As a presenter about the loose women of ITV, no subject is forbidden for Nadia Sawalha.
The daytime TV program is famous for the full and candid exchanges and confessions of its panel members about everything from divorce to bullying and boob jobs.
& # 39; I am a professional oversharder: I share absolutely everything & # 39 ;, says Nadia, 54, who lives in London with her husband, Mark Adderley, 47, a television producer and director, and their two daughters, Maddie, 16 and 11-year-old Kiki bee.
"However, when I agreed to become an ambassador for an awareness campaign about incontinence called Let & Pee Honest, I had to think about it, because there is still a taboo about talking about bladder problems.
Did you know? Like one in three British women and one in ten men, Nadia Sawalha suffers from bladder weakness – but uses her experience to spread awareness of the condition
"When I decided to be open about my own problems, a little bit of me said:" If someone sees me now, will they just think it's the woman who makes herself wet? "
She adds: & # 39; Like most women, when I'm with my friends, we go as far as saying: & # 39; Don't make me laugh or I won't make myself wet & # 39; but what we're not good at is taking that conversation one step further and saying, "Well, yes, it can be funny if we are with all our friends , but for many women it can be incredibly embarrassing and insulating. "
"Some people are so bad that they don't go out until they know where all are empty because they're worried about wetting themselves – it's so sad."
Like one in three women in the UK and one in ten men, Nadia suffers from bladder weakness – which causes involuntary leaks. In the case of Nadia, she experienced stress incontinence as a result of a weak pelvic floor, a pendulum of pelvic muscles that supports the bladder and is often damaged by the tension of carrying a baby.
Another common type of incontinence is urge incontinence, where there is a sudden, intense urge to urinate, with the person sometimes not getting to the toilet on time. This is often caused by cystitis, diabetes or neurological problems such as multiple sclerosis.
Some people suffer from a combination of both types.
Nadia, whose symptoms started after her youngest daughter was born, admits she has had a fair share of shameful accidents in the last decade.
"Once, about three years ago, I was in a hospital corridor with my daughter waiting for an appointment. Something made me laugh and I felt a leak and thought, "How the hell am I doing?"
"I was sitting on one of those gray NHS plastic chairs and was so terrified. I had to get up and go to the appointment and all those people who had looked at me were still there when I returned. & # 39;
A survey conducted in general practice in Leicestershire found that women need on average about ten years to seek medical help for incontinence, either because they are embarrassed to discuss this with a doctor, or simply because they don't know their bladder problems are to repair.
Update: Nadia tried self-help measures such as weight loss and Pilates to strengthen her pelvic floor, but since then she struggles
Many just accept it and wear incontinence material, without ever tackling the underlying cause.
& # 39; Childbirth, periods of weight gain and menopause are all times when stress incontinence can become a problem, due to hormonal changes and extra weight, as well as constipation overload, "says Sudhanshu Chitale, a urological surgeon consultant at Whittington Health NHS Trust and the private Princess Grace Hospital, both in London.
"Men often also suffer in silence with incontinence – especially after prostate surgery. Too many people accept it as a way of life and receive no help. & # 39;
For women, possible solutions include muscle-strengthening pelvic floor exercises (led by a physiotherapist) and vaginal weights (gradually heavier smooth cones fitted with a string or thread, which, when inserted into the vagina, such as a tampon, are held in place by contraction of pelvic floor muscles), as well as lifestyle changes such as weight loss and diet improvement to prevent constipation.
If these do not work, patients may receive injections of fillers or botulinum toxin or surgery to lift the bladder.
Vaginal mesh techniques, which were widely used until recently, are now unavailable due to safety concerns – an issue highlighted by Good Health.
Nadia tried self-help measures, such as weight loss and Pilates, to strengthen her pelvic floor, but since then she struggles. "I didn't do the pelvic floor exercises that you have to do after giving birth," she says. "I think it's because I didn't really believe they would make a difference.
"I was stressed after the birth of Kiki-Bee – I worked a lot, traveled a lot and finally got 4 ½ sts. My weight gain made my bladder problems worse – it was all that extra weight on my pelvic floor.
"I did some Pilates, which really helped, drink less coffee and lost weight, but I didn't see a physical therapist. People think, "Oh my God, why do people wait ten years to get help?", But it's a problem you're crawling. Sometimes it improved, but it never really went away. & # 39;
Frank: Nadia, whose symptoms started after her youngest daughter was born, admits she has had a good deal of shameful accidents in the last decade
When she entered the menopause at the age of 49, Nadia's symptoms returned with revenge. "Once I saw something very strange happening in the wings while I was on TV and I burst out laughing. I was wearing gold pants – and I couldn't stop it.
"People in the front row would have seen that, but I had to continue until the break." Then she started using pads in situations where she thought she might have an accident – such as when running.
Concerned about the environmental impact of the pads, which require hundreds of years to decompose, Nadia looked for a different solution.
It came in the form of special shorts (resembling cycling shorts) that send pain-free impulses to the muscles that control the pelvic floor through a set of connecting pads attached to the thighs and buttocks. Operation by manual operation, the pads contract and lift the pelvic floor muscles 180 times in just half an hour.
Nadia has worn the Innovo shorts for half an hour a day, five days a week, for eight weeks and says she is now dry – in all situations. She explains that although the movement is the same as with normal pelvic floor exercises, the contractions & # 39; turbocharged & # 39; to be.
"It's fantastic," she adds. "I could laugh right now and not even have a dribble. I could sneeze and I don't have to cross my legs. & # 39;
WHAT IS URINARY INCONTINENCE?
Urinary incontinence is the loss of bladder control.
It affects up to six million people in the UK and 17 million in the US to some extent.
Some patients occasionally leak urine when they sneeze or cough, while others insist that they are so sudden that they don't go to the toilet in time.
It is more common with age and can occur due to conditions such as arthritis if patients cannot undo their pants fast enough.
Other causes can include urinary tract infection, pregnancy, childbirth, menopause, hysterectomy and prostate cancer.
Alcohol, caffeine, carbonated drinks and spicy foods can stimulate the bladder and aggravate the symptoms.
Patients should seek help from their doctor because urinary incontinence may indicate a more serious underlying condition.
It can also limit people's daily activities and increase the risk of falling when they rush to the bathroom.
People can reduce their risk by maintaining a healthy weight, eating a lot of fiber, doing pelvic floor exercises and not smoking.
Source: Mayo Clinic
The recommendation is that the shorts are initially worn for half an hour, five days a week, for 12 weeks, followed by maintenance once a week.
A study of 19 women, published in the Neuromodulation journal in 2013 by researchers from the University of Dublin and North Georgia State University in the US, discovered that 87.4 percent of women jumped early after a week of wearing the shorts and cough reported a decrease in leaks. After two months of use, this had improved to 97.7 percent.
In another study in 12 American hospitals with 180 women with stress incontinence, half were treated with Innovo shorts and the rest with an internal vaginal probe that was known to work.
The results suggested that 87.2 percent of Innovo users reported dry or nearly dry after three months of use – similar to the 86.8 percent of the probe.
Mr. Chitale said that while the results were impressive, "I would say that these shorts should only be part of a multi-faceted approach – for example, if you are overweight and suffer from stress incontinence, you still have to lose weight; and if you suffer from constipation, you must adjust your diet to prevent overloading. Both will reduce the pressure on your pelvic floor. & # 39;
He also emphasizes that the shorts do not offer a solution, and adds: & # 39; They do not work for urge incontinence (which has different causes and are treated with medication), and I would recommend that women check that their incontinence is not caused by a vaginal prolapse (where pelvic organs such as the uterus or bladder fall into the vagina) before they use this gadget because they may need surgery. & # 39;
Sammy Margo, a physiotherapist based in North London, says the Innovo shorts, which are not available at the NHS and cost £ 249 per pair, can help improve the area around the pelvic floor.
However, she adds: & # 39; they may not be as effective at isolating and targeting the pelvic floor muscles because these muscles are located inside and are therefore more difficult to reach & # 39 ;.
Nadia is a paid ambassador for the Let Let & # 39; s Pee Honest bladder weakness campaign from Innovo.
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