SITTING at her desk and feeling an aggressive tickle in her throat, Nicola Mannakee suddenly began to panic – she knew exactly what was about to happen, and she was powerless to stop it.
Sure enough, no sooner had she coughed, she felt a familiar warm trickle as a little bit of wee came out – leaving the mortified office manager scuttling to the bathroom.

Ever since she turned 30, Nicola had suffered from stress incontinence.
It meant every single time she coughed, sneezed or even laughed she would temporarily lose control of her bladder.
She had to constantly wear incontinence panty liners as a result, which would need to be changed multiple times a day.
But Nicola, from London, is far from alone.
According to incontinence UK, the health issue affects around 300m people worldwide – about five per cent of the population.
Bladder and Bowel UK estimate around 14 million people in the UK suffer from incontinence problems.
Like many, it was an embarrassing problem Nicola, now 41, suffered with for nearly a decade in silence.
That was before she discovered a revolutionary vaginal rejuvenation treatment – a gentle, non-invasive therapy using radio frequency to stimulate collagen and improve blood flow.
This type of treatment – of which there are several different options – is sometimes referred to as ‘vagina Botox’.
Senior Consultant Midwife Arezou at Sadaf Jaffari Clinic says: “Just as Botox can tighten skin by relaxing muscles in the face, Morpheus8V uses radio frequency energy to stimulate collagen production and tighten vaginal and pelvic tissues.
“This can result in improved tone and firmness in the vaginal area, which is why it’s sometimes compared to Botox.
“It can help improve the appearance of the vulva, making it look more youthful and toned by reducing sagging or changes due to ageing.”

‘It made me feel so ashamed’
Incontinence wasn’t an issue for Nicola until she was in her early thirties, but it then became an embarrassing problem that dogged her for nearly a decade.
Nicola, who lives with her husband of 12 years, says: “I basically suffered from stress continence throughout my thirties until I had treatment.
“The first time it happened – I think I was either at work or at home one day – and I had a really bad coughing fit and a little bit of wee came out. I just couldn’t stop it.
“I was absolutely mortified, it was such a shock. My bladder just seemed weaker from then on.
“It made me feel so ashamed. Incontinence, especially if you’re young, is just so ‘taboo’ and just not something people talk about openly.
“It would happen daily, and I’d have to wear daily panty liners just in case – I was terrified I was going to end up having to wear horrible adult nappies as I got a bit older if I didn’t find a treatment.”
Going into the store and buying incontinence panty liners in my thirties was inconvenient and annoying, and I didn’t understand what caused it.
Nicola
There are several types of urinary incontinence including stress incontinence, which is when urine leaks out at times when your bladder is under pressure; for example, when you cough or laugh.
It can be caused by pregnancy or childbirth, increasing age, obesity or a family history of the condition.
For Nicola, she’s never been sure exactly what caused the issue.
She says: “I’ve never had children or been pregnant, so I’m not sure what caused it or if it’s just from stress.
“I think women getting older it’s just something that happens, and obviously it happens a lot with pregnancy – but I was so young.
“Going into the store and buying incontinence panty liners in my thirties was inconvenient and annoying, and I didn’t understand what caused it.”
What is stress incontinence?
- Stress incontinence is when urine leaks out at times when your bladder is under pressure; for example, when you cough or laugh.
- It’s also possible to have a mixture of both stress and urge urinary incontinence – which is when urine leaks as you feel a sudden, intense urge to pee, or soon afterwards.
- Stress incontinence is usually the result of the weakening of or damage to the muscles used to prevent urination, such as the pelvic floor muscles and the urethral sphincter.
Certain things can increase the chances of urinary incontinence, including:
- pregnancy and vaginal birth
- obesity
- a family history of incontinence
- increasing age – although incontinence is not an inevitable part of ageing
It’s not always possible to prevent urinary incontinence, but there are some steps you can take that may help reduce the chance of it happening. These include:
- maintaining a healthy weight
- changing your drinking habits, including cutting down on alcohol
- doing pelvic floor muscle exercises.
For more information on urinary incontinence, the symptoms and treatments available, visit the NHS website here.
‘Every time I would basically wee a little bit’
From there the problem got progressively worse, until it was happening daily – sometimes multiple times a day.
She says: “I tried everything. I did pilates and pelvic floor exercises and tried exercise instruments, which did help a bit but it wasn’t enough.
“If I coughed or sneezed I’d try crossing my legs to stop the problem, but nothing seemed to really work. It was really frustrating. ”
Sometimes it was unavoidable. Nicola adds: “Every time I coughed it would happen, or even if I sneezed, or laughed.
“It would also happen if I went running, or jumped on a trampoline – every time I would basically wee a little bit.
“It would happen everyday, sometimes up to four times a day if I had a cough, so I’d wear daily pantyliners just in case.
“I could easily go through two or three panty liners a day – a few boxes a month – so I always made sure I had a stash, just in case. It was embarrassing, and I just tried not to talk about it.”
‘I’d be mortified’
Nicola learned how to deal with the problem privately – but it was a source of great embarrassment.
She says: “If I was in public when it happened I’d be mortified. A few times I had to stop what I was doing, leave and just go home.
“I’m in the office a lot, so that was the main worry.
“One time I was at work, and I was wearing light coloured jeans, and it happened and the wet patch was clearly visible.
“I couldn’t change or dry my jeans out or anything obviously, so I had to just go home. Thankfully I was wearing a long jacket so I could cover it up.”
Over the years Nicola got used to the problem and learned to deal with it on her own.
She says: “My partner knew about it since we got together and was supportive, but we just didn’t really talk about it, and I generally chose to deal with it on my own.
“It would impact sex as I felt like I couldn’t relax properly and be in the moment – I was always worried it would happen.”
Nicola didn’t really talk about her problem at all with anyone until she was in her forties.
She says: “It seemed like women’s health issues and the menopause became more acceptable to talk about. I then realised how common the problem actually is.”

‘The results have been life-changing’
Two years ago, Nicola finally discovered a treatment that gave her hope for a panty-liner free way of living.
She says: “My best friend told me about this new treatment and I just said ‘sign me up’.
“I was willing to try anything, if there was a chance it would work.”
The specific therapy Nicola had was the empower Inmode vaginal rejuvenation Morpheus8V treatment and V-Tone pelvic floor stimulation, which she started a year ago.
The results have been life-changing… It’s been a game-changer really.
Nicola
Now, Nicola has had four out of the recommended six sessions, which cost around £950 a session but can vary – and her stress incontinence has completely gone.
Arezou at Sadaf Jaffari Clinic adds: “The treatment uses radio frequency energy to stimulate collagen production and tighten the tissues in the vaginal and pelvic floor area.
“By stimulating the deeper layers of the skin and tissues, Morpheus8V helps to strengthen pelvic floor muscles, enhance collagen production and improve tissue elasticity.
“This leads to better support for the bladder, reducing the likelihood of involuntary urine leakage.”
Nicola says: “It’s been amazing. It’s been a game changer really.
“The results have been life-changing. The treatment I had is like micro-needling with radio frequency, using a wand that goes in.
“You can’t really feel it, and I no longer suffer from incontinence at all.
“Touch wood, I haven’t had to buy a single incontinence pad since the beginning of last year and have had no accidents.
“I got it free as I volunteered to do it for training but I know it’s not cheap – around £950 a session. But it’s worth every penny and should be more available.
“The doctor I see swears by it and has actually been trying to push for this to be available on the NHS for years now. Every maternity ward should have it available for women with vaginal birth.
“Women have to put up with so much already with menopause, pain and periods – but we should be made more aware of what treatment options are out there, and they should be more readily available on the NHS, as it’s not cheap.”
Happily, it’s also had a positive impact on Nicola’s sex life with her partner, who has also noticed a positive change.
She adds: “Before I couldn’t enjoy sex as much, so I’ve definitely seen a change there.
“I feel more, and when we’re intimate now I can focus on being in the moment, whereas before my mind was somewhere else and I felt uncomfortable.
“I’ve definitely got more of a spring in my step now!”

Top tips
If you’re struggling with incontinence, there are some things you can do to help control it.
Strengthen your pelvic floor muscles: Having a strong and flexible pelvic floor will help you to hold on in the times you need it most.
Make sure you’re doing your Kegels correctly: Performing a contraction of the pelvic floor correctly is essential
Take care of your bladder: Stay wrapped up nice and warm and reduce your intake of bladder irritants, such as caffeine and alcohol.
Speak to your doctor for support: If you are experiencing urine leaks or notice you are passing urine more frequently during the day or night which is impacting your daily life, seek support from your GP. You don’t have to suffer in silence.
NHS guide to pelvic floor muscles
- Squeeze and draw in your back passage as if you’re holding in wind.
- Squeeze around your vagina and bladder tube (urethra) as if you’re stopping the flow of urine or squeezing during intercourse.
- Now relax. This is a short squeeze. Rest for a second, then repeat these squeezes until you feel the muscles get tired.
- After a short rest, squeeze again as above. This time, hold the squeeze for as long as you can, but no longer than 10 seconds, then relax.
- It’s important to keep breathing normally while you do these exercises. Make sure you don’t pull in your stomach or squeeze your buttocks when you squeeze.
- Aim to build up to 10 repeats of each exercise, four to six times a day.