Urinary incontinence

Urinary incontinence (leaking) is the unintentional loss of urine. Leaking can occur with things as simple as laughing, coughing, or sneezing. Or it may be associated with high load activities such as jumping, running, or lifting. It may also be associated with an uncontrolled need to urinate (see urinary urgency).

While this condition tends to be extremely common, although not seclusive, for women who have had children, it does not mean that leaking is “normal” or something you will just have to “put up” with.

Regardless if you are recently postpartum, have never had a baby, or have made your way through menopause, incontinence is not something you need to deal with in your everyday life.

Urinary urgency and frequency

Urinary urgency is the strong, overwhelming need to urinate. The urge may become so strong that it can be associated with uncontrollable leaking, often during an attempt to make it to the bathroom.

Some may even have “triggers” for this urgency such as pulling into the driveway or running hands underwater. Urinary frequency is urinating too often throughout the day.

Typical voiding time is between every 2-4 hours. Through bladder training, pelvic physical therapy can help break the cycle of urgency/frequency.

Painful intercourse

Sex may be uncomfortable, either gradually over time or from the beginning. The discomfort can range from mild to a sharp, burning sensation, or a restriction during intercourse, feeling like there isn’t enough space for penetration.

Other common symptoms that coincide may include difficulty with inserting a tampon or pain with a pelvic examination.

For a sexual partner, it could feel like “running into a wall” during penetration.

There isn’t always an obvious mechanism for painful intercourse. In some cases, it may be a result of gradual overactive pelvic floor musculature, a learned response of the nerves and muscles due to a painful experience with penetration, or after an event such as childbirth.

There is not always an obvious cause of painful intercourse. Regardless of onset, women should know that sex shouldn’t be uncomfortable.

Diastasis Recti

Diastasis Recti is a separation of the abdominal muscles via a stretching or thinning of connective tissue in the midline of the belly (linea alba). This commonly occurs during late pregnancy and can remain immediately and early postpartum. However, if the muscles remain apart after the baby is born, it can become a concern.

Diastasis Recti is not solely associated with pregnancy. Women who have not had babies and even men can develop this abdominal separation. Diastasis presents uniquely in each individual, but some common signs and symptoms to be aware of include:

  • Visible coning or tenting in the midline of the belly

  • A softness or protrusion around the middle of the abdomen Feeling a weakness or “disconnected” in the abdominal area

  • Associated symptoms of urinary leaking, lower back or pelvic pain

Pelvic organ prolapse

Pelvic organ prolapse refers to the descent of the pelvic organs (uterus, bladder, or rectum) through the vagina. Prolapse occurs over a period of time and is usually caused when the muscles and connective tissues that support the pelvis do not work as they should.

This could be a result of numerous factors such as pregnancy, childbirth, chronic constipation, lifestyle habits, repeated intra-abdominal pressure, etc. Symptoms will depend on the severity and type of prolapse.

Often, mild prolapse may not cause any symptoms. However, early treatment can stop your prolapse from becoming worse so it is important to be aware of common signs and symptoms:

  • Feeling or seeing a bulge or something coming out of the vagina

  • The feeling of pelvic pressure or heaviness

  • Pelvic pressure that gets worse with standing or towards the end of the day

  • Difficulty emptying the bladder and bowel or the need to press on the vagina to empty

  • Associated symptoms of urinary leaking, urgency, or frequency

  • General low back, pelvis, or hip pain

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