Nearly every second woman has experienced urinary incontinence, but many refuse to talk about it due to shame.
“I'm only 24, and I almost can't sleep due to frequent urination. I can't even lie on my back without leaking urine. Does anyone else experience incontinence at a young age?” asks a young woman on an anonymous forum.
“I don't remember ever not having urgent incontinence. I have no idea what it's like to have a single day without urine leakage. It was the worst in my childhood. My parents thought I just didn't want to go to the toilet. I came home from school in wet clothes,” admits a woman in her 30s in the discussion.
Forums are full of questions and confessions from women and even men who felt alone in this struggle. As kids, they faced ridicule, and as adults, feelings of shame hindered their daily activities. Despite this issue affecting up to 50% of women and 30% of men at some point in their lives, it remains a rarely discussed topic. Anonymous forums, however, are filled with questions and fears.
Many view incontinence as a health issue for post-menopausal women or women shortly after childbirth. But it also affects young women who’ve never given birth. Athletes who train intensively daily, for example, are commonly affected.
For young women, this problem can be taboo, making them too embarrassed to discuss it openly. Physiotherapist Adriana Plevková, who specializes in gynecological physiotherapy, says increasing awareness has encouraged younger girls to address their incontinence issues. Her youngest patient was 23.
I feel unattractive, repulsive, and weird
Though incontinence isn't a disease but a syndrome, studies show it negatively impacts mental well-being and significantly affects relationships and sex life. Women with incontinence often experience reduced self-esteem, shame, and anxiety. Fear of leakage during sex may lead them to avoid sexual activities, disrupting intimacy with partners.
“I'm trying to manage urgent incontinence. At the same time, I'd like to start casual dating and maybe casual sex, but my incontinence causes me great fear. I feel unattractive, repulsive, and weird. I'm afraid others will think the same,” shared a 29-year-old single woman.
“The physical and psychological are interconnected and influence each other. Incontinence can reduce comfort in daily activities or sports. Open communication with a partner, support, and ensuring conditions where women feel best throughout the day (intimate pads, spare panties, avoiding activities that promote leakage, following physio recommendations) are important,” explains an expert.
The issue was openly discussed a few years ago by Survivor contestant Johanka Fabišík, whom viewers saw as a strong, striking favorite and an attractive, confident woman.
After losing a challenge, she addressed the sensitive topic and candidly explained the difficulties she faced during the competition. “It's quite uncomfortable. I suffer from incontinence, so I was basically leaking urine the entire time,” she said directly on camera.
“Talking about women's intimate issues is challenging. It's definitely not something to be ashamed of. I think many women suffer from it, but it’s not talked about—it’s like a secret because it's not pleasant. Perhaps this moment will encourage someone to break the fear and learn to talk about it as a regular thing that happens to women of various ages,” Johanka later added.
Causes of incontinence in young women
Sports requiring high-intensity training, discipline, and time can exacerbate the issue. It’s common among gymnasts, athletes, or those in crossfit. The physiotherapist emphasizes that for top athletes, it’s not just physical but also a mental strain affecting pelvic floor tension.
“In young women with intense training routines, we often see hypertonic pelvic floor muscles, meaning they can’t relax or respond promptly. This can lead to situations where stress or increased abdominal pressure results in leakage,” she explains.
Other contributors may include repeated urinary tract infections, causing increased bladder irritation, sensitivity, and pelvic floor muscle tension (hypertonus).
Adriana Plevková notes that today’s young women often experience increased pelvic floor tension rather than weakness, which can contribute to incontinence along with bad posture. Poor posture affects the torso’s biomechanical function, influencing the pelvic floor, diaphragm, and deep abdominal muscles.
Solutions to the problem
Incontinence isn't irreversible and can be effectively managed. Gynecological physiotherapy can help you understand your body and the difference between relaxing and activating pelvic floor muscles. The expert explains that it can lead to improvement or even complete resolution of leakage (depending on the condition), adjust breathing habits, and improve posture. Significant progress can be seen after three to four therapies, though results are individual. Adriana Plevková mentions her youngest patient resolved her issue after just four in-depth sessions.
According to her, more women access articles and expert-backed info, embracing that they’re not alone. “They can consult specialists, physiotherapists, or doctors who guide them, reassuring them this issue can be addressed, making the topic less taboo,” says Adriana.
Some women still hide the issue for years before seeking help, either not knowing whom to approach or being busy like postnatal mothers preoccupied with their babies. “They try exercises from the internet that may not help. Luckily, I maintain close contact with pregnant women and those in postnatal care, making this information more accessible,” says the physiotherapist.
Vaginal Examination
Several physiotherapy options exist for incontinence. As the expert notes, it’s crucial to first assess the state, frequency, and intensity of incontinence.
“As a physiotherapist focusing on postnatal, prenatal, and urogynaecological therapy, I conduct vaginal assessments. This helps evaluate muscle condition, tension, and ability to relax pelvic floor muscles. Techniques include targeted relaxation, breathing, manual techniques to relax the jaw or chest, stretching, etc. Naturally, everything depends on a thorough assessment,” explains Adriana Plevková.
When physiotherapy isn’t enough and surgery is needed
The expert explains that in some cases, physiotherapy alone isn't sufficient, requiring surgical intervention. This is often in advanced incontinence stages with persistent leakage and significantly weakened pelvic floor muscles. Quality of life is notably affected. Surgery is also considered for pelvic organ prolapse, these issues often coinciding.
Surgical procedures are usually opted for in severe incontinence stages where leakage persists and the pelvic floor muscles are inadequately functional. Women’s quality of life is significantly impacted. Besides leakage, surgery is an option for organ prolapse, with these diagnoses often occurring together.
When prevention matters and when it can harm
A healthy pelvic floor, with no felt issues, doesn't need isolated strengthening, according to the expert. “On the contrary, excessive or incorrect exercises can increase muscle tension and disrupt natural coordination. For postpartum or pregnant women, activation and relaxation training is justified.”
As the physiotherapist explains, preventive steps aren't just about isolated pelvic floor exercises. It’s more about supporting its natural function through posture, breathing habits, varied movement, and for athletes, compensatory exercises balancing pelvic and torso strain.
