I’ve been a freelance writer for about a dozen years and have written for pretty much every women’s magazine out there. Before kids, I used to write a lot for Marie Claire. I pitched every one of my stories — that is, I came up with the idea, wrote it up, and it was approved and assigned by the editors. One of the ideas came about after a friend had her first baby. Afterward, she confided, she was having problems. Any time she laughed, coughed, or ran, she leaked urine. I did research for her and realized that her pelvic floor muscles were probably stretched out or damaged from pushing for more than three hours. It was a story, I decided, and I pitched it to my Marie Claire editor. Here’s an excerpt from the letter (yes, an actual snail mail letter since my editor wanted to see clips, too) I wrote:

Thank you for taking a look at my pitch on vaginal strength and gynecological physical therapy, which I sent to you today via e-mail. As I mentioned in my e-mailed pitch, the researchers I’ve spoken to such as Dr. Lauri Romanzi, a uro-gynecologist at Cornell University-New York Presbyterian Hospital say American women are missing out because few know that their vaginal problems can be solved using directed Kegels, biofeedback, and other physical therapy methodologies. This leads to needless suffering just because doctors and most media outlets are squeamish about the topic. I’d love to be the one that breaks down these barriers and helps let Marie Claire readers in on the secret.

Completely crappy letter, but hey, I was just a wet-behind-the-ears kid. But I digress as usual. The story was assigned, but not exactly in the way I envisioned. The title of my story morphed from “Get a Stronger Pelvic Floor,” to “Best Orgasm Ever!” You can read it here. There’s still advice and info that stands the test of time. The testers were two of my karate pals and me, of course. And I got to go into Dr. Glazer’s New York City office, get uro-dynamic testing, and take home a vaginal biofeedback machine. It was fairly awesome. (I remember being very offended that I was “strong” but lacked “endurance.” In layman terms, my pelvic floor muscles were strong, but got tired quickly.)

Anyway, fast forward a half a dozen years and I was pregnant with my second child — you know, after my first child that weighed in at 8 pounds, 5 ounces at birth and who has a giant head. I got the flu. Twice. I had HUGE issues. Every time I coughed, I leaked. (Sorry for that TMI.) I blogged about it. Anyone who is having similar issues should definitely read that post, Whiz Bang, You’re Wet (Or How Not to Pee Your Pants).

As my story and the book, The Bathroom Key, show, there are millions of women suffering with urinary incontinence but they don’t have to be. There are treatments and exercises and help available. You just have to be willing to talk about a problem that could seem a little embarrassing. In this case I think we as women need to take a page from men. They are more than willing to go into their doctors’ offices and tell them about weak urine streams and erectile dysfunction. Why should we be afraid of talking about a little leaky urine?

Have you ever had a problem with bladder incontinence or any other pelvic floor issues? Did you seek help? How did that go for you? I’d like to know.

I got the flu not once but twice when I was pregnant with Little Girl. I coughed almost non-stop from January through March. It was horrendous. All that coughing lead to leaking. It was so bad that I tried using panty shields, pads, wash cloths, but nothing worked until I sent my husband out to get Depends. I was crushed. Wearing Depends in my 30s. How could this be? I spoke to my midwife who told me I would get better once I stopped coughing. It was stress incontinence, she said. She also said that — once the rather large baby wasn’t in there pressing down on my bladder — I’d stop even the little leaks, too. Little Girl was a big baby, but her older sister, who clocked in at 8 pounds, 5 ounces, had stretched the muscles of my pelvic floor. It was almost a given that I would leak when I coughed.

The pelvic floor muscles, which hang like a hammock from the public bone to your coccyx bone, support your internal organs, holding up your bladder, uterus, and bowel. They also control the muscles that open and close the anus, vagina, and urethra. Mine were obviously a little loose. Think about taking a rubber band and holding it in one place for ten months. Once you let go, it’s going to sag. And I had issues with my bladder before pregnancy, too. As someone who is very, very flexible, my muscles weren’t as tight as they could have been. I am definitely not alone, since one-quarter of all women — and one third of older women – report having issues with their pelvic floor. So what’s the cure? Here are a few ways to tone your nether regions.

• Kegel exercises. Simple Kegel exercises — tightening and releasing the pelvic floor muscles — can help strengthen everything down there, and get it working again. But you have to be consistent. I often forget to do my Kegels, because, as I have found, they can be really difficult to do. That’s why the easiest place to start is on the toilet. Stop and start your urine stream when you go to the bathroom. Once you identify the movement, which is sometimes described as pulling your vaginal muscles up and in, you can do it out of the bathroom, too. You don’t want to squeeze your butt or abs. You’ll know if you’ve got it because you’ll see a difference in your “response” time when you try and stop the flow. Plus, you may even feel a little sore in your lower abdomen. I will honestly say I barely got one or two in when I first started after having Little Girl because I couldn’t get my muscles down there to work. But if you keep it up, it does work. An October 2009 study found that 83 percent of women who did Kegel exercises reported a decrease in urinary incontinence. (Note to pregnant women: Kegels while pregnant can reduce the length of labor, and help prevent urinary incontinence, according to two separate studies.)
• Physical therapy. If you hurt you arm, you’d see a physical therapist to help rehabilitate it. PTs can also help women rehabilitate their pelvic floor muscles when they don’t want to do it alone. A recent study found that women can get wonderful results with this method. The physical therapist, who should have special training for this type of work, can help you find different exercises to strengthen your pelvic floor. You can find a practitioner by checking out FindaPT.us, and selecting Women’s Health in the pull-down menu.
• Biofeedback. I actually tried biofeedback when I was writing a story for Marie Claire. You get a device that looks like a small radio attached to a t-shaped probe. The probe goes where you think it would; you hold the radio-looking thing in your hand. You have to try and get a set of lights to light up by squeezing on the t-shaped thingy. The lights move up based on the amount of pressure you apply, and stay lit up based on duration. The stronger your muscle, the higher the lights will go, and the longer they will stay on. I can tell you when I did this experiment, I found that my muscles were sore after the first week! Doing Kegels correctly, which is essentially what I was doing, is really hard! But worth it. And now that I’ve met my deducible with my health insurance, I think I’m going to get a biofeedback machine of my own.
• Having an orgasm. One of the least-invasive ways to start strengthening your pelvic floor again is by having sex, and having an orgasm, according to Dr. Lauri J. Romanzi, a uro-gynecologist I have interviewed in the past.  “Orgasm and arousal brings blood into the region and promotes healing. The contractions of an orgasm help strengthen the muscles and help bring muscle tone back into the area,” she explained. While you’re probably going to need to do one of the other three options, it’s good to know you can get started improving things by taking matters into your own hands. (Or your partners, as my husband wanted me to point out.)
• Meditation. This one surprised me. According to a study from Loyola University, you can visualize and meditate to improve bladder control. “[Patients] then listen to an audio recording with a series of relaxation and visualization exercises at home twice a day for two weeks. Patients track the number of incontinence episodes that they experience in a pre- and post-therapy diary. The majority of patients, including Raisor, experienced a substantial improvement in symptoms.”  Wow. And cool! I’m looking forward to trying it out soon!

Have you had issues with incontinence or pelvic pain? How did you treat it? How long did it take? I’d love to hear about it.

Also, if you suffer from this problem, you might want to check out AccidentalSisterhood.com. To celebrate National Bladder Awareness Month, 3,000 copies of The Accidental Sisterhood book will be available on a first-come, first served basis during the month of November. Women may log on to www.AccidentalSisterhood.com and enter the promo code SOLUTION, or they can call 1-866-549-3250 to receive a free copy.