Common, but not normal
A laugh, a sneeze, a jump with the children — and there it is, a small leak. Many women spend years wearing pads “just in case” and give up running or the gym, convinced it is simply the price of motherhood or of getting older.
Leaking with effort has a name — stress urinary incontinence — and it is very common in pregnancy, after birth and in menopause. But common does not mean normal, nor something you have to accept. In most cases there is a great deal that can be done, and the sooner the better.
What may be at the root
Leakage rarely has a single cause. In the consultation we look at what, in your body, is contributing:
- A pelvic floor that is weak or poorly coordinated. After pregnancy and birth, the muscles that support the bladder may be weaker or slow to “switch on” at the right moment, when you cough or jump.
- A pelvic floor that is too tense. It sounds contradictory, but a muscle that is always switched on does not work well either: it has no room to squeeze harder when needed.
- Pressure management. The way you breathe, hold your breath when lifting or push your tummy out can increase pressure on the bladder.
- Scars and tissues. An episiotomy, a tear or a caesarean can change how the surrounding tissues move.
- Posture and visceral mobility. The position of your pelvis and ribcage, and how freely your abdominal organs move, influence how pressure is distributed.
- Hormonal changes. In menopause, falling oestrogen makes the tissues of the urethra and vagina thinner and less elastic.
How we can help
Your first session starts by listening to your story: pregnancies, births, habits, sport, bowels, sleep. Then comes an assessment of posture, breathing and, with your consent, the pelvic floor itself, to understand whether the muscle needs strength, relaxation or coordination.
From there, pelvic physiotherapy focuses on guided muscle training — not just “doing Kegels”, but learning to contract and relax at the right time — and on bringing it into everyday life: coughing, lifting your baby, running. When appropriate, visceral osteopathy helps improve the mobility of tissues and scars. Many women notice improvement within a few weeks, but every body has its own pace.
What you can do now
- Breathe out on effort. When lifting your baby or a heavy bag, let the air out slowly rather than holding your breath.
- Avoid going “just in case”. Emptying your bladder without the urge, many times a day, can train it to ask earlier. Drink water steadily through the day, without overdoing it.
- Look after your bowels. Constipation and straining overload the pelvic floor.
If this sounds like you, get in touch. Together we will look at what your body is telling you.