Menopause may be openly discussed these days, but other issues such as the impact of pregnancy, childbirth and aging on women’s sexual function and bladder performance still needs to be put on the national agenda.

Obstetrician and gynaecologist Professor Barry O’Reilly, founder and clinical director of aNuMe, a health and wellness clinic, says there are solutions to incontinence, which many women suffer from on a daily basis.

With decades of experience working in women’s health – including obstetrics, gynaecology and pelvic floor dysfunction – the doctor says many issues women face in menopause are connected to a dysfunctional pelvic floor, and a loss of bladder control is a common symptom. However, these should be addressed long before midlife.

Read more: Nutritionist reveals the small diet changes to help with menopause weight gain and brain fog

“In later years pelvic floor problems can lead to urinary incontinence, bowel dysfunction, sexual dysfunction prolapse but pelvic floor problems can happen at any age,” he explains. “Girls as young as 16 come to my clinic with urinary problems.

“An overactive bladder is where the pressure rises and the bladder doesn’t stretch, requiring the patient to go to the toilet a lot and experience urgency. It can be caused by poor toileting habits or urinary tract infections. Stress incontinence becomes more of an issue after having babies, because of the damage of childbirth and carrying the baby. This can lead to incontinence from sneezing, coughing, laughing and exercising.

“Younger women may not have a stretchable bladder that doesn’t hold as much as it should. They get messages to the brain saying they need to drop everything and run to the loo. A lot of young women experience worsening symptoms when they start college as drinking exacerbates the issue.” (Both alcohol and caffeine are potent bladder stimulants.)

Treatment for incontinence/pelvic floor dysfunction

Many women believe that urinary incontinence is just a normal part of aging, so they suffer in silence. The topic is just too embarrassing for discussion and the ads about the pads may reinforce their mistaken belief that the only option is to put up and shut up. However, Prof. Reilly is on a mission to spread the news that urinary incontinence is very treatable.

“The BTL Emsella chair and Fotona StarFormer chairs are revolutionary devices that strengthen the pelvic floor to improve incontinence and vaginal looseness,” he explains. “It looks just like a regular chair and is comfortable enough to read a book during the treatment. The patient sits fully dressed on it for 30 minutes while it gives off an intense electromagnetic pulse that stimulates the pelvic floor.”

Six weekly 30-minute sessions are recommended, prices start from €300 per session (or €1,200 for six) and there is no downtime.

The aNuMe founder also believes in taking a holistic approach and the clinic offers patients advice on their lifestyle choices. “You should drink one-and-a-half to two litres of water a day – many women drink three to four litres of water in an effort to lose weight, but what goes in has to come out,” Prof. Reilly adds.

“Avoid too much water, avoid caffeinated drinks and alcohol. Sometimes we prescribe tablets to relax the bladder. On other occasions a woman may need a preventative antibiotic over six months if she is getting recurring cystitis episodes. If medications don’t work for this type of treatment we can inject Botox, to relax an irritable bladder. This is done under a general anaesthetic and will last for six months.”

According to Prof. Reilly, some women may need surgical correction such as a “bubble operation” where you inject a water-based bulking agent which creates a bubble around the tube of the urethra.

Childbirth is the primary cause of pelvic floor dysfunction, while the secondary causes include aging, weight gain, not doing pelvic floor exercises, and heavy lifting.

“We see it in women who do a lot of heavy lifting at home, at work and in the gym, which puts a lot of pressure on the pelvic floor.

“Women ask me what’s too heavy and I answer anything that makes your face strain. That strain is transmitted to your pelvic floor so if you can’t negate that by strengthening your pelvic floor at the same time, you will end up damaging it.”

And Professor O’Reilly adds there is evidence to show that the more babies you have the higher your risk for incontinence.

To read our full menopause special, pick up a copy of the October issue of RSVP magazine, out now.

The October 2023 issue of RSVP magazine is in shops now
The October 2023 issue of RSVP magazine is in shops now

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