With her usual candour and authenticity, Janette Bertrand speaks openly about a topic that is as common as it is taboo among older adults: urinary incontinence. Together with Professor Chantal Dumoulin, a physiotherapist and researcher specializing in women’s health at the Research Centre of the Institut universitaire de gériatrie de Montréal (CRIUGM), she explores the causes, impacts, and solutions related to urinary incontinence, a condition that directly affects intimacy and dignity. A much-needed conversation that sheds light on the issue while offering hope.

Professor Chantal Dumoulin, Physiotherapist – Researcher and Laboratory Manager
Research Centre of the Institut universitaire de gériatrie de Montréal
Full Professor and Program Director, School of Rehabilitation, Université de Montréal

Urinary incontinence affects many men and women, yet it often remains shrouded in shame and silence. Janette Bertrand does not shy away from the subject—she knows the challenges it brings all too well. And she is far from alone, as the many letters received through the Chère Janette campaign make clear. In them, older adults describe the devastating effects this health issue can have on their social lives and intimate relationships.

One in two women experiences urinary incontinence after the age of 60

These stories come as no surprise to researcher Chantal Dumoulin. Statistics show that urinary incontinence is a widespread issue. After the age of 60, one in two women experiences bladder leakage, compared with one in ten men.

In women, various life events—including pregnancy, childbirth, and menopause—can weaken the pelvic floor, the group of muscles at the base of the pelvis that supports the internal organs.

So, what can be done when these muscles no longer provide the support they should? Does it mean having to rely on protective underwear for the rest of your life? “Protective underwear can be helpful, but there are other options,” says the researcher.

Simple ways to treat urinary incontinence

Prof. Dumoulin offers a reassuring message, emphasizing that urinary incontinence is not something people simply have to live with. However, to effectively address the problem, it is important to first identify which of the following three types of urinary incontinence is involved:

• Stress urinary incontinence: This type occurs when coughing, sneezing, laughing or exercising puts pressure on the bladder. “It’s a sign that the pelvic floor muscles have weakened and need to be strengthened,” she explains.
• Urge urinary incontinence: This type is characterized by an intense and uncontrollable urge to urinate—what many describe as a race against the clock to reach the bathroom in time. “It’s not only a sign of weakened muscles, but also of an overactive bladder,” she says. In addition to pelvic floor strengthening exercises, specific techniques can help calm the bladder. Certain beverages, such as coffee and tea, may also worsen symptoms. While there’s no need to eliminate such beverages entirely, it’s wise to avoid them before going out and to vary the types of fluids you drink.
• Mixed urinary incontinence: This type combines the two forms described above. Specific exercises and lifestyle changes can help improve symptom control.

Pelvic floor exercises: Where, when, and how?

The good news is that it’s never too late to take action. Regularly practising certain exercises can significantly improve symptoms. The pelvic floor rehabilitation and bladder training programs developed by Prof. Dumoulin and her team, along with her lifestyle tips are available free of charge online.

And the results are encouraging. According to data collected by CRIUGM, 75% of women who complete the program no longer feel the need to wear protective underwear. Better still, the benefits can be maintained over the long term: after completing the three-month exercise program, just one exercise session per week is enough to help sustain the results. A small habit that can make a big difference in quality of life.

Talking about incontinence with dignity and respect

There are still many misconceptions and prejudices surrounding urinary incontinence. According to Janette Bertrand, the language we use can contribute to the stigma and may even be infantilizing for older adults. “The word diaper should be removed from our vocabulary. Diapers are for babies. Adults wear protective underwear,” she insists. So, let’s talk about urinary incontinence—but let’s also choose our words carefully and approach the subject with respect.

For her part, Prof. Dumoulin encourages anyone affected by urinary incontinence to speak with their doctor or consult a physiotherapist with expertise in pelvic floor rehabilitation. “Above all, it’s important to stay active and not let urinary incontinence impact your physical and social activities,” she emphasizes. Fortunately, simple exercises and small changes to routines can help people regain comfort, confidence, and freedom in their everyday lives.

 

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To learn more about Chantal Dumoulin’s work:

• Explore her pelvic floor rehabilitation and bladder training programs and check out her lifestyle tips
• Read this CRIUGM article and the guide titled Urinary Incontinence: How to prevent and treat this inconvenient problem
• Explore the resources and activities available through the Women’s Health and Aging Laboratory

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In this series

Explore other content from the Chère Janette campaign on topics that matter to you. Learn more

Learn more about the role of family caregivers		Learn more about neurocognitive disorders
Learn more about chronic pain

 

The Foundation would like to warmly thank Québecor, presenting partner of this campaign, as well as Desjardins, partner of the video capsules, and Fondation Drummond. A special thank you to the Fondation Mirella et Lino Saputo for their generous contribution to the project.