Have you ever crossed your legs before sneezing, or worried about making it to the toilet in time? You’re not alone. Around 40% of women in the UK experience bladder leaks, 8.5% seriously, but they might not be something you have to put up with.

If you’re leaking on the way to the bathroom, you’re probably cursing your pelvic floor. Maybe you’ve tried a few exercises to tone things up, but they didn’t help. You might even have started avoiding white trousers, or adding leakproof underwear to your wardrobe. But there may be more to the story than weak pelvic floor muscles.

What is the most common type of urinary incontinence in women?

It's stress incontinence. ‘This happens when urine leaks from physical pressure on the bladder, caused by sneezing, laughing or exercise,’ explains Rhiannon Bray, urogynaecologist at New Victoria Hospital in London. ‘It usually happens because the pelvic floor muscles and supportive tissue around the bladder and urethra become weakened and stretched over time.’

If you’ve ever experienced this kind of leakage, chances are your mind went to one word – kegels. Maybe even as you read that you clenched your internal muscles tightly – and then rolled your eyes, as there’s a common belief that kegels (pelvic floor exercises) don’t work. But the success rate of kegels can be as high as 75% if they are done well. The problem is that an estimated 25-50% of us don’t do them well – and that’s partly because we’ve been told half the story.

For starters, if your kegel move is just tightening your internal muscles as if you’re stopping yourself peeing, you won’t get optimum results. ‘Ideally, pelvic floor training includes both long holds and quick squeezes,’ explains Rhiannon. ‘Long holds help build endurance and support throughout the day, while quick contractions help the muscles react quickly when you cough, sneeze and laugh. If you’re also holding your breath, tightening the buttocks or tummy muscles instead, or pushing down rather than lifting and squeezing upwards, your kegels won’t work effectively.’

Over the past few years, biofeedback devices that aim to check your kegel technique have appeared on the market. ‘These devices can be helpful for some women,’ says Rhiannon, ‘but they are unlikely to work if someone is using the wrong muscles – or has the wrong diagnosis in the first place.’ And this is another part of the story you may not have been told.

What other types of female incontinence are there?

While stress incontinence is the best known type of female incontinence, it isn’t the only one. Urge incontinence is characterised by an overwhelming need to pee that can lead to leaks before you reach the bathroom. ‘This is caused more by the bladder wall contracting strongly than weakness in the supporting muscles, so strengthening the pelvic floor might not help it,’ explains Mittal Patel, consultant in obstetrics and gynaecology with special interest in urogynaecology at Kingston Hospital. ‘Many women have a mix of stress and urge incontinence – another reason why kegels alone don’t do the trick.’

What can I do about female incontinence?

Getting the right diagnosis and specialist advice about how to train your pelvic floor muscles can dramatically change your results. The first stop should be your GP, who may refer you to a pelvic floor physiotherapist. They will help diagnose the issue, work out which muscles you need to tone or relax, and teach you the correct techniques. ‘If you have multiple pelvic floor issues (UTIs, pelvic pain, incontinence, pelvic organ prolapse) or if correct pelvic floor muscles exercises alone don’t help, you might then be referred to a urogynaecologist to discuss further options,’ says Mittal.

‘While it may become more common with age, incontinence is not an inevitable or “normal” part of getting older and there are effective treatments available,’ says Rhiannon. ‘You do not have to simply put up with it.’