If you’ve ever leaked on a run, rushed to the loo all night, or wondered whether prolapse means you have to give up the exercise you love then this one’s for you. I’m joined by Dr Alice Landon, a specialty doctor in gynaecology and urogynaecology, to demystify pelvic floor health for women 40+.

We get real about:

• The difference between stress vs urgency incontinence and why it matters for treatment

• What actually causes urgency/frequency (including caffeine, fizzy drinks, alcohol and “just-in-case” wees)

• Why symptoms often appear in perimenopause/menopause (hello, falling oestrogen)

• Pelvic floor exercises (how to make them stick - Squeezy app!)

• Running, jumping & lifting: can you keep training if you leak?

• Prolapse explained in plain English: signs, what’s safe, and when to treat

• Options that work: vaginal oestrogen, pessaries, pelvic health physio, lifestyle tweaks, and when surgery is the right call

• Botox for the bladder (who it’s for and how it helps)

• Post-op do’s and don’ts to reduce recurrence (lifting, constipation, driving)

  Key takeaways

• Leaking is common but not “just normal” and there’s a lot you can do.

• Start with the basics: consistent pelvic floor work, consider vaginal oestrogen for GSM, review fluids and “just-in-case” habits.

• You don’t have to stop the movement you love; adapt and treat so you can keep going.

• Pelvic health physiotherapy is game-changing and often avoids surgery.

• If you need surgery, careful aftercare (no heavy lifting/straining, manage constipation) matters for long-term success.

If you to make change that feels good at 40+ , with an approach that works with life & not against it then join us in The No Crap Cake Method.

You can find Ruth on instagram @ruthmacfit