Bladder control problems may be seen as a problem of older people, but a good percentage of college-age women have symptoms too, a study published Monday suggests.
In a survey of 1,000 young Australian women, researchers found that 13 percent said they’d had urinary incontinence in the past month. That meant problems like leaking urine when they exercised, or often having to rush to the bathroom to avert an accident.
“The traditional belief has been that incontinence really occurs as a consequence of pregnancy and aging,” senior researcher Susan R. Davis, of Monash University in Melbourne, said in an email.
“What prompted us to undertake this study was the fact that nobody had actually looked at incontinence in younger women who had never been pregnant,” said Davis, whose work was supported by Australian state and federal funds.
The study “contributes significantly to current knowledge about urinary incontinence in young women,” said Mary K. Townsend, an epidemiologist at Brigham and Women’s Hospital and Harvard Medical School in Boston.
Townsend, who was not involved in the research, has studied the prevalence of urinary incontinence and possible risk factors for it.
“Overall, a key message from this study is that urinary incontinence is a significant problem for women of all ages,” Townsend said in an email.
But, she noted, the 13 percent figure could be either an underestimate or overestimate.
That’s because the study participants, who were about 22 years old on average, were recruited from college campuses and health clinics. So they may not be representative of all young women.
“It will be important for future studies to confirm these results in a larger, population-based sample of young women,” Townsend said.
LINK TO BIRTH CONTROL USE
The study, which appears in the Annals of Internal Medicine, also tried to weed out the possible risk factors for urinary incontinence in young, never-pregnant women.
It turned out that women were sexually active and not using birth control pills had the highest risk: about 22 percent had urinary problems in the past month.
That compared with rates of around 10 percent among women who had either never had sex or were sexually active and on the Pill.
The link to sexual activity might be related to urinary tract infections, Townsend speculated. Sexually active women have a higher rate of UTI, and those infections can trigger incontinence.
But the reasons for the birth control finding are not clear.
Townsend said past studies have come to conflicting conclusions on whether birth control pills are related to higher or lower risks of urinary incontinence – or whether there’s a relationship at all.
She and Davis both said more research is needed to see whether birth control pills, themselves, have any effect on bladder control problems.
There was no strong evidence that overweight young women had an increased risk of incontinence. And that’s in contrast to what’s been seen among older women.
But Davis said that may be because of numbers: only 15 percent of the study participants were overweight. And as a group, they were fairly healthy and physically active.
“This leaves open the possibility that the rate of incontinence we observed may in fact be an underestimate of the rate in a less healthy group of young women,” Davis said.
Both she and Townsend said that young women who find their urinary symptoms troublesome should seek help. In this study, women with symptoms scored lower on a measure of mood and psychological well-being.
“I think the most important take-home message is that if young women experience urinary incontinence they should not feel embarrassed to seek help,” Davis said.
There are different options for combating the symptoms, she noted.
Sometimes all you need are lifestyle changes – like cutting back on caffeine and alcohol, and limiting how much fluid you drink at night.
Another option is “bladder training,” which involves tactics like going to the bathroom at fixed times, even if you don’t feel like you need to go. That often includes Kegel exercises to strengthen the pelvic muscles that control urination.
Depending on the type of incontinence, medications – like oxybutynin (Ditropan), solifenacin (Vesicare), tolterodine (Detrol) – may also help. But research shows that they work for only a minority of women, and they can have side effects like dry mouth, constipation and blurred vision.
SOURCE: Annals of Internal Medicine, July 17, 2012
Urinary Incontinence in Young Nulligravid Women: A Cross-sectional Analysis
Results: 1018 of 1620 questionnaires (63%) were returned, and 1002 provided analyzable data. The mean age of participants was 22.5 years (SD, 3.2). The rate of any UI was 12.6% (95% CI, 10.5% to 14.7%). Incontinence was slightly more common in students than in nonstudents (13.2% [CI, 11.0% to 15.8%] vs. 10.6% [CI, 6.7% to 14.6%]). Rates of UI varied according to sexual activity and use of combined oral contraceptives (COCs), with highest rates reported by students who were ever sexually active and not using COCs (21.5% [CI, 16.7% to 27.3%]). Women with UI reported significantly lower overall well-being than women without UI and had worse PGWBI scores related to anxiety, depression, positive well-being, and self-control.
Limitation: A convenience sample of healthy, well-educated women was recruited, and response rates and participant characteristics varied by setting.
Conclusion: In a sample of young nulligravid women, UI was associated with ever being sexually active and no COC use, as well as lower psychological well-being. Further research is needed to assess the prevalence and risk factors for UI in nulligravid women.
Tessa O’Halloran; Robin J. Bell, MBBS, PhD; Penelope J. Robinson, MBiostat; and Susan R. Davis, MBBS, PhD