Urinary incontinence is often not taken seriously, and most women will have experienced an “oops” moment at some point in their lives. When you start finding that you often leak a small amount of urine when coughing, exercising or when the toilet is just too far away, this is a sign you have a weak pelvic floor.
The pelvic floor is composed of muscle and tissue supporting the bladder, uterus and rectum. Various reasons why the pelvic floor may become weak include:
- Pelvic injury
- Conditions that cause constipation
- Weight gain.
The most common types of urinary incontinence are:
- Stress incontinence:
Pressure on the bladder causes a small amount of urine to leak.
- Urge incontinence or overactive bladder (OAB):
You experience a sudden urge to urinate, followed by a loss of bladder control. You may also feel a constant urge to urinate and only manage to pass small amounts of urine. You may also need to go to the toilet regularly at night (Nocturia).
- Mixed incontinence:
This is a combination of different types of urinary incontinence.
Pelvic floor exercises have been shown to increase the strength of pelvic floor muscles and improve bladder control. They can be done effectively, with or without kegel weights, vaginal weights or pelvic floor exercisers. Pelvic floor exercises can help to strengthen pelvic floor muscles, which can help with common health problems in women associated with a weak pelvic floor, including:
- Pelvic organ prolapse (POP)
- Urinary incontinence
- Faecal incontinence.
There is no need to use kegel weights to do pelvic floor exercises effectively. You need to learn how to identify the pelvic floor muscles. This can be done by simply clenching your muscles like you would if you wanted to stop yourself from peeing. Many women find that stopping themselves from urinating mid-flow is the easiest way to isolate their pelvic floor muscles. You can do this occasionally but not regularly, as it can worsen urinary incontinence.
The NHS has excellent resources and an instructional video to show you how to do pelvic floor exercises without using kegel weights. All women cannot use kegel weights and if you find using kegel weights or balls uncomfortable, speak to your doctor. This may indicate that your vagina is narrowed or scarred, and you should not use vaginal weights. Always check with your doctor before using kegel weights or other pelvic floor exercisers if you have:
- Recently had a baby
- Recently had gynaecological surgery
- Pelvic pain
- Pelvic inflammatory disease (PID)
- An active pelvic infection.
Kegel weights and balls are devices that can help women do pelvic floor exercises. They are made from medical grade silicone, and some women find that they make it easier to locate and exercise the correct muscles. They are inserted into the vagina, and to keep them from falling out, you need to use your pelvic floor muscles. Some women find they make it easier to correctly perform pelvic floor exercises, as they can feel their muscles gripping the kegel weight or kegel ball.
Using kegel weights and balls is considered safe for most women and is very much down to personal preference. Research shows that when pelvic floor exercises are done correctly without kegel weights or balls, they are just as effective as when they are done with them.
Biofeedback therapy uses sensors that are placed close to your anus and on your stomach. They are connected to a computer screen and display your pelvic floor muscle movements. With the help of a therapist, biofeedback can help you learn how to effectively use your pelvic floor muscles without needing to use any internal devices. Biofeedback therapy measures the actual strength of the pelvic floor muscles. It is an effective way to check that you are doing your pelvic floor exercises correctly in between therapy sessions.
Electric pelvic floor stimulation/e-stim therapy using a device often called an e-stim. Unlike biofeedback therapy, this device does not train you to use your pelvic floor muscles. Instead, the device uses electrical currents to activate your pelvic floor muscles. This strengthens them without you needing to do anything.
Bladder retraining is an alternative to pelvic floor exercises and can help reduce urge and stress incontinence by increasing bladder strength. With the assistance of your doctor, you will have a plan that involves increasing the time you wait between urination. Over time, this will develop your bladder’s capacity to hold greater volumes of urine.
The Emsella Chair is a relatively new treatment for urinary incontinence, that has been found to be highly effective. This device is offered by specialist clinics and is FDA cleared and scientifically proven to stimulate the pelvic floor muscles at a greater rate than any other device.
Research and numerous studies have shown that strengthening pelvic floor muscles can help with urinary incontinence. Using kegel weights and balls is only one way to increase pelvic floor strength. The most important thing is to perform pelvic floor exercises regularly. For women who find it challenging to perform pelvic floor exercises or are concerned they are not doing them regularly enough, using kegel balls and weights may be helpful.