A lack of public toilets is causing women with bladder weakness and other pelvic issues to suffer from loo-related anxieties.
Despite the recent delay in the easing of coronavirus restrictions, life is beginning to get back to normal - but for women suffering with hidden bladder-related conditions, the opening up of society is fuelling fear over being unable to access toilet facilities.
Findings by pelvic floor experts INNOVO have revealed almost a quarter (23%) of the 2,000 women aged 35-65 surveyed expressed concerns about finding the nearest toilet, while almost a third (32%) are worried about the cleanliness of public toilets.
Toilet access has been an issue of national concern over the last 12 months, but for the one in three women in the UK who will suffer from bladder weakness at some point in their lives it is of particular worry.
Recent stats by the British Toilet Association have revealed there are now fewer than half the public toilets open that there were 10 years ago.
Meanwhile a Daily Mail investigation back in October last year found that more than 300 loos have shut since the start of the pandemic.
Despite restrictions beginning to ease, women are still struggling to access facilities, with further figures from the INNOVO survey revealing 39% of women admit to finding it hard to seek out a public toilet since the easing of lockdown.
This worry is reflected on social media, with an average of 100 tweets a day about closed toilets and with Google search data around incontinence spiking as each lockdown has lifted.
But this lack of loo-access is leading to some women suffering toilet-related anxiety, and having a pretty drastic impact on their behaviour, with six in 10 women admitting to having controlled their food and drink intake over worries about public toilet access.
Watch: Sitting down for too long increases incontinence risk to women.
Others have had discomfort holding it for longer than usual due to a lack of facilities, and three in 10 have either turned down social invitations through anxiety about having access to a toilet or been reluctant to go out due to the 1-in-1-out rules being operated on some toilets.
Drastically, one in 10 have even admitted to being forced to pee in public places due to lack of available toilets.
“Moving towards a life out of lockdown is a welcome relief for many, but it’s important we recognise that this can trigger stress and anxiety in others, particularly those with hidden conditions," explains psychologist Dr Meg Arroll, an expert in invisible illnesses.
"With one in three women in the UK suffering from bladder weakness at some point in their lives, it’s no surprise that the combined issues around finding a toilet and how clean they are have topped the anxiety-provoking list.
"Anxiety takes many forms, and these findings help us understand some of the less talked about issues, which we should all be aware of.”
So what can be done about it?
According to the charity the Bladder and Bowel Community, those with registered conditions and disabilities can apply for a RADAR key, which provides access to locked accessible toilets.
"The RADAR key provides you with access to over 9,000 accessible public facilities around the UK," the site explains. "They can be found in many shopping centres, pubs, cafes, cinemas, bus and rail stations."
The National Key Scheme/ RADAR key was developed to prevent damage and misuse of accessible public toilet facilities in order to increase the amount of public toilets being available in a clean and functional state for those who need to use an accessible toilet.
Some local councils give Radar Keys free-of-charge to people with health conditions, or you can order one via Disability Rights UK and the National Key Scheme for £5.
Meanwhile it may also be possible to access a ‘Just Can’t Wait!’ card issued by the Bladder and Bowel Community to those with medical conditions, which mean they need quick toilet access.
"The holder of this card has a medical condition and need to use the toilet quickly – please help!" the card reads.
You can also order a 'Need to Pee' card from The Urology Foundation for a nominal donation of £2.50.
The discrete card fits inside your wallet and has been designed to help people with urinary incontinence to gain quick access to a loo when needed.
The text on the card explains the circumstance of incontinence, which can allow those with bladder weakness to feel more confident about being in public.
For women who are feeling toilet-anxiety there are some things you can do to ease the stress.
"When we start to worry about something like not finding a loo in time, our stress response is triggered which can make the urge to wee even worse," explains Dr Arroll.
"Combat this by engaging your parasympathetic nervous system through deep breathing via your diaphragm.
"To do this, put one hand on your belly and one on your chest. Deep, diaphragmatic breathing occurs when the belly lifts on the inhale and dips on the exhale.
"Breathe in for a count of three and out for a count of four, repeating the word ‘calm’ in your mind. This will reduce the cascade of brain-bladder signals that are triggered by the stress response, giving you enough time to find a facility."
During World Continence Week (till June 27th), INNOVO are calling for an increase in awareness of the problem.
“Urinary weakness is an invisible ball and chain and these findings highlight the level of anxiety it can cause," Susanne Judd of INNOVO says.
"We want to raise awareness of the very real worries that women have, as we ease back into normal life and help women all over the UK to put an end to their bladder weakness problems.”