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“Don’t make me laugh, the tears run down my leg” – comedy and continence

- Elaine Miller

I reduced my nether regions to rubble by having three giant headed babies in four years.  The bed collapsed during the birth of the last one, which didn’t help.  Falling off a bed during labour caused a spike of intra-abdominal pressure which was of sufficient force to eject the baby from within –  my son was, literally, air born.

So, I wasn’t too surprised to find I needed to cross my legs when laughing with my friends over a glass of wine.  But, by the time my kids were in school, and I was still wetting myself it was time to admit that I wasn’t so much “leaky new mum” but, nearer to being a “smelly old lady”

Luckily, I’m a physiotherapist, so I knew all about what a pelvic floor was and what I needed to do to fix it.  I’d just never bothered – but, pissing all over my coir “welcome” mat in full view of my neighbours (why do keys hide in handbags?) turned out to be the motivating experience I needed.

I did the exercises at traffic lights and in queues.  I did them during the adverts, and I did them every time I shouted at my kids, thought an evil thought about my husband or craved a glass of pinot grigio. 

Three months later, I could go on a trampoline and had a new welcome mat.

I am entirely typical - a third of women aged 35-55 wet themselves when they cough, sneeze, laugh, run or jump.  Did you read that?  A THIRD of your peers are miserably sitting on pads.

Women do have a vague idea about what their pelvic floor is, and they faithfully do their exercises every single time they hear the words “pelvic floor”.  Twice a year isn’t enough,  people!

These muscles are like any other – they strengthen with training and lose power with disuse.  Evidence shows doing pelvic floor exercises, three times a day for three months will improve most cases of simple stress incontinence .   And, the happy side effect is that having a strong pelvic floor enhances sexual function.

The reason for that is that the nerves which supply the pelvic floor muscles also supply your tickly bits.  So, if your orgasms are weak the chances are your muscles are too.  

You should not just shrug their shoulders and accept that satisfying sex is now beyond you.  Or, that having control of your bodily functions is something that you can live without. Or, that it is ok to live with a wearing physical condition that grinds down their emotional well being was ok.

There is help available, and, if you do nothing then the organs sitting on your pelvic floor can, well, fall out.

That’s what a prolapse is – a bit like a hernia in your vagina, so your bladder, rectum, intestines or uterus isn’t properly supported and hangs down into it.  Which can be helluva uncomfortable, to say the very least. 

There are wider public health issues.  Heart disease is the biggest killer in the UK, but, sometimes, zumba’s not pretty (ask me how I know!).  Stress incontinence can be an absolute barrier to exercise. 

A third of people with continence problems also have clinical depression,  having less control over your bladder than your toddler has doesn’t make you feel good about yourself.  Indeed, incontinence can break your hip – eldery women who keep needing to get up for a pee in the night can slip in a puddle, and there’s nothing funny about that.

Your pelvic floor isn’t a very good bit of mechanics.  There are layers of muscle which attach onto the bone and ligaments of your pelvis.  Their job is to lift, that action supports the neck of bladder against the force of your intra-abdominal pressure.  Unfortnately, as you age the ligaments stretch, or you might sustain injury to the muscles – so they can’t lift or lose power.

The lift is a tiny movement.  Imagine you are trying to create just enough space for a folded £50 note to be slipped into your gusset.  That’s a mental image which grates against every single one of my feminist principles – but, it is effective.  You’re doing it right now, see?

I teach three exercises.

The first one is a simple clench.  Imagine you’ve got a huge fart brewing, but you are on a first date with someone you want to spend the rest of your life with.  That clenching you are doing round your bum hole is you working your pelvic floor.  Hold it for a count of 10 seconds.  You should feel a “drop” when you let go, no “drop” and you’ve lost the contraction, so will have to work on it.

The second exercise is doing 10 quick clenches in a row.

The third exercises is a bit odd – imagine you’ve got a lift in your vagina.  Take it to the first, second and third floors and then back down to the second, first and ground floors.  And, relax.

The “relax” is important.  Sometimes tightness in your pelvic floor can mimic weakness.  If you experience pain when you are doing your exercises, during sex or whilst pooing – show your pelvic floor to your GP or women’s health physio.

Otherwise – repeat after me: “we won’t pee with a 10, 10, 3”

Hold for 10, 10 quick flicks and up three floors and back down again.  Three times a day, every day, for three months.  And then, once a day, every day, until you die.  Sorry about that, if you stop doing them you lose all benefit and will be back to pissing on your doorstep within a matter of weeks.

Stress incontinence is a debilitating condition which interferes with everything.  People laugh and joke to disguise how relentless and wearing it is.

“Oh, I laughed until the tears ran down my leg” led to my mixing my hobby of stand up comedy with continence advice.  Delivering the information in a social setting, and making it funny, bursts the taboo.  I encourage compliance by using twitter -  @gussiegrips “when I tweet, you twitch your twinkle”.  Follow me,  I promise to remind you to #doyerblardyexercises.

The feedback is encouraging.  I am presenting Gusset Grippers at the Edinburgh Fringe Festival (shameless plug: 1-25th August, 1200 at The Newsroom, free, non-ticketed) and will gather data from the audience for a study.

Meanwhile, please just #doyerblardyexercises.  I mean YOU.  Now.  10, 10, 3.  Go on, then!

Elaine Miller is a physiotherapist, comedian and recovered incontinent.  For further information see www.gussetgrippers.weebly.com

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