Dealing with stress incontinence and premenstrual bloat can by tricky

I’ve had stress incontinence since the birth of my second child two years ago. I’m doing pelvic floor exercises which are helping. Is there a remedy I could take?

Weakness in the pelvic floor muscles and urinary stress incontinence are more common in women than men. While we tend to associate this issue with pregnancy and childbirth, research shows that it occurs equally among women regardless of whether they have had children.

Recurring cystitis or urinary tract infections can trigger episodes of acute urinary incontinence, as can chronic constipation due to the pressure exerted by the bowel. Food intolerances, sensitivities, and allergies can also be contributing factors.

Kegels are the most common exercises recommended for stress incontinence. However, biomechanist Katy Bowman caused a stir in 2010 when she suggested that Kegel exercises were doing more harm than good.“In doing my research on the physics of the pelvis, movement, and how the pelvic floor works, it became clear that while the pelvic floor’s problem was weakness, it was weakness that is the result of too much tension - not weakness that comes from flopping around,” said Bowman.

So if tension is the underlying issue diligently practising your Kegels could further aggravate the problem.

Squatting is often recommended as an effective way to maintain a healthy pelvic floor as it also works to strengthen the other supporting muscles in the core and back areas. If our abdominal muscles are weak, this places more stress on the spine and can create issues with musculoskeletal pain and organ health. A distended intestinal tract impinges physically on the bladder, pushing it out of place and distorting the natural shape.

While Bowman recommends squats to support a healthy pelvic floor, she is not suggesting we swap our Kegel’s for squats. Instead, we need to aim for supple, strong glutes working together with pelvic floor muscles.

Bowman’s book, Move Your DNA, examines the differences between the movements in a typical hunter-gatherer’s life and the movements in our own lives, explaining the science behind our need for natural motion.

What you eat and drink can have a significant impact on how your bladder functions. Consuming more than a cup of coffee daily can irritate the bladder and cause issues with urinary frequency. Inflammatory foods can also exacerbate stress incontinence and lead to incomplete emptying of the bladder.

It is crucial to fully empty your bladder whenever you urinate. For a woman, this means sitting on the toilet, placing her feet flat on the floor and leaning forwards slightly (as if reading a magazine on the floor) to ensure complete relaxation of the pelvic floor muscles.

I get a lot of fluid retention during the run-up to my periods, which leaves me feeling bloated and tired. What would you suggest?

Vitex agnus-castus is a hormone-specific herb that many women find helpful in treating menstrual-related fluid retention. Aso called Chasteberry or Monk’s Pepper, the herb can help to balance physical and emotional pre-menstrual symptoms along with cycle regulation.

Other herbs that may help include dandelion leaf, celery seeds, and gotu kola. Dandelion leaf adds potassium and gently removes excess fluids. Celery seeds work to cleanse and tonify the liver and kidneys, also neutralising excess acidity in the body. Gotu kola helps with lymphatic circulation and drainage.

Drinking enough water is crucial – aim for six to eight glasses (1.5 - 2 litres) daily. Many try to cut fluid retention by reducing their water intake, but this has the opposite effect.

Fibre is an important factor in regulating fluids. Fresh fruit, vegetables, leafy greens, nuts, and seeds are essential to help with keeping the fluid moving.

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