Stress Incontinence
If you leak when you cough, sneeze, laugh, or exercise, you are far from alone.
Stress incontinence is one of the most common pelvic floor conditions, and most people who live with it do so quietly, managing around it rather than seeking help. It is also very treatable. If it has been getting in the way of how you want to live, we can help.
What is stress incontinence? Stress incontinence happens when the pelvic floor muscles and supporting tissues are not strong or coordinated enough to keep the bladder closed when pressure builds suddenly in the abdomen. The "stress" in the name has nothing to do with feeling anxious or overwhelmed. It refers to physical pressure: a cough, a sneeze, a burst of laughter, picking something heavy off the floor, a run or a high-intensity workout.
For many people it starts small. A minor leak when you sneeze, nothing more. But over time it tends to take up more space in daily life: avoiding certain exercise, always locating the nearest loo before you leave the house, managing the low-level anxiety of not knowing when it might happen next. That is not something you should simply accept as a fact of getting older or having had children. Some people experience a combination of stress incontinence and a sudden, urgent need to go, which is sometimes called mixed incontinence. Both respond well to the right assessment and treatment, and the approach at BTC is the same starting point for both.
Why it happens
The most common cause is a change in pelvic floor function. The pelvic floor is the group of muscles running across the base of the pelvis, supporting the bladder, bowel, and uterus. Pregnancy and childbirth put significant strain on these muscles. The growing weight of a baby during pregnancy bears down on them for months, and delivery, including tearing, stretching, or the use of instruments, can affect how well they function afterwards. In some cases the effects show up immediately; in others they develop gradually over months or years. Hormonal changes are another major factor. As oestrogen levels fall during perimenopause and menopause, the tissues of the pelvic floor become less elastic and more vulnerable. Stress incontinence can appear or worsen at this stage even in women who had no problems after childbirth, or in women who have never given birth.
How we can help
The right starting point for stress incontinence at BTC is pelvic floor rehabilitation. This is a specialist assessment and treatment for women that looks at the whole picture: your symptoms and health history, how your muscles are moving, whether tightness or tension is contributing, and a pelvic floor assessment to understand exactly what is happening. From there, your practitioner puts together a plan tailored to what they find, whether that involves hands-on treatment, targeted pelvic floor exercises, or a combination of both. The goal is real and lasting improvement, not just managing symptoms day to day. If your symptoms are linked to a recent birth and you are looking for a dedicated postnatal check-up, the Mummy MOT may be a better starting point for you.
Ready to book your appointment?
We offer a range of treatments to help you feel your best. Book online,
call us or visit our centre to schedule your appointment.
You do not need a formal diagnosis to come in
If you are leaking and it is affecting your life, that is enough reason to book. You do not need a GP referral, a confirmed diagnosis, or any certainty about how your symptoms compare to what is considered normal. Our pelvic health specialists will assess you properly and take it from there.
Questions people ask us
Is stress incontinence only something that affects women who have recently given birth?
No. While it is very common in the months and years following childbirth, it also frequently develops around perimenopause and menopause, when hormonal changes affect the strength and elasticity of pelvic floor tissues. If leakage is getting in the way of things you want to do, it is worth coming in regardless of where you are in life.
I have been doing pelvic floor exercises for months but am not seeing much improvement. Should I still come in?
Yes, and here is why. Pelvic floor exercises work best when they are the right exercises for your specific situation. Without an assessment, it is easy to be working the muscles in a way that is not well-matched to what your body actually needs, or to be focusing on strengthening when what is needed is something different altogether. Our specialists can give you guidance that is properly targeted to your pelvic floor, rather than the generic advice you find online.
Will I need surgery?
For most women, no. Surgery is one option for stress incontinence but it is rarely the right first step. Pelvic floor rehabilitation and hands-on treatment bring real improvement for many people, and a proper assessment gives a clear picture of which approaches are most appropriate for your specific presentation. If you have been told elsewhere that surgery is your only option, it is worth getting an assessment with us before making that decision.
Can things get worse if I leave it?
They can, though it varies from person to person. Pelvic floor function can deteriorate if the underlying issue is not addressed, particularly around hormonal transitions. Getting an assessment now means understanding what is actually happening and getting on top of it early. Earlier treatment generally leads to better outcomes than waiting until symptoms become more disruptive.
Can men get help for stress incontinence?
Our pelvic health service at BTC is designed for women. Stress incontinence in men is a different presentation and requires specialist input that falls outside what we offer here. If you are a man experiencing urinary leakage, the team at London Men's Health Physiotherapy are specialists in exactly this area and would be a good starting point. You can find them at londonmenshealth.physio.
Related Conditions
Pelvic girdle pain: another common pelvic condition that often develops during pregnancy or in the postnatal period, and one that can affect pelvic floor function too
Still Not Sure?
If you're in pain and wondering whether we can help, that's exactly why we're here. You don't need to know what the problem is. You don't need a referral. You just need to take the first step. Book online today or call 020 7733 9944 to speak to us.