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" This content has been created in collaboration with TENA. You&amp;#039;ve just enjoyed a side-splitting laugh when, whoops, were those a few drops of urine that escaped? If so, you have experienced, like millions of women in the UK, an episode of urinary incontinence. Not only does it happen when you laugh, but also when running, jumping, sneezing, coughing and even during sex.  Laura, 48, says: &amp;#039;I have had a terrible cough over the past few months and experienced a number of small leaks. During a coughing bout I literally have no ability to remain dry. When I mentioned it to my sister, who has also had a chest infection, she admitted the same was happening to her.&amp;#039; How common is urinary incontinence?  Between 3 and 6 million women in the UK are estimated to be affected by urinary incontinence, but exact figures are hard to come by as women tend not to report the problem or seek help, according to consultant gynaecologist Julian Brady. Other figures show that over 40 per cent of women may experience this condition.  The two most common types of urinary incontinence are: Urge incontinence \u2013 when you feel a sudden, intense urge to pass urine, or soon afterwards, which results in a leak of urine. Stress incontinence \u2013 when urine leaks out at times when your bladder is under pressure, for example, when you cough or laugh. This is more common. It is also possible to have a mixture of both stress and urge urinary incontinence. So what exactly is stress incontinence? I don&amp;#039;t feel stressed Stress incontinence is nothing to do with &amp;#039;stress&amp;#039; in terms of being over-worked or anxious, but describes what happens when urine escapes from the bladder when it shouldn&amp;#039;t.  Dr Ahmed Ismail, consultant gynaecologist, explains: &amp;#039;Stress incontinence is when there is a disturbance between the angle of the bladder and the urethra. This affects the urethal sphincter \u2013 the valve that would normally prevent urine escaping.&amp;#039;  Why does stress incontinence occur?  There are a number of reasons including childbirth, ageing and lifestyle. Hannah, 35, says: &amp;#039;I had twins and although they were delivered by C-section, the weight of them on my bladder during pregnancy has caused changes to my body. I&amp;#039;ve noticed problems doing certain exercises and using a trampoline.&amp;#039; And similarly for Claire: &amp;#039;I had a forceps delivery and noticed issues when I starting exercising again. I thought I was sweating a lot; in fact I was soaked through and had to leave the class.&amp;#039;  The reason for bladder issues after childbirth is damage to the pelvic floor. These are the muscles that run from the pubic bone to the tailbone. When they are working properly, they support the bladder, uterus and bowel, holding them in place and keeping us continent.  If they aren&amp;#039;t functioning as well as they could be, after being over-stretched or damaged by pushing or tearing during childbirth, they don&amp;#039;t work effectively. Without the right support, the opening from the bladder to the urethra isn&amp;#039;t able to stay closed when there is an increase in pressure \u2013 such as when performing high impact exercise, or even walking in more serious cases.  However, women who have not had children can still experience incontinence.  There are a range of lifestyle factors which include:  Being overweight  Lifting very heavy weights, either at work or at the gym  Smoking  A chronic cough  Constipation  Menopause  Stress incontinence and the menopause During the menopause and perimenopause, falling levels of hormones can be the cause of incontinence. Mr Narnedra Piscal, consultant gynaecologist, explains: &amp;#039;Vaginal tissues are oestrogen-dependent and so is the bladder. Urinary problems are more common in women over fifty.&amp;#039;  Many women find that they can&amp;#039;t hold as much urine, have to rush to the toilet or experience leaks, ranging from a few drops to something more significant. Alexandra says: &amp;#039;I am 52 and the problem started a couple of years ago. It&amp;#039;s mainly when I cough. I&amp;#039;m coping at the moment and don&amp;#039;t need special protection but I&amp;#039;m worried whether it will become worse.&amp;#039;  What are the solutions?  In the short term, many women use purpose-made pads, such as TENA Lady, to manage their bladder weakness. It&amp;#039;s important to use protection specifically designed to deal with the faster flow of urine, rather than regular sanitary towels which aren&amp;#039;t equipped to hold urine.  But it&amp;#039;s also possible to use self-help techniques and surgery to overcome the problem altogether: don&amp;#039;t assume that bladder weakness is forever, or that it&amp;#039;s an inevitable consequence of ageing and something to accept.  Making lifestyle changes  The easiest way to help yourself is to make lifestyle changes where appropriate \u2013 lose weight, stop smoking, treat a chronic cough, avoid heavy lifting whenever possible and start doing pelvic floor exercises. These are also called Kegel exercises.  They involve tightening the pelvic floor muscles by lifting and squeezing slowly 10 times, three times a day. The technique has to be performed correctly otherwise it won&amp;#039;t work. Your GP can refer you to a women&amp;#039;s health physiotherapist for advice and assessment of your pelvic floor.  Mr Pisal says: &amp;#039;For 6 out of 10 women, pelvic floor exercises alone are enough to produce a huge difference.&amp;#039;  But it may take as long as four months, so don&amp;#039;t expect quick progress.  Other treatments include HRT which helps put oestrogen back into the vaginal and bladder tissues. Local vaginal oestrogen in the form of cream helps many women. This does not carry any of the small risks associated with systemic HRT. This is only available from your GP on prescription.  Medical intervention  If none of these give enough improvement, surgery is an option. The type of surgery depends on the precise cause of the problems, but one common procedure, Mr Brady says is, &amp;#039;The sling-type procedure which aims to re-position the urethra.&amp;#039;  This helps keep the valve from the bladder opening when you don&amp;#039;t want it to. This is a relatively minor operation, usually carried out with local anaesthesia.  The important message about those embarrassing accidents is that you don&amp;#039;t have to live with them. Help is available and many women find a complete cure, or at least a significant improvement, with help from a gynaecologist or a physiotherapist.  "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.prima.co.uk/diet-and-health/advice/a35157/causes-urinary-incontinence-stress-incontinence-and-treatments/>