason, it might be worth knowing that regular walks can more than suffice to have a preventive effect.

Nygaard IE, Shaw JM. Physical activity and the pelvic floor. Am J Obstet Gynecol. 2016;214(2):164-71.

Huang AJ, Chesney M, Lisha N, Vittinghoff E, Schembri M, Pawlowsky S, et al. A group-based yoga program for urinary incontinence in ambulatory women: feasibility, tolerability, and change in incontinence frequency over 3 months in a single-center randomized trial. Am J Obstet Gynecol. 2019;220(1):87.e1-.e13.

Weight

Overweight women more commonly have incontinence than women of normal weight. Several studies have shown that losing weight results in reduced leakage, especially at a BMI of over 30. Losing 5% of one’s weight is often enough to improve leakage. That means 4 kg of weight loss if you weigh 80 kg.

Fuselier A, Hanberry J, Margaret Lovin J, Gomelsky A. Obesity and Stress Urinary Incontinence: Impact on Pathophysiology and Treatment. Curr Urol Rep. 2018;19(1):10.

Auwad W, Steggles P, Bombieri L, Waterfield M, Wilkin T, Freeman R. Moderate weight loss in obese women with urinary incontinence: a prospective longitudinal study. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19(9):1251-9.

Smoking

Incontinence is more common in smokers than in non-smokers. This may be due to “smoker’s cough” creating leakage, but also because smoking affects connective tissue and mucous membranes.

Sexuality

Urine leakage can affect one’s sex life. Concern about leaking and the smell of urine may mean that one withdraws and avoids initiating sex. These concerns may also make it difficult to let oneself go and relax in close, intimate situations. There is a risk that one’s self-esteem can be negatively affected, which may have an impact on the relationship and emotional closeness.

Mota RL. Female urinary incontinence and sexuality. Int Braz J Urol. 2017;43(1):20-8

The following advice is based largely on clinical experience:

Leaking urine during sex is not dangerous, it can instead be seen as your being able to relax. And not all fluid is urine either – even women can have an “ejaculation” Some people are bothered by the fluid, others think that it increases enjoyment.

Here are some tips if you feel your sex life is being negatively affected:

– Talk to your partner! It often feels easier to share the problem.

– Train. Some women have described that their ability to enjoy sex has improved after pelvic floor muscle training.

– Try different positions. It’s good to choose positions that reduce pressure on the bladder.

– Have a towel ready if needed.

– Try a lubricant for dry mucus membranes. If you are in the menopause or have gone through the menopause, oestrogen applied locally often helps, e.g. vaginal pills, rings/inserts or creams.

Aids

Leakage during physical exertion can be reduced with the help of a so-called bladder support. It is inserted into the vagina and supports the area where the bladder and urethra meet.

Hu JS, Pierre EF. Urinary Incontinence in Women: Evaluation and Management. Am Fam Physician. 2019;100(6):339-48.

Vaginal balls or cones can be used to help find the right muscles, but they do not improve the effect of the exercises.

Herbison GP, Dean N. Weighted vaginal cones for urinary incontinence. Cochrane Database Syst Rev. 2013(7):CD002114.

Alouini S, Memic S, Couillandre A. Pelvic Floor Muscle Training for Urinary Incontinence with or without Biofeedback or Electrostimulation in Women: A Systematic Review. Int J Environ Res Public Health. 2022;19(5).

The following advice is based largely on clinical experience:

Incontinence protection is designed for urine leakage and has a different absorption functionality to the protection used for menstruation. Some incontinence products also stop the risk of odours arising. Incontinence protection in the form of panty liners and pads can be purchased in normal grocery stores and at the chemist.

Protection should only be used when really needed, and not ”just in case”. One should not use larger protection than needed nor should it be used during sleep. Constant use can irritate the genital area.