Urinary incontinence affects 25-45% of women.

Over half of perimenopausal women may experience some urinary incontinence and 25 % wear protection or have to change their underwear regularly because of the condition.

The incidence of urinary incontinence in pregnancy is often reported as one in three. An estimated half of all women who have had a child will have some degree of pelvic organ prolapse and up to 20 % will seek medical help.

The National Institute of Health and Care Excellence (NICE) recommends a trial of supervised pelvic floor muscle training of at least 3 months duration as first-line treatment of women with stress or mixed urinary incontinence.

In addition NICE recommends that all women should be taught PFME during their first pregnancy and a large multicentre randomised trial has shown the benefit of PFME for pelvic organ prolapse.

Research suggests that PFME should be repeated three times a day.

Advice for patients on exercising the pelvic floor:

– PFME can be practised in any position. However at the beginning, sitting or lying down may be preferable so you can concentrate on what you are doing.

– Squeeze and pull in the muscles around your back passage as if you are trying to stop yourself from breaking wind. Now also squeeze and lift at the front, as if you are trying to to stop yourself while passing urine. Hold for a couple of seconds, then let go. Repeat a few times, to get the feel of it.

– Start with slow squeezes: squeeze and lift the muscles slowly and firmly and hold as long as you can up to 10 seconds. Let go, and relax the muscles for a few seconds. Do not worry if you can manage only a squeeze of perhaps just a couple of seconds. Gradually increase the length of the hold as you feel your muscles are becoming stronger.

– If you can, do 10 slow squeezes. If your muscles get tired quickly start with fewer squeezes and gradually build up the number.

– Now switch to fast squeezes. Squeeze and lift your muscles hard and fast. Let go straightaway. See if you can manage 10 quick squeezes or begin with fewer at first.