Wendy Hill knows the shame of wetting her pants in public. Make no mistake, her stories aren’t distant memories of elementary school mishaps. They represent the 50 year old’s current reality .
She experiences accidents because of overactive bladder (OAB). They happen at the most awkward times – at a work team-building event with colleagues, which triggered a panic attack, and in her friend’s new Lexus.
As a professional with a busy career and active social life, living with chronic overactive bladder is more than an inconvenience. It’s a constant source of stress, not to mention embarrassment. “It’s just not something you’re supposed to do as an adult,” she says.
What is OAB?
Overactive bladder happens when the detrusor muscle in the bladder contracts more often than normal. This can lead to frequent urination (defined as more than eight times a day, often disrupting sleep) and also feeling a sense of urgency to go.
One study, by McGovern Medical School in Houston, TX, found that for women between the ages of 25-64, increased urgency is associated with a higher body mass index.
Though not everyone with OAB suffers bladder leakage, it is a common symptom with almost 40 percent experiencing wetting accidents. And the prevalence of overactive bladder is about equal among men and women, with symptoms increasing with age.
Help is out there
Surprisingly, more than half of those with OAB don’t seek treatment. Dr. Adrian Wagg, president of the Canadian Continence Foundation, says two-thirds of older women falsely believe that incontinence is a normal part of the aging process, especially if they have borne children. Men, on the other hand, are often embarrassed. “They think it’s demeaning and almost feminizing,” says Dr. Wagg.
Often, people don’t want to trouble their doctor with an ailment they perceive is less serious than other chronic conditions. “Incontinence becomes an also-ran,” he explains, or it’s only mentioned on the way out the door. Primary care providers often don’t have significant experience treating OAB, and may dismiss patients’ complaints. “Often the women are the recipients of those kinds of attitudes. They are told: ‘Well, what do you expect, you’ve had babies.’”
While there is no cure for overactive bladder, there are many available treatments. Hill, for instance, wears absorbent pads. With our aging population, demand for over-the-counter adult bladder leakage garments is expected to surpass the demand for baby diapers within the next decade. Kimberly-Clark leads the market in adult incontinence products. They continue to develop new designs for their popular brands – Depend underwear and Poise pads and liners – to provide maximum discretion and absorbency.
Some doctors will prescribe anticholinergic medications designed to calm the bladder by reducing bladder contractions. Other medical interventions include mechanical implants, surgeries and even Botox injections around the wall of the bladder.
Most women are aware of Kegel exercises, which are typically recommended during pregnancy to strengthen the muscles of the pelvic floor. They can help those with overactive bladder. A physiotherapist can offer instruction on how to do them properly and reap maximum benefits.
For now, Hill is managing her condition through lifestyle choices. She avoids drinking anything two hours before she goes out. And, while she and her husband are avid cyclists, he is the only one who packs a water bottle. She also selects her clothing wisely. She learned this the hard way. During dinner with a friend at a pub, she lost control of her bladder after coughing. She was wearing red capris. “I couldn’t hide it,” she says, and now opts for black pants, which conceal accidents better than lighter colours.
Tackling the stigma
Dr. Wagg points out that while other conditions, including erectile dysfunction, have become “more common parlance,” incontinence has not. “It’s a close and intimate thing and people get stigmatized and shunned,” he says. As a result, become less physically active and avoid places, like the theatre. “Questions might be asked,” he says like “It’s the third time you’ve been to the john in the last hour. Why is that?”
Fortunately, attitudes are changing. “We’ve seen a bit of a shift in perception of incontinence as an un-talkable about problem,” Dr. Wagg explains. Hill was until recently reluctant to talk about a condition she calls “embarrassing” and “undignified.” Turning 50 has given her more confidence to share her story.
Hill’s hope is that OAB becomes less of a taboo topic – similar to how mental health issues are now better understood and less stigmatized. Still, her condition is constantly in the back of her mind: “I would love to find a way to not always be thinking, ‘Am I going to pee?’”