water lily to illustrate bladder support devices

Bladder support pessaries: how do they work?

Bladder support pessaries: extra support from the inside

updated 2021 (original 2019)

Strengthening your pelvic floor is still first prize for bladder leakage problems.  But what if you cannot create enough strength and support for the bladder with your pelvic floor muscles alone? You may benefit from one of the modern bladder support pessaries that give some reinforcement to the bladder neck and bladder tube.

These are devices that you can buy on the internet and then insert and remove yourself. They are designed to be worn all day but not all the time. These can be a surprisingly inexpensive & eco-friendly option, compared to disposable pads. Ideal if you know when you will leak and need to use the device only for intermittent pre-planned activities.

Available in the UK at the moment are , Contam, Contiform, Efemia and Uresta.  They vary in price chiefly relative to how many times they can be re-used.  Contiform and Efemia are available on prescription.

Would they suit you ?

Have you done your pelvic floor exercises, improved your core, modified high impact and improved your fluid management? Still not quite resolved your bladder leakage? Then one of the bladder support pessaries may offer an alternative to surgery (NICE Guideline NG123 2019). They have a similar mechanism of action  (mechanical support of the urethra) to the TVT and colposuspension surgical procedures but no side effects or surgical risk.

In my clinical experience, these support pessaries work particularly well in certain situations.  For example when the bladder has dropped only a little bit and the uterus is still well supported. Or, if exercises have created a good layer of muscles but you still need more bladder support to be active.

How do internal bladder support pessaries reduce urinary leakage?

These devices work by providing more support for the bladder neck.  When you move fast (eg jogging, playing tennis) or there is an increase in abdominal pressure (coughing, sneezing, jumping), the pelvic floor muscle is supposed to support the bladder neck so that there is no leakage.  However, if the muscles are weakened and/or untoned that support can be lost. 

hose lying on grass and path
Would it be easier to stop the water by standing on the hose on the grass or on the path?

Are a visual person?   Imagine a running hose pipe, lying on  soft grass.  When you lay your foot on the pipe you may slow the flow of water. But you may not be able to stop it completely.  However, if you lay your hosepipe on a firmer surface, like a garden path, when you press down on the hosepipe the water flow stops. A toned pelvic floor should act like that firm path. But if yours isn’t up to scratch a pessary could do that job instead.

What type of urinary leakage will they help?

Bladder support pessaries are best for small leaks associated with movement. Or leaks when the bladder is under pressure from coughing, sneezing or laughing (stress urinary incontinence).

They create a mechanical uplift to support the bladder neck the way the pelvic floor is supposed to do. 

These would suit women who don’t generally experience day to day stress incontinence but know when they are going to leak. For example if you know you will have incontinence if you do a run, or when you go to Zumba. Or if you feel anxious about an event, like going to a wedding, or travelling. You might only use a product like this once or twice a week. With one of these in you might not need any other protection, or would feel confident with simply a liner or a pair washable knickers “just in case”.

They can’t help with urgency or irritable bladder

What these devices can’t do is change symptoms like urgency.  If your bladder is irritated by caffeine, being too full, or you have an overactive bladder, you won’t see any improvement using one of these.  Pelvic floor exercises DO help these symptoms because the pelvic floor contracting activates neurological messages which calm the bladder down.  Unfortunately these devices can’t do that. 

If urgency or frequency symptoms are your bother – then you need to practice “endurance/holding” pelvic floor exercises (see more in the Pelvic Floor School) and have also read of the article “How much should you drink in day and when should you have a wee?” for more impact on these problems.

a glass how much should you drink in a day

Can I leave it in to wee?  What about during my period?

Yes, they are all designed to be left in when you have a wee or bowel movement.  The pressure of the bladder squeezing is enough to push the urine past the supported area when you need to.

You could still use the Contiform or Efemia pessary when you had a period (as the menstrual fluid can flow through it) but you couldn’t use a tampon at the same time.  The other designs (Contam, Uresta) act as a block but are not absorbant like a tampon, so shouldn’t be used during your period.

Note: The term pessary can be confusing

Because these devices to reduce bladder leakage sit inside the vagina they are termed a “pessary” but they should not be confused with a  traditonal pessary used for supporting Pelvic Organ Prolapse (POP). For more information about pessaries for prolapse read here

Field Guide: bladder support pessaries to reduce stress urinary incontinence

Each company markets their own product and may use more than one distributor so prices can vary.  Here is my personal “quick guide” to what’s out there at the moment, apologies if it has already changed again by the time you read this!  Please do let me know if I have missed something out, or you find a new supplier or product before me! Please do comment to support other readers & share your experiences:

Contrelle Activgard

picture of Contrelle Activgard

single use only 

currently unavailable in UK  but understood to be returning soon.

Contam Pessary

picture of contam

 

single use only

£26.99 for a starter set (range of 3 sizes “normal” or “large”). From £12.95 each bought singly, or just under £10 each if bought in groups of 3 thereafter from www.stressnomore.co.uk 

* use promotion code SUPPORTEDMUMS at checkout for a 15% discount

These are quite new on the market.  There are no clinical trials listed.

Contam is a brand offering a variety of shapes and sizes of single-use vaginal pessaries. It is the tampon shaped ones that are suitable for supporting the bladder neck. The cube shaped ones are for going much further back in the vagina to support a more severe uterus prolapse. Unlike tampons they do not absorb moisture from the vagina. You soak them in water before use to make them pliable and elastic to insert and to prevent drying out of the vaginal wall.

It is suggested that you position them differently according to the problem: For incontinence: “insert the pessary deep into your vagina, then pull it back slightly so that it’s within reach of your fingers”

Note: see a size chart under “product description” on the website.

Contiform

picture of Contiform

available on NHS prescription

re-use up to 30 times

£85 starter pack of 3, £40 per unit thereafter* from contiform.co.uk

*further 20% reduction if you complete a VAT exemption form

Also available on NHS prescription from your GP [starter pack: NHS order code   SKU184 , PIP code 375-5808 ]

The principle of the Contiform is to create uplift and support for the neck of the bladder.  These are guaranteed to be re-usable up to 30 insertions. So if you felt you needed support daily rather than ad hoc this is likely a more economical option in the longer term.

The Contiform Pessary looks like a plastic hollow tampon.    The smaller circle supports the bladder tube (the urethra). The larger surface lies against the floor of the vagina, giving support to the bowel wall.  They are made of a firm but flexible non-latex plastic. Each can be reused, with the guarantee up to 30 times. There is a “slit” that develops with wear to show you when the device needs changing. Use for longer if not worn all day. There is an optional ribbon to help with removal.

You can buy Contiform online or they are available on NHS prescription.  You would need to tell  your GP about your symptoms, and ask him to prescribe a starter pack for you.  While you are there ask for a referral to specialist physiotherapy too if you haven’t already got your own pelvic floor coach(!).  Especially if using a Contiform works for you – it suggests that a stronger pelvic floor could do this job naturally for you too!

Fiona Rogers, physio, clearly explains how to use the contiform. See 2:18 to understand how the “split” works. 3:08 about removal with or without the ribbon.

Efemia Bladder Support

efemia bladder support device

available on NHS prescription

re-use for 3 months

The Starter Kit contains all three sizes (S- 30mm, M- 35mm and L- 40mm) to find your best fit. £59. Thereafter £49 for each single replacement.

www.aghealth.co.uk

The newest member of this ‘family’ of bladder support pessaries. Efemia feels more petite, lighter and softer than the Contiform & Uresta. It is made of transparent flexible medical grade silicone. It is designed to sit lower in the vagina, tucking just behind the pubic bone. Similar to the space where a TVT procedure is positioned. Positioning correctly is straight forward. You leave the handle part on the outside of the body, but this could be irritating to the labia or vulva tissues for some women (efemia recommend using water based lubricant if this occurs). The external loop makes it easy to remove. It needs just a rinse between uses. You can leave it in place during menstruation but you could not use a tampon at the same time.

The Efemia website has a good video to show you the position it takes up and how this helps to support the bladder tube (the urethra) as you cough or move.

Like Contiform and Uresta it’s effectiveness is supported by small clinical trials. It is available on NHS prescription in England. You would need to tell  your GP about your symptoms, and ask him to prescribe a starter pack for you.  While you are there ask for a referral to specialist physiotherapy too. Especially if using an Efemia Bladder Support works for you. That suggests that a stronger pelvic floor could do this job naturally for you too!

Uresta

picture of uresta

resuable for a year

£179 (ex-VAT ) + £8 P&P  for a starter kit containing 3 sizes  from iMEDicare on 01923 237795 or via uresta.uk

Uresta, designed and manufactured in Canada, joins this family of internal support devices with the unique selling point that it is fully reuseable for one year.

So if you have had good success with one of the devices above this would be a natural progression to a potentially more environmentally friendly and overall less expensive option.

A clinical trial of 32 women found that of those still using it at 2 weeks (21 women out of the original 32), 76% of them (16) were still using it at their 12 month visit.*

*    Farrell SA, Baydock S, Amir B, et al.  Effectiveness of a new self-positioning pessary for the management of urinary incontinence in women.  Am J  Obst  Gynaecol 2007:196:474e.1-474.e8

There is a helpful video from their website below. If you are worried about the high initial cost Uresta offer a full money back guarantee. There is also give good advice about how to find the right size for you.

this video is from uresta.co.uk

Beware misleading marketing

Some of the marketing blurbs list “strengthen your pelvic floor” as a benefit of using their pessary device.  This is only true in the loosest meaning. While they are in place, by artificially re-inforcing the vagina wall,  I suppose you could claim that is “strengthening” the pelvic floor action – but they are in no way making any change to the muscle.  Only exercise can change the composition and activity of the muscles or surgery the non-muscular elements.  When you take the device out the structural situation remains the same.   However, these devices definitely offer an alternative to surgery. Or a Buy Some Time option if you need to complete your family or are undecided about a bigger procedure.

Living life to the full

To conclude – I would suggest that these devices are part of your package of things you are doing/using to change the way that bladder leakage limits your lifestyle. Make it your goal to cure your leakage problem rather than simply manage it.

However, if you are not worrying about leaking, you will fee more confident to exercise. This is a Good Thing for your overall health, wellbeing and mood.   

Do contact your local specialist physiotherapist to help support you. She will guide you towards the right products, exercises and sports for your needs

Have you tried one of these internal bladder support pessaries? What did you think? Any tips for other mums?

Field Guide: incontinence pads and pants and knickers

Field Guide: incontinence pads and pants

Trying to stay dry with bladder leakage? Not sure what will work best for you – incontinence pads or pants?  Overwhelmed by the choices in the shops and online? This detailed post & video discusses all the options and explains the difference between them. Don’t waste money buying the wrong thing. Tips and tricks to feel safe and dry without irritating your skin.

This is a practial, unbiased, useful overview of incontinence protection products, to help you decide what might suit you best. 

Even a few drips or spurts when you cough or sneeze (stress incontinence) can quickly make your knickers feel wet and uncomfortable. It’s natural to worry that it has gone through onto your clothes and be anxious that everyone can see what has happened.  Irritable bladders can catch you short before you make it to the toilet, or even unexpectedly empty without much warning (urge incontinence). Those leaks can be very big. 

 Fear makes you avoid doing things.  Feeling anxious takes the edge off life and motherhood.  Let’s start by making you feel safe.  #No More Miserable Mums.

full disclosure: this article contains some affiliate links marked*. As an amazon associate I earn from qualifying purchases. If you make a purchase by clicking through from an affiliate link I receive a small commission  at no further cost to you. Thank you, this helps to support this blog.

#1.  Disposable incontinence pads

Sanitary pads and incontinence pads are not made of the same thing.  It is important to use a pad designed for bladder leakage not menstruation.

The products designed to be used for menstruation are great for that purpose. However, they do not to cope well with liquid.  This is because they are predominantly cottonwool based. So if they get wet, they just go soggy and misshapen. If you are moving about they can get scrunched up, rub,  and leave your skin in contact with urine causing chafing and soreness.

The right pads for the task are worth the little bit of extra cost.   With the advent of new technology you will be amazed how slim a proper bladder leakage pad can be to hold a large amount of liquid, keep damp away from your skin and control smell.  

WHAT TO LOOK FOR IN THE SHOPS (or online )

Products for incontinence are usually in the same ‘feminine hygiene’ aisle (or website section of an online store) separated into one column of shelves for products for periods and one for bladder leakage.

Most brands will send you free samples from their websites.  Collect them up and see which suit you best!

disposable incontinence pads

Some of the main UK brands are Tena, Always, Attends, Poise, as well as supermarket own-brands and Boots’ StayDry range

How much urine leakage do incontinence pads hold?

The most common indicator of absorbency is a row of filled ‘drip’ or circle symbols to indicate the level of leakage they will contain.

In general, pads for ‘lighter’ bladder leakage look and feel like pantyliners. They come in boxes to keep them flat and compact.   This makes a good starting point if you are looking for something to keep you confident and safe against a small leak (up to 6 teaspoons = 30ml). These would work for or a few drips or spurts if you move awkwardly, or cough unexpectedly with a full bladder.  

If you suffer with more severe leakage, you will be worrying about getting wet clothes. Look at the pads in bags which will be more absorbent or disposable absorbent pants (see below).

A bad cough, hayfever, trying anything bouncy for a prolonged period could leak a small yogurt pot worth (= 100ml). Of if you have an irritable bladder (officially called overactive bladder) which can trigger a sudden urge and empty at the front door, or if you wait too long, you have the risk of potentially emptying most or all of your bladder (which could be 200ml – 400ml),

If you are getting wet when you do sport or play with your kids your priority should be to solve the bladder problem further.  Talk to your physio about organising a full assessment. 

TOP TIPS for using pads

  • Shape them – to create a gully (see video)
  • Put them a bit further forward in your knickers, as the bladder tube (urethra) is just below your pubic bone
  • Change them regularly to avoid irritating your skin
  • Wear knickers that hold them snug

#2   MODERN DISPOSABLE PANTS

If you need complete confidence that no matter which way you bend, stretch, move or lie you will have full protection in all directions these are better than a substantial pad that only protects the gusset.   

  • ideal for night time leakage
  • exercise classes with lots of matwork or changes of position
  • crazy play with the kids
  • a bladder that struggles to make it to the toilet first thing in the morning
  • long car journeys or travel when toilets and timing are so uncertain.

The modern absorbent waterproof disposable knicker is technically sophisticated.  Still a way to go on style (they are trying).  Unfortunately, thye need to be big to be absorbent and need a deep waistband to hold them snug & safe. Available in standard white, cream and black.  Some with dodgy flowers.

I don’t believe these could ever feel “normal” (as marketed). However, they do give mums freedom to move without worrying. Put a big pair of “PE” pants (aka Bridget Jones) over the top to make them a tad more “out of sight out of mind” (- and organise a physio appointment to solve this problem).

If you are often using disposable incontinence pads or pants definitely look at the next option, washable knickers.  You will be amazed to see that you can get the same absorbency in a much more “normal” looking knicker.  Worth the upfront costs and kinder to your skin as well as the environment.

#3  WASHABLE KNICKERS WITH INBUILT PROTECTION

We are so lucky to be in the era of textile research and design. I am delighted to see this being applied to continence underwear. 

Advantages:  

  • good for the environment. 
  • great if you are usually fine but like to know you have back up. 
  • more discreet if you need a thicker pad. 
  • look much more like real knickers.
  • most are machine washable
  • available in a range of colours and styles
  • Natural products and airflow around your vulva, less irritation

Disadvantages:

  • once you are wet you need to change the whole knicker
  • some are not machine washable

Brands: washable incontinence knickers UK

Brandwill holdsame as…Laundry
ProTech Dry High Waist Briefs
(also called Maxi Pant)
30-60ml 2-3 tablespoonsUp to 60 degrees
Speax. Hi-Waist, Hiphugger,
French Cut, Bikini
40ml 8 tspsCold wash, tumble or line dry
Speax Thong 15ml3 tspsCold wash
Love Luna (Sainsburys),
Lady Leaks No VPL, Lady Leaks Maternity Knickers, Lady Leaks Midi Knickers
30ml 6 tspscold machine wash, do not tumble
GiggleKnickers 30ml 6 tsps 40 degree, tumble or line dry
Hush Hush
Seamless Panty or Lace waist panty
100ml small yogurt pot
Wearever Underwear
regular absrobancy
Maximum absorbancy
175ml
650ml
half a cup or a full bladdermachine wash warm, tumble dry (cotton style only)
Pro-tech black knickers absorbent for incontinence

PROTECH DRY High Waist Brief (also called Maxi Pant)

made from sturdy cotton, 3 layer mesh-style gusset, surprisingly flat: an absorbant layer (40ml = 8 tsps), odour retention layer & wick away surface, smoothly sealed seams.

www.stressnomore.co.uk

* use SUPPORTEDMUMS at checkout for a 15% discount

Speax washable incontinence pants

SPEAX

From the manufacturers of Thinx period pants. Five different styles: from Hip Hugger, through classic bikini to thong.  Varying prices depending on style £16 – £24 . 

The main knicker is a quality silky material (not cotton), gusset is subtle. Fun colours!

Speax incontinence pads are silky & colourful

NB: they  are  cold wash only (no bleach or fabric softener) with low tumble dry which you might miss in the instructions (and then be very cross about!).  Answers to other FAQs here:

shethinx.com

Giggle Knickers cotton washable incontinence pants

Giggle Knickers

A fresh feeling, environmentally aware, small company with a quality range of machine washable cotton pants designed to replace a liner.

Brief or high waisted £12.99-£14.99

www.giggleknickers.co.uk

GK are zero rated for VAT as long as you are an individual and you don’t buy more than 9 at a time. Compostable mailing bags.

Love Luna (Sainsburys)

Good budget choice. Silky material 91% nylon, gusset is 100% polyester with cotton padding, quite a wide stiff gusset, so a little more ‘aware’ that you are wearing them, than more expensive brands.

3 styles: full knickers, no VPL workout knickers, maternity knickers

£12 per pair.

www.tuclothing.sainsburys.co.uk

Wearever washable incontinence pants knickers

Wearever

A ‘sturdier’ look but this range can cope with more leakage than the more fashion based ranges. Variety of styles, colours and absorbancies (regular or maximum).

pair shown here are silky panel at front with lace panel at back

available from iMedicare at www.mypelvichealth.co.uk

You are eligible for VAT relief on your order if you are an individual purchasing Wearever for the treatment of incontinence.

What will suit you best?

Probably a mixture of different things! Life is sweet with all it’s variety, messy moments, strategic plays and aspirational hopes. No one product will solve a typical situation or day. Be open minded, treat yourself. Mums matter.

And don’t forget – you can CURE this!

80% of women can improve or completely cure their incontinence through the simplest strategy of sticking to a 3 month programme of pelvic floor exercises. Best success comes from a 1:1 assessment of your situation and a bit of supervision by a specialist physiotherapist. You can self refer to an NHS physio or many private clinics all over the UK.

Look after yourself, share your troubles with a friend, encourage other women to seek help. #No More Miserable Mums

Please let us know which products you like best in the comments below. Have you changed your life through the right knickers or exercises?

EVB capris may help support your pelvic floor when running

EVB Sports Shorts: an active mum’s best friend?

Is running making you feel leaky, heavy or vulnerable? EVB Sports Shorts could be your new BF.

What are EVB Sports Shorts?

EVBs (as they are affectionately called) are sports kit – shorts, capris or leggings. Specially designed for women who feel vulnerable when they run or take part in higher impact activities.  Women’s health physiotherapists recommend them for those who need to find discreet ways to manage a bladder or prolapse problem. They add an extra layer of support to your body from the outside. Special panels lift and protect your bladder and pelvic organs.

Full disclosure: this post is not sponsored but I received a free pair of shorts to trial. If you find this article helpful and decide that you would like to buy a pair, please use my affiliate link – there is no extra cost to you but a small share to me, which helps to support this site.

Would you benefit?

Do you find your bladder leaks a few kms in? Or get a feeling that your entire lower half moves about too much as you pick up your pace?  Or that you beloved run is counterproductive at the moment – straining and fatiguing your core muscles? Do you finish feeling leaky, achey and with vaginal or anal heaviness, spoiling the rest of your day?

Sound familiar? These specialised sports shorts/leggings have helped mums with these symptoms.

EVB sports shorts in 4 styles

How do they work? More support everywhere that matters…

EVB Sports Shorts are made of a specialist high quality stretch material. This is designed to create more lift and support for the perineum and abdominal wall.  They aim to BE your essential support muscles while you work on recovering yours (with your pelvic floor exercises).https://supportedmums.com/pelvic-floor-school/

They are not just guess work or cosmetic.  Their inventor, Yvonne Brady, is a chartered engineer (as well as mum of 3 and regular marathon runner).  Her company have invested over a million in R & D, including projects with physios, to design-in specialised support panels. These are in the gusset, to support the pelvic floor and in the front panel to support the abdominal wall.

If your bladder leaks when you run EVB shorts give extra support to your abdominals and pelvic floor

 Ultrasound studies have shown they mimic the role of the pelvic floor muscles. They lift the bladder neck and prevent the anterior vaginal wall from moving down.  Also it may be that better positioned muscles and tissues will themselves function better. Or the better positioning will train them to do what they should be doing when you run.

Reality Check – I tried them out..

I had seen and heard physios rave about these. But I like to try things out for myself before highlighting them here.  I asked Yvonne to send me a pair to try and to show my mums in clinic.    

Sizing – do it properly – no guessing

You size yourself by measuring your waist and hip size.  NB: Not guessing!! It’s really important that you have the right size for NOW. Not who you would like to be! They need to be really tight to work well. However, if they are too tight they will they be horribly uncomfortable. And I worry that you would risk the waist band pushing down into your tummy.  There is a useful video guide to sizing on their website

Styles:

The shorts, capris and leggings are intended as outerwear (knickers on underneath) – available in black

The “Boxer Brief” is available black or nude to wear underneath other clothing.

Getting them on:

They come beautifully packaged with clear instructions.

They warn that fitting into them first time can take a few minutes due to the technology they supply.  Everything reassures you that you can pull them hard. “they will not rip”, it says, but I had to read that twice to have confidence!  It really is a wiggle process to get them over your hips and pulled right up to give gusset support. Once you get there (!) they do fit like a second skin (with benefits) and were entirely comfortable.  

Initially I wasn’t sure about the “look” for going out out. I am not normally a tight tight shorts person and a more fairweather jogger. But you will see on the website pictures & happy testimonials of proper mum runners! They are meant to be worn as your outerwear, shorts or capri style, with normal underwear underneath.  However, the bottom-conscious could easily fit another pair of leggings/looser clothes over the top.

Returns & Exchanges

Yvonne is passionate about her EVBs and wants women to feel confident to make an investment in themselves.  Customer support is quick and responsive with generous & fair exchange & returns policies.

I support women designing for women.

I firmly believe that self-care is not self-indulgence. Looking after our bodies after birth is essential. Exercise is fundamental to both physical & mental wellbeing. Fit mums enrich their own and their kids’ lives.

We live in a modern world. With amazing technological inventions to help us enjoy our sports & hobbies and care for our bodies. Mums need Good Kit too. Even happier to recommend them now I’ve tried them:  ww.evbsport.com   

squeezy app settings

How to change Squeezy App settings for a beginner

Beginners Guide to change Squeezy App settings –

  • How to slow the speed down
  • shorten the “slow” holds
  • create a pattern to suit a beginner
  • less (or more!) reminders!

I LOVE squeezy app but my (minor) bugbear is that the default settings it comes with are actually the “end goal”. In the long run you want to be able to hold for 10 seconds 10 times in a row but I don’t come across too many beginners who can manage that! Not easy for beginners, and for many people a bit demoralising at first try. If you could perform like that already you likely wouldn’t need the app!

How to tweak the settings if you are a true beginner…

  • Go to the green-ish petal “exercise plan”.  
  • Set yourself timings for THREE times a day.
  • scroll down to find the “Professional Mode” and turn it ON

Make the Slow Ones “shorter” holds

  • then go back to the “Slow exercises” and change to:
    • the number of reps to 8
    • squeeze time 5 seconds
    • Hold time 0
    • Relax time 5 seconds
    • rest time 0

Now they will be shorter on/offs to get you started. Little and often through the day.

More Tortoise than Hare?

  • Then go to “quick exercises” and change the dial to TORTOISE speed = Speed A.  This will mean that they don’t come at you so fast giving you more time to release between contractions.

Lose the sub-max exercises for now

  • Then go to “sub-maximal exercises” and choose repetitions = 0
squeezy app settings

Or a tweak if you’re a bit bored of the pre-set “slow” pattern

Our brains get bored easily and switch off a bit once something becomes familiar. Wake yourself up a bit with a pattern change:

  • Go to the green-ish petal “exercise plan”.  
  • scroll down to find the “Professional Mode” and turn it ON
  • then go back to the “Slow exercises” and change to:
    • the number of reps to 10
    • squeeze time 4 seconds
    • Hold time 4 seconds
    • Relax time 4 seconds
    • rest time 4 seconds

How do you do yours?? Do share your tips, tricks and successes below!

Squeezy app review

Squeezy App: because we don’t remember To Do Them…

Squeezy App review:

Checklist (tick all that apply)

  • I Mean to do my pelvic floor exercises but then I Forget.  
  • I drift off partway through my routine. 
  • I like to do them at top speed to get them done
  • I always feel guilty that I should have done more
  • I can’t remember how many you’re supposed to do a day?
  • umm… what are you supposed to do again?

Easy Solution…

NHS Squeezy App.  It counts for you.  It reminds you.  It gives you a happy little chart and messages to tell you how clever you are when you do them.  All for £2.99.

NHS Squeezy app reminds you to do your pelvic floor exercises

So download it NOW (or re-upload it if you already had it but it’s now back in the cloud….). 

Other app features (which you may not have noticed!)

  • bladder diary – are you drinking too much or not enough?
  • reminders – set the perfect timings for you
  • record of your exercising – to feel pleased with yourself!
  • information about how to do your squeezes

And on the Squeezy website:

  • videos about how to do the exercises or change the settings
  • a Directory to help you find a physio

Beginners might want to change the settings

My only (minor) bugbear with it is that the default settings are actually your end goal (10 second holds, 10x in a row).  And the Quick squeezes are really quick!!.  Follow these instructions to make Squeezy App more user friendly for a beginner.

Any questions? Do ask in the comments below – you won’t be the only one with the same query!

Field Guide: Pelvic floor muscle biofeedback gadgets and devices

Field Guide: pelvic floor biofeedback gadgets

There has been a recent explosion in “fem-tech” options, particularly pelvic floor biofeedback devices. On the one hand this is empowering women to improve their exercising in the privacy of their own homes, on the other hand resulting in a more than a little confusion about what they do.  With most devices over £100 it is important to spend your money wisely.

Pelvic floor Biofeedback devices

Generally, we advise that if you can already contract your pelvic floor muscles then you don’t need to do passive pelvic floor muscle stimulation. Your muscles will develop quicker by doing ‘active’ exercises where the brain initiates the activity rather than a machine. Check out the videos on our Pelvic Floor School.

However, if you WANT to work with a gadget to do active exercises, a biofeedback device can enhance your practice. Particularly, if you need to work on your brain skills (co-ordination, multi-tasking, downtraining) as much as your isolated muscle strength & endurance (which they can be helpful for too).

How to they work?

  • The action of your muscles contracting is relayed to a machine which “shows” you what you are doing.  There are several different ways this can be done.  
    • Some machines pick up the electrical signal from your muscles while some respond to pressure.  
    • Some give you a visual picture of what you are doing,
    • others beep or vibrate in response to your contraction.
  • Biofeedback devices are great to correctly identify your pelvic floor muscles in different positions. They also ensure you are contracting correctly and also help you focus on relaxing fully between contractions
  • These gadgests let you see how well your muscles contract and relax.
  • They give targets to aim for to improve strength, endurance and co-ordination.
  • Practice more complicated tasks. Skills you need for real life or your sport.
  • Make exercising a bit more fun (!) and interesting. This will help you to keep up long-term practice (rather like a piece of gym-kit for your pelvic floor!)

Examples of pelvic floor biofeedback devices:

To be professional, I do not recommend a single specific product or supplier. But I have aimed to narrow down the list of options for  you.  Please do read customer reviews to help you make your decision. Specialist physiotherapists, like myself, have units in clinic for you to try before you buy.

Electrical biofeedback devices: with connecting wires

Peritone EMG biofeedback unit and Simplex EMG biofeedback unit are  the ones we have used in our clinic for many years (same device in different packaging).  Many physiotherapy departments have these for you to use at your visit and/or to borrow. Just like French women train in their postnatal rehabiliation sessions.

They are effectively two parts.  You place a small internal electrode (called a Periform, which is single person use,  into the vagina. Then put your clothes back on!. Then link your internal device by a cable to the handheld Pelvitone or Simplex unit (we can loan one of these to you).  

When you contract your pelvic floor muscles their electrical activity registers on the screen. This makes the  lights change from orange to green and gives an audible beep.  

You can practice your quick maximum power squeezes seeing how high you can make the lights go. Also, practice keeping the lights green while you cough or try moving your arms or legs. There is also a work/rest function which ‘counts’ the endurance holds for you and tells you your average squeeze score at the end.

These devices are widely available from lots of online sellers +/- £160 (including the Periform).

Pelvic floor training devices: which connect via bluetooth to a phone app

Elvie Trainer

Elvie for pelvic floor biofeedback

Elvie  £169

The Elvie updates the design of the traditional units above. It is popular as it has modern smart phone visuals, easy charting & a sense of community amongst users.  

I have one I can show you in clinic but the internal device (the pebble) is the expensive part, and understandably single use only, so I’m afraid you can’t try before you buy.

It is a discreet, attractive, wireless bluetooth pebble-shaped device. This goes inside the vagina. Use an app to turn your phone into the biofeedback monitor/exercise tracker.  No cables between you and the phone but you can’t put knickers back on or the bluetooth can’t connect. It is beautifully packaged and well designed by women. It can be used in the second trimester of pregnancy but is not recommended for the 1st and 3rd trimesters.

Elvie is officially available “on prescription” but sadly, I don’t know anyone whose managed to get one this way.

Pericoach System

Pericoach System for pelvic floor biofeedback with a phone app which can also connect to your physiotherapist

Pericoach System £145

Pericoach System shows your pelvic floor contractions as clear graphs on your phone. Pre-set programmes guide you to practice exercises twice daily and, like the Elvie, uses algorythms to automatically progress you as you improve your skills. You can give you physiotherapist access to your data so that she can guide you virtually.

Pelvifly/K-Goal

Pelvifly is a package connecting the K Goal pressure sensor to a phone app for sensitive imaginative  pelvic floor biofeedback with sophisticated integration to a remote physiotherapist if required

Pelvifly £189 with basic plan. Subscription for full integration with a physiotherapy coach.

Pelvifly is a package connecting the K Goal pressure sensor to a phone app for sensitive imaginative biofeedback games with sophisticated integration to a remote physiotherapist if required

The largest of the internal probes, which will suit those who find more petite devices fall out too easily. It responds to the pressure of your pelvic floor squeezes. This is particularly useful for those who need to learn to relax the pelvic floor (called downtraining). Pelvifly offers the greatest variety of challenges with innovative vibrant visuals – including butterflies visiting flowers, rockets flying through tunnels, basketballs into hoops and an engaging octopus!

The BASIC plan (no further cost after purchase) sends you a muscle test once a month and daily challenges. With a SMART subscription (£24/month) you will have more programs to follow to suit your chosen goals. Pelvifly are rapidly expanding their telehealth services. With a CARE package (£96/month) you will be connected, virtually, to a Pelvicoach (a specialist physiotherapist) who can interact remotely to set up bespoke assessment and training programmes, support your progress, exchange messages and save and print your progress reports.

Pressure Biofeedback devices

kegel8 trainer for pelvic floor biofeedback uses a pressure system

Kegel 8 Biofeedback Pelvic Trainer £94.99

Kegel8’s biofeedback pelvic trainer uses a pressure system where you squeeze on a larger tube (NB latex covering) which moves a dial on the hand held unit.   Unsophisticated but effective for checking what you are doing and therefore a relatively inexpensive option

Epi-no Delphine Plus birth trainer can also be used for  pressure pelvic floor biofeedback can be used in pregnancy

Epi-No Delphine Plus £99.99

Eip-No’s primary purpose is a tool to stretch the perineum in preparation for vaginal delivery. It can also be used as a biofeedback tool before & after birth. The dial lets you visualise the amount of squeeze pressure you are creating with your muscle contraction.

Epi-No (like the Kegel8 Trainer) is less sensitive than the electrical biofeedback or bluetooth devices. However, the advantage of the Epi-No is that it is  certified for use through your whole pregnancy. It can also be used in the latter part of pregnancy (after 37 weeks) to help to stretch the vaginal opening. A recent study * did not show evidence of a protective effect of the Epi-No device on birth trauma, however, anecdotally many women feel it has helped with their confidence to relax the vaginal opening in preparation for birth.

*Kamisan Atan I, et al. BJOG 2016  Does the Epi_No birth trainer prevent vaginal birth-related pelvic floor trauma? A multicentre prospective randomised controlled trial.

Other trainers

Vibrance Pelvic Trainer

The Vibrance Pelvic Trainer    is a petite internal device which vibrates when you correctly contract your pelvic floor muscles.  The device is  easy to insert but you may need to hold it in position. There are no wires, or external unit, the vibration is felt in the device itself.

This device could also be useful as a ‘bridge’ back to penetrative sex, if you don’t want to use a traditional vibrator. You could practice inserting the trainer at your own pace. You might find the vibration element helpful to re-sensitise your tissues.   They are available directly from www.vibrancepelvictrainer.co.uk  £140.83 with VAT exemption.

This links to a digitally annotated instructional video for Vibrance PFT on youtube:https://www.youtube.com/watch?v=n8IoqefRzTU

Note about VAT exemption

If you have had a problem for more than 3 months, you can declare yourself as having a ‘chronic medical condition’ and do not have to pay VAT. There will be a form to complete. This does not apply to the Elvie which is registered as an exercise tracker not a medical device. Not all the online suppliers can offer this service.

Combined Stim & Biofeedback Machines

You can buy combined units which do both functions. However, these are surprisingly expensive (and a bit fiddly). If you feel you need both systems I usually suggest you buy two separate simpler units and switch between them.

Lubricating gel

You will need a water-based lubricating gel to help the insertion of the devices. It is essential to help the electrical devices to operate correctly. A simple, in-expensive, chemist-own or basic brand name is theoretically all you need. If you have concerns about ingredients you may prefer an organic version.   Do read my posts about the difference between water-based and oil-based lubricating products.

.

Not sure what YOU need?

Get clarity first

If you are not too sure how good your muscles are then before you spend ANY money on a gadget or device I would highly recommend an hour spent with a specialist physiotherapist! Your appointment will be £70-90 outside London.

Our role at physiotherapy is to do an internal assessment of your pelvic floor muscles. We will check how well they are working and teach you how to get the best from them – you may not need any gadgets at all! And if you do we can help you make the best choice for your needs.

Try before you buy

Many physio clinics can loan you both muscle stimulation and biofeedback units to try out at home. To see how well they work for you before you consider buying your own. (NB you still have your own internal probe – no sharing of those!).

It is particularly important to consider an individual assessment by a specialist physiotherapist if you are at all worried that your pelvic floor muscles might be too tight rather than too weak.

Physios can also teach you active exercises , which require no equipment at all! We usually combine pelvic floor exercises with appropriate abdominal muscle work as these two areas need to work well together for best support of our internal organs.

Please don’t hesitate to be in touch if you have further questions. Readers would love to know your experiences if you would be happy to share?

Savage, A.M (2021). Handheld biofeedback devices to enhance pelvic floor muscle training. Journal of Pelvic, Obstetric & Gynaecological Physiotherapy, 128, 54-57

Field Guide: pelvic floor muscle stimulation machines

Field Guide: Pelvic floor muscle stimulation machines

Pelvic floor Muscle Stimulation Units

These units are designed to be used at home to artificially stimulate the pelvic floor muscles to work. Electrical impulses are sent from the machine directly to the pelvic floor to mimic the messages that your brain is supposed to send.

These units are ideal for people who really don’t know where their muscles are. Or what they are supposed to do! They are also good for very weak muscles that can only contract a few times before they fatigue. Or muscles that can only muster a very tiny amount of strength.

  • the sensations (a sort of tingly feeling) created by the electrical impulses help your brain to correctly identify the location of your pelvic floor muscles.
  • the machine will stimulate the muscles to work (contract). It is possible to change the settings to favour different parts of the muscle.
  • you can practice joining in with the machine to learn how to contract your muscles without help
  • the machine can help you to ‘hold’ a muscle contraction while you concentrate on learning to breathe and/or move at the same time
  • we usually recommend that you wait until 3 months postnatally before using a stimulation machine.

Examples of stimulation units:

To be professional, I do not recommend a single specific product or supplier. But I have aimed to narrow down the list of options for  you.  Please do read customer reviews to help you make your decision.  Many specialist physiotherapists, like myself , have units in clinic for you to try out before you buy.

Traditionally the stimulation is delivered by a battery-operated handheld unit with wires to a internal electrode. The price points vary depending on the number of programmes available & the style of the electrode supplied. A new design on the market is Pelviva, which are wireless foam single-use electrodes.

kegel8 tight & tone

The kegel 8 Tight & Tone Electronic Pelvic Toner £98.99 is a simple classic pelvic floor stimulation unit which we  have used in our clinic for many years.  The buttons are large and few! You may prefer to use it with a periform electrode

Neen Pericalm is discreet and easy to use

Neen Pericalm £69 + buy a probe

is often brought in by customers (availabe on amazon). I also find this one easy to follow the instructions and set the programmes.  It is also very small and discreet. You will need to buy a vaginal or anal probe to go with it.

Kegel8 Mother Nuture is also a TENS machine

Kegel 8 Mother Nuture £79.99

Even though it is the cheapest one that Kegel8 offer it has all the programmes you will need, plus doubles up as a TENS machine if you anticipate another delivery. A periform probe is a more slender option than the one provided with it.

Nu-tek levator mini

Nu-tek Levator mini continence stimulator.  

 Win-health  supplies our practice.  It is a good stimulator though the buttons and set up are a little fiddly until you understand how it works. I recommend you select the Periform probe (which has a hole in the middle rather than solid) most clients find it more comfortable.

kegel8 Ultra20

Kegel8 Ultra 20 £134

has more programmes & is supplied with the shapely Glide Gold Vaginal Probe. The customer instructions are good. My videos with Kegel8 use this machine as the demo

pelviva foam internal electrode

Pelviva £44.95 for starter pack of 3/£214 for 1 month pack x15

Pelviva is a unique product that does not require a handheld unit like those above. It is a disposable single use foam electrode which is activated just before use then delivers 30-min internal stimulation. video here

How to use a stimulation machine: video series

I have created a series of videos to show how a machine works, what the cables and probes look like and explain in a not-too-tech way how to use them to help problems with bladder leakage, prolapse or recovery after a baby.

These videos will help you understand your condition, as well as how the machines work. Then, you will be able to decide whether a machine would benefit you and which programmes you would choose.

You will see that these videos were created as a project for Kegel8. However, you will find most of the information applies to stimulation machines in general.

Note about VAT exemption

If you have had a problem for more than 3 months you can declare yourself as having a ‘chronic medical condition’ and do not have to pay VAT. There will be a form to complete. This does not apply to the Elvie which is registered as an exercise tracker not a medical device. Not all the online suppliers can offer this service.

Combined Stim & Biofeedback Machines

You can also buy combined units which do both functions. However, these are surprisingly expensive (and a bit fiddly) so if you feel you need both systems I usually suggest you buy two separate simpler units and switch between them.

Lubricating gel

You will need a water-based lubricating gel to help the insertion of the devices. It is also essential to help the electrical devices to operate correctly. A simple, in-expensive, chemist-own or basic brand name is theoretically all you need. However, if you have concerns about ingredients you may prefer an organic version.   Do read my posts about the difference between water-based and oil-based lubricating products.

.

Not sure what YOU need?

Get clarity first

If you are not too sure how good your muscles are then before you spend ANY money on a gadget or device I would highly recommend an hour spent with a specialist physiotherapist! Your appointment will be £70-90 outside London.

Our role at physiotherapy is to do an internal assessment of your pelvic floor muscles. We will check how well they are working and teach you how to get the best from them – you may not need any gadgets at all! And if you do we can help you make the best choice for your needs.

Savage, A.M (2019). Neuromuscular electrical stimulation devices. Journal of Pelvic, Obstetric & Gynaecological Physiotherapy, 125, 16-25

Try before you buy

We can loan you both muscle stimulation and biofeedback units to try out at home. To see how well they work for you before you consider buying your own. It is particularly important to consider an individual assessment by a specialist physiotherapist if you are at all worried that your pelvic floor muscles might be too tight rather than too weak.

We can also teach you exercises , which require no equipment at all! We usually combine pelvic floor exercises with appropriate abdominal muscle work as these two areas need to work well together for best support of our internal organs.

Please don’t hesitate to be in touch if you have further questions. Readers would love to know your experiences if you would be happy to share?

Savage, A.M (2019). Neuromuscular electrical stimulation devices. Journal of Pelvic, Obstetric & Gynaecological Physiotherapy, 125, 16-25

Savage, A.M (2018). Continence products and medication devices: issues that pelvic health physiotherapists need to consider. Journal of Pelvic, Obstetric & Gynaecological Physiotherapy, 122, 30-40

What's the difference between a pelvic floor biofeedback gadget and a muscle stimulation machine

What’s the difference between a pelvic floor biofeedback device and a stimulation machine?

Help! So many different pelvic floor gadgets – which one for me?

You have probably heard of “gadgets” to help exercise your pelvic floor muscles.   If you have been thinking about buying one you may already have looked around online.  My complete sympathy if you are feeling overwhelmed and confused!  Not only  about which one to get but also the difference between them.  They range in price enormously.  The language can be confusing.  There are so many different suppliers..… 

This post aims to help you understand:

  • the braod difference between a stimulation unit, a biofeedback device and weights/resistance devices and reminder devices/apps

I hope this overview will start to clear the confusion for you.  Once you have a fair idea which category gadget or device interests you most do read the Supported Mums Field Guides (with regularly updated product links)  to each: 

There are broadly four types of pelvic floor gadget

  • Stimulation units
  • Biofeedback devices
  • weights/resistance devices
  • Trackers/Memory Aids

# Stimulation units

send electrical impulses TO your muscles to help them to contract/exercise  (they wholly or partially do it for you)

examples:  Kegel8 Mother Nuture, Kegel8 Ultra20, Neurotrac Continence, NuTek-Levator, Neen Pericalm, Pelviva Muscle Trainer, Innovo Shorts

whereas

# Biofeedback devices

show you what you are doing with your muscles when you contract/exercise them using your own brain.  Some do this by sending an electrical impulse from you to the machine but there are others that do this using a pressure signal or another type of sensor.  

examples: Neen Educator, Kegel8 Pelvic Floor trainer, EpiNo, Simplex,  Pelvitone, Nu-Tek Levator Mini,  Elvie, Pericoach, KGoal (Pelvifly), Vibrance Trainer

Then there are gadgets for pelvic floors that are already working well:

# Gadgets that add resistance and/or weight

to your ‘ordinary’ pelvic floor exercises – to make the muscles work harder – just like you push or pull weights in the gym or pull against a resistance band or  work with a Pilates circle

examples:   Educator,, Pelvic Toner, Pel, Aquaflex Cones, Kegel Weights, Secret Whispers 

# Gadgets and apps that help you remember

to do your pelvic floor exercises, keep track of your progress, or prompt you to follow a sequence to make sure you regular perform a full range of tasks

examples:  Squeezy App, Intimina,  Tena’s PPX app

Note:  Combined Stim & Biofeedback Machines

You can also buy combined units which do both functions but these are surprisingly expensive (and a bit fiddly) so if you feel you need both systems I usually suggest you buy two separate simpler units and switch between them

Keen to learn more? Check out our Field Guides

  • which piece of kit might be useful to you depending on your circumstances
  • the detail of how they work, subtle differences and where to get them
  • when a gadget is not suitable or contraindicated

Supported Mums Field Guides: 


Not sure what YOU need?

Make the most of your local specialist physiotherapist

Most electrical devices cost over £100.  An hours appointment 1:1 with a specialist physiotherapist would  cost £70-90 (depending on area).  If you are hesitating what to buy, or even if you need a device at all,  why not first have a full assessment of your situation first?

Get clarity first

Remember that a specialist physiotherapist like myself, will do a proper examination of your pelvic floor, to give you complete clarity on what your personal pelvic floor strength, endurance and function.  Then together you can decide and plan the most appropriate and effective strategy for you to develop your muscles and skills further.

It is particularly important to consider an individual assessment by a specialist physiotherapist if you are at all worried that your pelvic floor muscles might be too tight rather than too weak.

Try before you buy

Most clinics will have a drawer full of gadgets and devices for you to see, touch  and discuss – and many, like our clinic, have units for you to borrow if you prefer to try before you buy.  

Or if you have already bought a unit or gadget and don’t feel that you are getting the most from it do book an appointment with a physiotherapist who will be able to help you to:

Or you might not need a gadget at all!

We can also teach you exercises , which require no equipment at all! We usually combine pelvic floor exercises with appropriate abdominal muscle work as these two areas need to work well together for best support of our internal organs.

Please don’t hesitate to be in touch if you have further questions. Readers would love to know your experiences if you would be happy to share?

Savage, A.M (2019). Neuromuscular electrical stimulation devices. Journal of Pelvic, Obstetric & Gynaecological Physiotherapy, 125, 16-25

Savage, A.M (2021). Handheld biofeedback devices to enhance pelvic floor muscle training. Journal of Pelvic, Obstetric & Gynaecological Physiotherapy, 128, 54-57

Savage, A.M (2018). Continence products and medication devices: issues that pelvic health physiotherapists need to consider. Journal of Pelvic, Obstetric & Gynaecological Physiotherapy, 122, 30-40

Is a pelvic floor stimulation machine right for you?

Are you thinking of trying a pelvic floor muscle stimulation machine? Perhaps you’ve got one already but it’s been gathering dust?!  Are you using yours correctly?

Are you are puzzled by the settings, the different electrodes and which programme to use? I can explain! 

I recently wrote an article on these devices, for my physiotherapy colleagues *. Can you believe I found more than 40 different products available to buy online? The manufacturers instructions can be a little hard to follow. I didn’t feel that there was enough explanation of how the machines work to help with pelvic floor problems.

* Savage A.M (2019) Neuromuscular electrical stimulation devices Journal of Pelvic, Obstetric & Gynaecological Physiotherapy, 125, 16-26

New Videos : How to use a pelvic floor stimulation machine

I have a new video series for you covering:

  • Why do we have machines to send electrical impulses to somewhere as delicate as the pelvic floor?
  • How muscle stimulation works – is it what you need?
  • Which probe is right for you
  • Step by step setting up your machine
  • How to use a pelvic floor stimulation machine for different problems eg stress incontinence, urgency, pain or prolapse or after delivery.
  • FAQs from clinic!

You will see that these videos were created as a project for Kegel8. However, you will find most of the information applies to stimulation machines in general.

These videos will help you understand your condition, as well as how the machines work. Then, you will be able to decide whether a machine would benefit you and which programmes you would choose.

How to use a Stimulation machine : video series link here

Stim or biofeedback??

Not sure if you need a stimulation machine (common brands are Kegel8, Nu-Tek, Sensatone or Pelviva) or a biofeedback machine (like Pelvitone, Elvie, Pericoach or Vibrance)?  Start with this article which explains the difference between them.

bladder leaks when running

Bladder leaks when running? 6 discreet ways to keep dry and avoid a VPL

What do you do if you worry about bladder leaks when running? Or at the gym, your exercise class, or playing with your children ?? Mums I meet in clinic tell me that they are avoiding events that require them to look “sporty”.  They worry about a VPL if they wear normal figure hugging gym kit.  They don’t want to stand out in a baggy tracksuit trying to hide a pair of substantive knickers with a pad.  Heaven forbid a party or wedding?

I’m an experienced women’s physio so I know pads aren’t (and don’t need to be) the solution but they could be a vital part of your journey out of the Miserable Place.⁠

Tips to manage bladder leaks when running or active:

full disclosure: this article contains some affiliate links marked*. As an amazon associate I earn from qualifying purchases. If you make a purchase by clicking through from an affiliate link I receive a small commission  at no further cost to you. Thank you, this helps to support this blog.

#1.  Use a pad designed for bladder leakage not menstruation

Sanitary pads and incontinence pads are not made of the same thing.  

The products designed to be used for menstruation are great for that purpose but do not to cope well with liquid.  As they are predominantly cottonwool based, if they get wet, they just go soggy and mis-shapen. If you are moving about they can get scrunched up, rub and leave your skin in contact with urine causing chafing and soreness.

The right pads for the task are worth the little bit of extra cost.   With the advent of new technology you will be amazed how slim a proper bladder leakage pad can be to hold a large amount of liquid. They also use fabrics that can wick fluid away from the surface. This keeps damp away from your skin and reduces your worries about odour.

Some of the main UK brands are Tena, Always, Poise  and Boots Staydry range. All will send you free samples from their websites.  

 The products are usually in the same ‘feminine hygiene’ aisle (or website section of an online store) but separated into one column of shelves for products for periods and one for bladder leakage.

The most common indicator is a row of variously filled ‘drip’ or circle symbols to indicate the level of leakage you wish to contain.

In general, pads for ‘lighter’ bladder leakage look and feel like pantyliners and come in boxes to keep them flat and compact.   This makes a good starting point if you are looking for something to keep you confident and safe against a small leak. 

but if you need more than a light pad

If you suffer with more severe leakage and could potentially empty half your bladder, or would risk getting wet clothes, then look at the pads in bags which will be more absorbent or disposable pants (see #3).  

#2   Disposable Pants

No one really believes that these look like “normal” knickers. However, their big advantage is the all-around cover, front, back and sideways. For an activity involving lots of changes of direction and position (aerobics, yoga, kids tumbling) they will give the most protection against bigger leaks.

Put your biggest PE pants over the top to hide them at your waist line.

However, if you are getting this wet when you play sport your priority should be to solve the bladder problem further.  Talk to your physio about what they recommend for you.

#3  Knickers with inbuilt protection

We are so lucky to be in the era of textile research and design and I am delighted to see this being applied to underwear. 

Good for the environment.  Great if you are usually fine but like to know you have back up.  Possibly more discreet if you need a thicker pad than a liner. 

Disadvantage – once they are wet you need to change the whole knicker.  However, ideal for things like the gym – if you get bladder leaks when running on the treadmill or other higher impact classes. Strip off in the changing room and no worry to dispose of a pad. 

Note: a couple of clients who have tried this option swear they will never wear pads again, certain that the pad itself  was irritating their vulva and making their incontinence worse.

black knickers absorbent for incontinence

Pro TechDry panties and maxie panties  

  www.stressnomore.co.uk   

* use SUPPORTEDMUMS at checkout for a 15% discount

The gusset in these  ProTech knickers is hardly thicker than your normal good robust cotton “pants” but is made of 3 layers, an absorbent fibre (holding up to 40ml = 2+ tablespoons), an odour retention layer and wick away surface.  Like some of the best quality pads but fixed in place with sealed seams.

SPEAX (previously Icon Undies)

shethinx.com

These are made by the same manufacturers as the Thinx range of period pants.  A forward thinking company with their open-ness about the need for products to empower women to be active.  And addressing sustainability and waste. They have a rather quirky style of presentation and some bold adverts. 

Speax incontinence pantss are silky & colourful

Five different styles: from Hip Hugger, through classic bikini to thong.  Varying prices depending on style £16 – £24 .  They sent through some samples lately for me to show in clinic.  The colours are fun: deep orange, blue, nude, grey and black.  They are made from a silky rather than cotton fabric, much more like an ordinary fashion knicker.

NB: they  are  hand wash only which you might miss in the instructions (and then be very cross about!).

#4   A subtle cover-up with skorts and skirts

picture of a skort to hide pads if you get bladder leaks when running

It started with school uniform but now we can all wear skorts!  Perfect for just hiding a good pair of  pants with a pad and getting on with whatever you wanted to do. 

£20-£80. Offered by brands Decathalon, Salomon, Reebok and many others.

#5   Add extra support to your core from the outside

Maybe not so much worried about leaks?  More that your entire lower half moves about too much? Or that exercise is straining and fatiguing your pelvic floor and core muscles. Have a look at these if you feel just generally ‘unsupported’ at the moment:

If your bladder leaks when you run EVB shorts give extra support to your abdominals and pelvic floor

EVB Sports

EVB Sports range of shorts, leggings and capris

www.evbsport.com  *  £60-£80

EVB Company founder, Yvonne Brady tells her story of returning to running after her third baby and struggling with muscle strength.  Women’s health physiotherapists like myself are recommending these as an ‘extra’ layer. To create more lift and support for the pelvis, abdominals and pelvic floor.

Most of my clients have gone for the shorts style, giving the option of wearing them underneath any of their other leggings.

# 6   Add extra support to your bladder from the inside

The options have recently expanded for devices that aim to give support to your bladder from inside the vagina.   Often called pessaries. The devices/brands you may see advertised include Contam, Contiform (available on prescription) and Uresta.  The devices increase in price, partly reflecting the number of times that they can be used – from single week use only to monthly to reuseable for a year.

These work particularly well where you or your physiotherapist feel that the bladder has dropped only a little bit (prolapse of the anterior wall/cystocele).   Yet everything else inside (particularly the uterus) is still well supported. You both feel you have created a good layer of muscles through exercise but could do with a bit more support when you are trying to be more active

water lily to illustrate bladder support devices

This market has recently expanded. I have written a separate post explaining how these products work, the differences between them & where to get them from.  :  Bladder Support Devices to reduce stress urinary incontinence: how do they work?

Before you go…a promise?

……that you will not use these ideas to make you complacent about a leakage problem.  Nor as an excuse to avoid the issue of your bladder for another 3 months!

  • Incontinence might be “common” (45% of women report bladder leakage at 3 months after birth, even 10% of those after Caesarean) …. but it is never “normal”. 
  • Incontinence is also a sign of lack of pelvic floor support.  You may need to consider how pelvic floor friendly your sport is (ummm….trampolining….)??   Or you may need to modify activities to protect yourself from risk of pelvic organ prolapse.

DO use these stop-gap options to get comfy, happier and more active NOW.  But please, please commit to doing something about your pelvic floor muscles.  Book an appointment with you GP to get a referral to a Specialist Physiotherapist for full assessment,  support and advice.  You can be much better than you are right now. 

What are your tried and tested tips?  Please share your experiences with other mums in our comments section below.  Your story will inspire others.

#beyouroptiMUM  #pantsnotpads #NoMoreMiserableMums