Hi there- Have you ever tried pelvic PT? I don’t want to sound redundant because I find myself frequently mentioning this on this forum lol, but it’s only because I’ve found so much benefit from it, and I almost didn’t find out about it. And when I did, I was amazed at all the things a pelvic PT can treat.

I don’t have incontinence, but I had/have the opposite problem—urinary retention related to an overly tight pelvic floor and possibly related to POTS. I was initially told there was not much that could be done except medication, but that turned out to be wrong.

When I was referred for a course of pelvic PT, I was amazed because they explained they can help teach how to strengthen or relax the pelvic floor muscles just like any other muscles in the body to help with incontinence or retention or even constipation. They also frequently treat people who’ve experienced conditions like anal cancer or have lingering effects of chemo.

And yes…they can teach kegels as well. Interestingly, I have both a tight and weak pelvic floor, and even though I have urinary retention, kegels help me because contracting the pelvic floor also helps relieve the tension as long as I don’t overdo it. And strengthening it helps keep me from bracing my muscles so much that I literally get pain. It’s sort of like how taking a walk can sometimes relieve pain.

If you haven’t looked into it, I highly recommend it. I found it very empowering and have had a really positive experience.

I don’t have as much direct experience with incontinence since I have the opposite problem. But I do know that other than doing regular kegels, sometimes kegel weights can be appropriate. You could even try it at home if you’re not able or comfortable seeing a pelvic PT. A website I find helpful is Intimate Rose. It’s a brand founded by a pelvic PT, and they do sell products but there are also lots of educational videos and resources.

Wishing you all the best!