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Written by

Dr.Masarat Jilani


Hey there, I’m Dr. Masarat. I'm passionate about smashing health taboos and tackling medical myths.

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For words you might want to know more

Overactive bladder

Overactive bladder, sometimes referred to as OAB, causes a frequent and sudden urge to urinate that may be difficult to control. You may feel like you need to go to the loo many times during the day and night, and may also experience involuntary loss of urine (urge incontinence).

Pelvic floor physiotherapy

A therapy programme designed to improve pelvic floor function. It includes assessments, exercises, treatments and education.

Hormone replacement therapy

Hormone replacement therapy (HRT) is a treatment to relieve symptoms of menopause. It replaces hormones that decrease as you approach menopause.

Sling surgery

Sling surgery is the most common surgery used to treat urinary stress incontinence. It involves putting a sling (made of mesh or human tissue) under the urethra. The sling is like a hammock that lifts and supports your urethra and the neck of your bladder (where your bladder connects to your urethra) to help prevent leaks.

How pelvic incontinence can affect your mental health

Not only are mental health and incontinence both taboo subjects, but many people also don’t realise that they can be inextricably linked.

Aside from the physical symptoms they cause, bladder issues like incontinence have a huge impact on our self-confidence and mental wellbeing.

How does incontinence affect mental health?

The relationship between mental and bladder health is complex, and how one person experiences incontinence can be completely different to another person.

Regardless of severity, bladder issues can massively impact your quality of life.

Research shows that people dealing with an overactive bladder report having a lower quality of life, while 20-40% of those with bladder leakage have depression. This can lead to further isolation, missing out on things you used to enjoy, and even losing your appetite.

Since leaks affect every aspect of life, people worry about the minutiae of their daily schedules. This can mean hours of planning – for example, the whereabouts of toilet facilities on a day out.

One study indicated that up to 50% of people with overactive bladders suffer from anxiety. It may manifest in frequent checking that you’re dry, carrying many changes of underwear, and fearing new social situations.

As if living with the effects of bladder leaks isn’t enough, many go to extreme lengths to hide the problem to avoid perceived shame and loss of dignity.

You may be left feeling worried about whether your leaks are noticeable during social occasions. Similarly, intimate moments may come with a sinking feeling that your partner may be judgemental or turned off.

There may be a loss of confidence at work as you have to battle with your bladder on top of other work challenges. And nightly trips to the toilet may affect your mood and leave you feeling sleep deprived.

Seek help and support

Despite low uptake and lack of awareness, there are solutions for both incontinence and to support its effect on your mental health.

The stigma around bladder leaks may prevent you from discussing the topic with your doctor and accessing those solutions. Bladder & Bowel UK also runs a national, confidential hotline that can provide advice on managing leaks as well as helping you find local services. To access, simply call 0161 214 4591.

If your leaks are making you feel anxious, depressed or isolated, talking to your doctor can also help you access talking therapy such as cognitive behavioural therapy (CBT) which aims to provide you with strategies to manage your thoughts and feelings and to challenge negative behaviours.

Your doctor will also make an assessment and provide a range of options, including:

  • Pelvic floor physiotherapy

  • Tablet medications to help with bladder leaks

  • Hormone replacement therapy (HRT)

  • Topical treatments

  • Non-surgical treatments like laser or botox

  • Surgical options, including sling surgery

Join the conversation

With only one in five people seeking help from their doctor about bladder leaks, something has to change.

Talking more openly about our health and how it affects us can seem daunting, especially when no one else seems to be talking about it.

Yet there is a desperate need to tackle the assumption that bladder leaks are a normal part of growing older rather than a health issue that has management options available.

Making that first step easier may mean finding an online community where you can share your experiences in a safe space or talking to a trusted friend or family member.

Simply talking about your bladder leaks and how they affect you not only helps you to access solutions but it can help tackle the stigma that breeds misinformation and mental health difficulties.

Not only are bladder health issues treatable but they can be preventable – that’s why we need to start this conversation, too!

No one should feel ashamed about bladder health since it affects an overwhelming 14 million people. The first step is to start talking more openly about our bladders and we can start to banish healthcare’s last taboo.

Poor bladder health shouldn’t be a “normal” part of ageing or childbirth — that’s why we created the Bladder Care Handbook: our guide to life’s trickly moments. Download your free copy for expert tips on how to look after your bladder.

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