She Did 125 Kegels a Day for 3 Years. A Retired Nurse Stopped Her in a Pharmacy Aisle and Told Her Why It Never Worked.

By Dr. Helen Marsh, Continence and Pelvic Health
Reporting a patient case, in the patient's own words Medically reviewed · Updated August 27, 2026

She had done the exercises for 3 years. Pelvic floor therapy twice a week, 20 miles each way. A $500 specialist. A cream that helped at first and then stopped. Her own therapist measured her and said her pelvic floor was in great shape, and she was still standing in a pharmacy buying liners. Then a woman she had not seen since 2018 looked in her basket and said 6 words that explained all of it. Here is her story, in her own words.

This is who she was in the spring. Working out where the bathrooms were before she worked out anything else.

My grandmother complained about leaking for 5 years. Then she was in diapers. I was a child and I still remember it.

I am 61 and it started happening to me.

I am not doing that. If I can help it, I am never doing that.

I still work, on the road with clients most weeks, in rooms where you do not get up and walk out.

It started 6 years ago, a few years after my periods stopped. A few drops when I sneezed. Not even every time.

Then it was every time.

The Boardroom, and the Call at 2 That Did Not Exist

She stayed in the chair with her folder open until the room emptied.

I began obsessing about being within close distance of a bathroom. Not planning. Obsessing.

I know which rest stop on the way to the Columbus account has the clean one, 40 minutes past the exit I need.

I have ruined a chair and had to wait for an entire boardroom of people to clear out.

I kept my folder open like I was still reading it. Ray finished packing up and said Cheryl, you coming down to lunch, and I said go on ahead, I have a call at 2.

I did not have a call at 2.

I could smell it. I was certain everyone else in that room could too.

Six Years of Doing Everything She Was Told

The shelf that kept getting fuller while nothing got better.

I brought it up with my family doctor in the spring of 2020, at the end of an appointment about something else, hand on the door. He said do kegels. That was the whole appointment.

So I did kegels.

When that did nothing I went to a gynecologist, and she told me I should be doing 100 kegels a day. I increased to 100, then 125, each day.

125 a day. In the car. At my desk. In that same boardroom.

Still leaking.

Then pelvic floor therapy, twice a week for 8 weeks, 20 miles each way. My insurance covered 2 visits out of the 16.

I paid $500 out of pocket for an hour with a menopause specialist because there is not one inside 90 miles who takes my plan.

She put me on vaginal estrogen cream, and to be fair it really helped with my stress incontinence at first.

At first is the part nobody warns you about. By month 4 I was back where I started.

Poise liner in the day. Poise pad at night. Around $1,500 a year, and I know that because I finally added it up in a hotel room in Toledo.

There is a franchised place near me now with a chair you sit in fully clothed. $3,000 for the course, $300 a year after that. I sat in the lot for 20 minutes and drove home.

Not because of the money.

Because every single thing on that list was the same idea. Squeeze harder. And I had been squeezing 125 times a day for 3 years.

The only thing left was surgery. A sling, to hold it up from underneath. I have had the referral since March. I have not called.

The sling is the only one that is not the same idea. It is also the only one you cannot undo.

They Have Been Treating the Wrong Tissue

Two weeks later I was in the pharmacy with a bag of liners in my basket and somebody said my name.

Lorraine and I worked in the same building for 9 years. She retired in 2018 and we had not spoken since. She looked in my basket before she looked at my face.

31 years a nurse, the last 12 on a geriatric floor, and the only person I have ever met who does not get uncomfortable saying the word urine.

She did not say anything about the basket. She asked me how long.

So I told her, standing in an aisle in a pharmacy. All of it.

She listened to the whole thing. Then she said it.

"They have been treating the wrong tissue."

I told her my therapist had measured me and said my pelvic floor was in great shape.

"I believe her. It probably is."

Then why am I standing here holding these.

"Because she measured the muscle, and the muscle is not what gave way."

"Leaking is not a weak muscle but a band of collagen that has gone slack, and the pelvic floor muscle is only the drawstring pulling against it."

My therapist had not been giving up on me. She had run out of things aimed at the muscle, and the muscle was fine.

The muscle is the drawstring. The collagen band is the elastic. Pulling the drawstring tighter does nothing for slack elastic.

"Think about a waistband that has gone," Lorraine said. "Not the drawstring. The elastic itself. You can pull a drawstring as tight as you like. If the elastic underneath has lost its snap, the waistband still gapes."

I have been pulling on a drawstring for 6 years.

What a Hospital in Bristol Measured in 1997

I asked how she knew any of this. She went looking, she said. 12 years on a geriatric floor, every second woman on it in a brief, and not one doctor could tell her what had broken.

"So I read. It has been sitting there since 1997. A hospital in Bristol took tissue from women who leak and from women who do not, and they measured it. The ones who leaked were short of 3 things at once."

Short of what.

"Go back to the waistband. Cut one open. That elastic is not one solid piece. It is threads."

The 3 shortages measured in women who leak. Fewer threads, thin instead of thick, and not tied to each other.

I have seen that. An old pair where the elastic has gone dead and you can pull the casing back and see the little rubber threads inside it, half of them snapped.

"That is your band. So there are only 3 ways it goes on you."

"You end up with fewer threads than you started with. Or the ones you have are the thin stretchy kind instead of the thick strong kind. Or they are not tied to each other, so they slide instead of pulling together."

"The thick strong one has a name. Type 1 collagen."

And the women in Bristol.

"All 3 at once." Fewer threads. Thin ones. Not tied.

That sounds like wear and tear, I said. I have had 2 children.

"Those women were young. And not one of them had ever given birth."

Not one.

So it was never the babies. It was never the weight. It was never the exercises I did or did not keep up. The difference was in the material itself.

I asked why there was less of it. "You do make less of it. Everybody does. In skin, where it is easy to measure, it drops about 1% a year from your twenties."

"That is the half you would have guessed. There is another half."

Somebody collected a full day of urine from women who leak and from women who do not, and measured the broken down collagen floating in it. The ones who leaked were passing 63% more.

63% more of the thread that is supposed to hold you closed. Every day. Into the toilet.

I was never only failing to build it. I was losing it faster than I could put it back.

And every single thing that had failed me made sense right there in the aisle.

125 kegels a day, every one of them pulling on the drawstring. The therapy was the same drawstring, better supervised.

The liners caught what came through and never once pretended to repair anything. And a sling would hold the whole thing up from underneath without putting a single thread back.

Why the Cream Did Something for the Dryness and Nothing for the Leaking

Four months on the cream. Something for the dryness. Nothing for the leaking.

What about the cream, I said. My own doctor gave it to me for exactly this.

"Then you already know what it did. Something for the dryness. Nothing for the leaking."

She said there was a trial. 6 months on estrogen, placebo controlled, in women with proven stress incontinence, and they sampled this exact tissue before and after.

"The collagen went down," she said. "Not up. Down."

So those months were not my fault either. I was putting the right thing on the wrong problem, because that is what I was handed.

I asked her what gave way.

"Nothing gave way," she said. "Something stopped being replaced as fast as it was being lost. It went a thread at a time."

"There is no day it happened to you. Nothing hurts while it is going, and nothing about it shows. That is the whole reason you are 61 and hearing it for the first time in a pharmacy."

Three Things Missing, So Three Things Needed

Three ingredients, one for each of the 3 shortages Bristol measured.

So it was never a stronger squeeze. And it was never the hormone.

3 things were missing, so you need 3 things. More thread. The thick kind. Tied together.

Lorraine said there is one formula built around those 3 and it is called Bladder Restore Trifecta.

A supplement, I said. I did not say it kindly.

"I know. Let me tell you what is in it."

"Start with more thread, because that one is 2 jobs and not 1. You can be short of something because you are not making enough. Or because you are losing too much. You were doing both."

The first thing in it is an Altai mountain resin called shilajit, and she said it works on the making.

"8 weeks, human trial. The marker for building new type 1 collagen came back at nearly double what they started with. The marker for losing it dropped 29%."

Type 1 collagen. The thick thread. That is 2 of the 3, out of one ingredient.

The second thing is pearl powder. I said pearl powder back to her, out loud, the way you do.

"I said it that way too. Then I read what it was tested against."

Your body makes an enzyme whose whole job is to cut collagen apart. It is supposed to. That is how worn thread gets cleared out so new thread can go in.

"Yours never slowed down when the building did. Pearl was tested against that exact enzyme, and it slows it."

And then she told me the part I could not get out of my head. In that same 6 month estrogen trial, the one where they sampled this tissue, that enzyme went up.

The hormone cream in my own bathroom cabinet was speeding up the exact thing the pearl slows down. The same enzyme. Opposite directions.

"One puts thread in. One stops it going out the door. Between them you end up with more than you started with."

The third thing in it is bamboo silica, and it is the one that ties.

Thread on its own is not a band. It only holds when the threads are locked to each other.

"Those locks are the third thing on the Bristol list. Silica is what your body makes them out of."

More thread. The thick kind. Tied together.

Is it a hormone, I said. Because I am already on one.

"No. It adds no estrogen to you at all."

Why Her Own Doctor Never Told Her

Four things to offer, and nobody who ever walked in with a fifth.

I said if this has been sitting there since 1997, why does my own doctor not know it.

"Because there is nobody whose job it is to tell him."

You cannot patent a mountain resin, or a seashell, or a stalk of bamboo. So there is no company with a reason to run the trial, and no rep who turns up on a Tuesday with lunch and a folder.

"He was handed 4 things to offer you. You have had all 4. Nobody has ever walked into his office with a fifth."

I ordered it that night, in the car outside the pharmacy, before I could talk myself out of it.

3 capsules with breakfast.

What Changed, Week by Week

Month 5. The trampoline she had been finding reasons to avoid for two years.

I am not going to tell you it is gone. On a bad week I still put a liner in.

But I have stopped bracing, and I did not know until it stopped how much of me had been doing it.

I did not give up the garden. I put the beds back in this spring. I was out there on my knees in April with the radio going.

At some point I realised I had been out there 3 hours without once working out where the nearest bathroom was.

It was never only the leaking. It was how much of my day the leaking had quietly been running.

Most of my life I was the child watching my grandmother go from complaining to diapers in 5 years, and I thought that was a road you got put on and rode to the end of.

I am the grandmother now, on the trampoline with my granddaughter, and the road did not end where hers did.

Real Women, Real Results

Women who stopped planning their days around the nearest bathroom.

★★★★★

"I was going through four a day and I have kept a spare set of clothes in the car for six years. I am on one liner now and it is mostly there because I do not trust it yet. Four months in. I did not expect to be writing one of these."

Maryann L., 64, Walla Walla, WA  ·  Verified Buyer

★★★★★

"My gynaecologist told me my pelvic floor was in great shape and I sat there still leaking and went home and did more kegels. Nobody ever said the word collagen to me. This is the first thing I have read that explained why the exercises did nothing."

Jacqueline M., 59, Dayton, OH  ·  Verified Buyer

★★★★★

"I bought it for the leaking. The surprise was the nights. I was up three and four times and I am up once now, sometimes not at all, and I had forgotten what a whole night feels like."

Diane M., 67, Asheville, NC  ·  Verified Buyer

Where Can I Get Bladder Restore Trifecta?

Bladder Restore Trifecta. Shilajit, pearl and bamboo silica in one formula.

The company is called Optimum, and Cheryl looked them up before she ordered because she had been burned before.

Optimum have it independent third party lab tested twice over, for heavy metals and for mycotoxins. The results are posted where you can read them instead of sitting behind a request form.

Every heavy metal in that report sits far below the safe harbor limits, so the product carries no California Proposition 65 exposure warning.

Small and family owned, down in Florida, where a real person answers the phone.

You will not find Optimum on Amazon. They sell direct from their own site and nowhere else, so what arrives is the real thing and not a knockoff.

In every study ever done on shilajit, not one serious side effect.

They stand behind it for 90 days, and there is a reason for that number. This is rebuilding a material, not loaning you a dry afternoon.

The human trials that measured this tissue changing ran 8 to 14 weeks, so 90 days is the full window those women needed with room on the end of it. If nothing has changed by then, every penny comes back.

Ninety days, the full window the trials needed, with room on the end of it.

Dr. Helen Marsh

Continence and Pelvic Health Researcher

Dr. Marsh has spent her career on the connective tissue of the lower urinary tract. She shares patient cases like Cheryl's because most women who leak are still being handed exercises for a muscle that measurements keep showing is fine.