Community pharmacists have a big role to play in helping women talk about embarrassing conditions such as urinary incontinence…

According to the British Journal of Urology International, between three and six million people in the UK have some sort of urinary incontinence. Yet it is women who are more likely to suffer from stress urinary incontinence than men because of the effects of childbirth and the menopause.
However, women are not necessarily seeking help. Despite the fact that women are five times more likely to develop urinary incontinence then men and half the female population will experience the condition at some stage, just one in five women seek help.
Pharmacists should also be aware that 6% of women between 15 and 44 experience bladder weakness. The statistics differ from company to company but the size of the problem remains significant wherever you look.
Recent figures from TENA Pharmacy show as many as one in four women experience bladder weakness or incontinence and yet a stigma still exists around the condition. Many people suffer in silence or, of great concern, use inappropriate products to manage it.
The British Association of Urological Surgeons estimates that between 60% to 80% of people with urinary incontinence have never sought medical help and 35% view it as simply part of the ageing process.
“It is a common misconception that only elderly people suffer with the condition, with NHS England estimating that 900,000 children and young people under the age of 19 experience bowel or bladder problems,” said TENA training and brand manager Donna Wilson.

Types of incontinence to watch out for
Wilson says that when treating someone you suspect experiences bladder weakness, there could be a number of things that you can look out for.
“Firstly, stress incontinence is the involuntary leakage of urine at times when the bladder is under pressure, for example, laughing, coughing or heavy lifting. Some of the causes and risk factors for women include; pregnancy and vaginal birth, the menopause, age, obesity, long-term constipation and a family history of incontinence.
“Urge incontinence is the involuntary leakage of urine caused by an overactive bladder. The main symptom is an urgent need to pass urine but not being able to reach the toilet in time. Three in 10 cases of incontinence are due to this condition and it’s more common in women. In many people, the cause is unknown, but it can happen following a stroke.
“Symptoms can get worse at times of stress and can be made worse by alcohol or caffeine found in tea, coffee and cola. Age can also be a factor that leads to incontinence in women as well as the more serious issue of dementia.
“For people with dementia, most only experience incontinence when their illness has progressed considerably. However, it could occur at any point, depending on other pre-existing medical or health issues.
“People with dementia are often left with incontinence issues because the condition damages the nerve pathways in the brain that control the bladder and bowel. Furthermore, people with this illness find it difficult to communicate they need to go to the toilet, they forget where the toilet is, or they have mobility problems which means they struggle to get to the lavatory.”

The role of community pharmacy teams
Pharmacy teams can use what Wilson describes as their “unique skills to engage with women who have bladder weakness in a sensitive and professional way to help normalise the condition which can have a positive impact.”
Her advice is clear. “Bladder weakness can be a sensitive topic to discuss in pharmacy – not just for customers, but for staff too. It is therefore important that pharmacy teams are confident in their knowledge of the condition and can speak to customers with empathy, reassuring them that there is nothing to be embarrassed about.
“The team has a critical role to play in providing information and advice, not only about bladder weakness itself, but to encourage women to seek medical advice, if they have not done so already, to rule out a sinister cause.
“Pharmacy staff should also familiarise themselves with the different demographics of people on the shop floor. The footfall could be anyone from a reluctant acceptor to a first-time purchaser, so it is important to recognise that a customer may also not be buying for themselves; they could be a caregiving relative.
“Leveraging these differences will ensure pharmacy becomes known as the local expert hub for management of bladder weakness and a trusted source of advice.”

• SCA Hygiene Products dominated adult incontinence in the UK in 2016 with a 68% share of value sales worth £124 million. The company’s most successful brand is Tena Lady which is sold in various distribution channels and has a good reputation among consumers.

Source: Euromonitor