Almost every second woman has experienced urine leakage, but many hesitate to talk about it due to feelings of shame.
“I'm only 24 and I barely sleep because I'm constantly running to the bathroom. I can't even lie on my back without a little leak. Has anyone else dealt with incontinence at a young age?” asks a young woman on an anonymous forum.
“I can't remember a time without urgent incontinence. I have no idea what it's like to go a day without leaking. It was worst during childhood. My parents thought I was just too lazy to go to the toilet. I’d come home from school in wet clothes,” admits a woman in her thirties.
Online forums are full of questions and confessions from both women and men who thought they were alone in this. During childhood, they faced ridicule, and in adulthood, they felt embarrassed, which stopped them from doing normal activities. Even though up to 50% of women and 30% of men deal with this issue in some form during their lives, it’s still not openly discussed. Anonymous forums get flooded with lots of queries and concerns.
- What incontinence is and its causes.
- How it affects confidence and sex life.
- Why vaginal exams are crucial for diagnosis.
- The options gynecological physical therapy offers and what results to expect.
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Many think incontinence is a problem for post-menopausal women or those just after childbirth, but it can trouble young women who haven't given birth. A common group is athletes who train intensely every day.
For young women, this issue can be taboo, and they're ashamed to discuss it openly. Physiotherapist Adriana Plevková, who specializes in gynecological therapy, says that due to growing awareness, younger girls with incontinence are starting to seek solutions. Her youngest patient was 23 years old.
I Feel Unattractive, Gross, and Weird
Though incontinence isn't a disease but a syndrome, studies show that it negatively impacts mental well-being and can affect relationships and sex life. Women with incontinence often feel less confident, ashamed, and anxious. Fear of leakage during sex might stop them from engaging in it, disrupting intimacy with partners.
“I’m dealing with urgent incontinence. I want to start dating and maybe casual sex, but I’m really scared because of my condition. I feel unattractive, gross, and weird. I'm afraid others will think the same,” admitted a 29-year-old single woman.
“Physical and mental aspects are connected and affect each other. Incontinence can make everyday activities or sports uncomfortable. Open communication with partners, support, and making sure conditions are as comfortable as possible (using pads, having spare clothes, avoiding certain activities at first, following physiotherapist advice) are crucial,” explains the expert.
A few years back, Survivor contestant Johana Fabišík, a standout personality on the show, spoke openly about her incontinence issue. Viewers saw her as a strong, attractive, and confident woman.
After a lost challenge, she didn't shy away from the sensitive topic and frankly explained the issues she faced during the competition. “It's quite unpleasant. I suffer from incontinence, so I was leaking the entire time,” she admitted in front of the camera.
“Talking about women's intimate issues is challenging. It's not shameful at all. I think many women deal with it, but it's not often discussed. This could encourage others to break the silence and speak about it as something normal that happens to women of different ages,” Johana added later.
Causes of Incontinence in Young Women
In Slovakia, around 500,000 people have involuntary urine leakage, and 40% never address it. High-intensity sports can worsen the issue, seen in gymnasts, athletes, and those in crossfit. A physiotherapist notes that for elite athletes, it's not just physical but also psychological stress that impacts pelvic floor tension.
“In young women with intense training, pelvic floor hypertonus is common. The pelvic floor can't relax enough or react at the right time, leading to leaks during stress or increased abdominal pressure,” says the expert.
Repeated urinary tract infections can also contribute to incontinence. These infections increase bladder irritation, hypersensitivity, and pelvic floor tension (hypertonus).
According to Adriana Plevková, young women today often experience increased tension in the pelvic floor rather than its weakening. This tension, like poor posture, can contribute to incontinence. Poor posture affects overall body mechanics and the function of the pelvic floor, which is closely linked to the diaphragm and core muscles.
Solutions for the Problem
Incontinence isn’t irreversible and can be addressed effectively. Gynecological physical therapy helps you understand your body and the difference between relaxing and activating pelvic floor muscles. The expert explains that it can improve or even eliminate urine leakage (depending on the condition), adjust breathing habits, and improve posture. Significant improvement can be seen after 3-4 sessions, though results vary. Adriana Plevková notes that a young patient resolved her issue after just four thorough sessions.
She points out that more women now access articles and research-backed info, realizing they’re not alone. “They can seek advice from experts, physiotherapists, or doctors who can guide and assure them that this can be addressed early, making the topic less taboo,” shares Adriana.
However, some women still hide the issue for years, seeking help only later because they don’t know who to turn to, or like mothers post-childbirth, prioritize their infants. “They try internet exercises that aren’t always helpful. Luckily, I’m in close contact with women during pregnancy and postpartum at Nitra Hospital, making it easier for them to get this information,” says the physiotherapist.
Vaginal Examination
There are several physiotherapy options for incontinence. The expert stresses the importance of assessing the overall stage of incontinence first—its frequency and intensity. “As a physiotherapist working with women postpartum, during pregnancy, and in urogynecology, I perform vaginal examinations. This helps assess the condition, tension, and ability to relax pelvic floor muscles. Techniques like relaxation, breathing, manual techniques on the jaw or chest, and stretching exercises are used depending on the examination,” clarifies Adriana Plevková.
When Physiotherapy Isn’t Enough and Surgery Is Needed
The expert notes that in some cases, physiotherapy alone isn’t sufficient, and surgery is necessary. This applies to advanced stages of incontinence where leakage continues, and pelvic floor muscles are significantly weakened, affecting quality of life. Surgery is also considered for pelvic organ prolapse, where these issues often coexist. Surgery is primarily necessary in severe incontinence stages, where leakage persists, and pelvic floor muscles can’t function adequately, greatly impacting a woman’s life. Besides urine leakage, surgery is also considered in prolapse (organ descent), often accompanying incontinence.
When Prevention Is Important and When It Can Harm
For a healthy pelvic floor without problems, the expert says isolated strengthening isn’t necessary. “On the contrary, excessive or incorrect exercise can lead to increased muscle tension and disrupt natural coordination. In cases of post-pregnancy or during pregnancy, practicing activation and relaxation is justified.”
The physiotherapist explains that preventive steps aren’t just isolated pelvic floor exercises. It’s about habits that support its natural function through posture, breathing, varied movements, and compensatory exercises for athletes to manage pelvic and trunk strain.
