By Morgan Conner, DPT, PHRC Los Gatos
Let’s set the stage here, you just peed your pants. I’ll let you fill in the details of the backstory, but here are a few possibilities. Maybe you just gave birth last week or perhaps six months ago (or six years ago!) and whenever you pick up your little one or laugh when they do something silly, you leak. Maybe you’ve been peeing a little in your pants every time you jump since you were a high school athlete but it’s gotten worse lately (if this is you check you this awesome blog post by Lis Thompson ). Maybe you just had your prostate removed and, no matter how hard you try, every time to stand up from a chair it just comes out. Perhaps you’ve been through menopause and since then, when ever you go upstairs, you can’t seem to stop yourself from wetting your underwear. All of these are examples of Stress Urinary Incontinence (SUI), or the involuntary loss of urine with physical movement or activity.1 If your SUI has gotten to the point where you need something to keep the urine from soaking through your underwear or outer garments, what are you going to grab? If you or you partner is someone who has menstruated recently, you probably have a menstrual pad in your bathroom somewhere. Because they are already there or are easy and not embarrassing to purchase, you might think, I’ll just slap one of these suckers in and go about my day. Let’s take a closer look and see if that’s really the best idea.
Menstrual pads and incontinence pads have roughly the same general composition. They are both a series of three, sometimes four, different layers of material each with a different task. The first, topmost layer, (the part that is in contact with your skin) is a perforated sheet whose job is to transfer fluid away from the skin to the absorbency layers below. The second layer is the absorbency core. As the name implies, it absorbs the fluid and stores it. The third, and outermost layer, is the backsheet which is water-proof and prevents the fluid that is absorbed from leaking out onto your clothes. Some brands will put in an additional fourth layer between the second and third layers called the acquisition or distribution layer. This layer helps distribute the fluid evenly throughout the pad and can also help to retain fluid in the absorbency layer.2
Now let’s talk about how these two types of pads are different. While the perforations in the top layer of menstrual pads have larger holes to accommodate thicker liquids, these same holes in an incontinence pad as well as the distribution layer in, are designed to accept a large amount of less viscous liquid, i.e. urine, and distribute it throughout the absorbency layer. Tena® is one brand that highlights this difference with an easy-to-understand graphic. (Link in references) Additionally, the absorbency layer of incontinence pads are typically made with higher absorbency materials because it needs to be able to absorb more fluid, more quickly, and in a very short period of time, unlike menstrual pads which absorb fluid more slowly over a longer period of time. Moving on to the backsheet, incontinence pads often have an elastic component which helps to prevent leaking when full. Finally, let’s turn to odor control. Menstrual pads often control odor via deodorants whereas incontinence pads control odor via pH control. Healthy urine is slightly acidic (pH of ~6.0), which means if not neutralized, (neutral pH is 7.0) it may irritate the skin.3
Now, it’s decision time, albeit a little bit more informed decision time than when we started. Here are my recommendations. If you are experiencing moderate to heavy leaking or are having full bladder losses, put the maxi pad away for another day and use an incontinence pad. The high absorbency and pH neutralization capabilities of the incontinence pads will be important for maintaining good skin health and preventing leaking onto your clothes. If you are only having small infrequent losses AND you are actively addressing this issue (I’ll get to this in a second), you might be fine with a menstrual pad, however, I am still going recommend an incontinence pad as the skin irritation factor is still present.
So, now that you’ve gotten your incontinence pads in your shopping cart (either online or at a brick and mortar store) what are you going to do next? Just deal with it and keep buying pads for the rest of your life?? I hope not. I would encourage you to talk with your doctor or schedule an appointment with a pelvic floor physical therapist. Pelvic floor physical therapists are uniquely suited to treat urinary incontinence as we are trained to evaluate and help you improve your pelvic floor muscle function which can play a role in incontinence (you can read a little more about what to expect at a pelvic physical therapy evaluation here. Here at the Pelvic Health and Rehab Center, we are here to help you with this and we can also help with many other pelvic conditions and disorders (https://pelvicpainrehab.com/our-services/)
- Bae J, Kwon H, Kim J. Safety Evaluation of Absorbent Hygiene Pads: A Review on Assessment Framework and Test Methods. Sustainability. 2018; 10(11):4146.