Diapers as the Latest Fashion Statement?

Am I the only one that goes a little crazy every time there is a commercial for adult diapers that not only normalizes grown-ups wearing diapers, but makes it seem like the height of fashion? 

Well, it turns out there is a lot of money to be made from adults who have leaky bladders and leaky bowels and companies that formerly catered only to babies are cashing in on the 30% of women, (many in their 30's or 40') who experience incontinence. 

According to Bloomberg:In the next decade there will be "a 48 percent increase in sales in the category". Sales of diapers for adults are soon expected to surpass those for babies! 

The comment of Jay Gottleib, head of Kimberly-Clark’s adult and feminine-care business in North America says it all," “We’re trying to make the product more normal, and even fun, with real people in our ads saying, ‘Hey, I have bladder leakage, and it’s no big deal,’

No big deal? Fun? Fun to try not to laugh, cough or sneeze? Fun to avoid intimacy and sex since you worry about peeing on your partner? Fun to not play a game of tennis because there may be a puddle on the floor? Fun to stay home instead of going out without bringing a change of clothes or risk smelling like a toilet? 

Keep in mind, commonis not the same as normal, and just because something is common does not mean you have to live with it.But sadly, that is exactly what most women do. Eighty percent of women who suffer from incontinence do nothing about it assuming that the only treatment options are to have a surgical procedure or take a medication. 

On one hand I am glad that this taboo topic is getting out in the open, but the approach for this common (but not normal and certainly not FUN situation) is to fix it, not manage it.

 

 

Here are my top options to eliminate diapers, pads, and dark pants as key wardrobe accessories.

 

Kegel Exercises

Kegel exercises are commonly recommended to strengthen weak pelvic floor muscles that are often the cause of leaking. And almost as commonly, they fail. Studies show that few women do them correctly or consistently. Success is most likely in the young, highly motivated patient who works with a pelvic floor physical therapist. 

 

Pelvic Floor Physical Therapy

Pelvic floor muscle training along with behavior modification and biofeedback with an experienced pelvic floor physical therapist  has long been established as successful treatment for incontinence, but relatively few women have access to an experienced pelvic floor physical therapist, have adequate insurance coverage, or even if they do, are willing to commit to the time required for successful therapy. Indeed, only a small percentage of women utilize this highly effective option. 

 

Do it Yourself Devices

There are no end of over-the-counter­ vaginal weighted cones and balls and other devices that claim to cure your incontinence but there are no scientific studies to show that these products work despite enthusiastic testimonials on the product websites. There also are a number of products to facilitate Kegels that link to an AP on your phone, and while that seems like a very cool idea, I am more than a little uncomfortable with an AP that talks to your vagina.   

 

My go to for my patients is ATTAIN, the only FDA cleared over the counter device for both leaky bladders and leaky bowels that has been shown to be effective in clinical trials.  

ATTAIN is like having a personal pelvic floor therapist, who lives in your home (no guest room required!)  and does a quick therapy session when it is convenient for you. Attain essentially reproduces what pelvic floor PT's do utilizing 3 components:

·     Muscle stimulation

·     A guided exercise program 

·     Visual biofeedback (so you know if you are doing the exercises correctly) 

 

If you are lucky enough to work with an actual pelvic floor physical therapist, ATTAIN not only reinforces what the PT is doing, but is a great way to maintain pelvic floor health long after your therapy sessions have run their course. 

I was initially in the camp that if it sounds too good to be true, it probably is to be good to be true, but when one of my patients donated her stash of diapers to a local nursing home, I was sold. 

Consultation with a urogynecologist

While pelvic floor physical therapy and using ATTAIN will help most women, some women have more complex causes of incontinence and require help from a specialist who may explore options such as Botox, surgery or medication. If your own doctor doesn't have a solution, or simply says your leaky bladder is "a normal consequence of aging"it doesn't mean there isn't a solution! Stop laughing with your legs crossed or wearing black work out pants to the gym to hide your damp crotch. Get another opinion from someone who has particular expertise.  

 

So yes, diapers are a reasonable way to manage your leaky bladder. But unless you are an investor in the adult diaper market, let's put an end to the normalization of incontinence. It may be in the best interest of diaper manufacturers, but not in yours.