Too wet to exercise? Leaking urine as a barrier to physical activity in women

doi:10.1016/S1440-2440(01)80046-3

Journal of Science and Medicine in Sport

Volume 4, Issue 4, December 2001, Pages 373-378

https://doi.org/10.1016/S1440-2440(01)80046-3 Get rights and content

Leaking urine is frequently mentioned (anecdotally) by women as a barrier to physical activity. The aim of this paper was to use results from the Australian Longitudinal Study on Women's Health (ALSWH) to explore the prevalence of leaking urine in Australian women, and to ascertain whether leaking urine might be a barrier to participation for women.

More than 41,000 women participated in the baseline surveys of the ALSWH in 1996. More than one third of the mid-age (45–50 years) and older (70–75) women and 13% of the young women (18–23) reported leaking urine. There was a cross-sectional association between leaking urine and physical activity, such that women with more frequent urinary leakage were also more likely to report low levels of physical activity.

More than one thousand of those who reported leaking urine at baseline participated in a follow-up study in 1999. Of these, more than 40% of the mid-age women (who were aged 48–53 in 1999), and one in seven of the younger (21–26 years) and older (73–79 years) women reported leaking urine during sport or exercise. More than one third of the mid-age women and more than one quarter of the older women, but only 7% of the younger women said they avoided sporting activities because of leaking urine.

The data are highly suggestive that leaking urine may be a barrier to physical activity, especially among mid-age women. As current estimates suggest that fewer than half of all Australian women are adequately active for health benefit, health professionals could be more proactive in raising this issue with women and offering help through noninvasive strategies such as pelvic floor muscle exercises.

References (14)

ArmstrongT et al.
Physical Activity patterns of Australian adults: results of the 1999 national physical activity survey
(2000)
BoK et al.
Single blind, randomised controlled trail of pelvic floor exercises, electrical stimulation, vaginal cones, and no treatment in the management of genuine stress incontinence in women
British Medical Journal
(1999)
BrownPR et al.
Constraints, social support and active leisure among mothers with young children
Leisure Sciences
(2000)
BrownWJ et al.
Women?s Health Australia: recruitment for a national longitudinal cohort study
Women and Health
(1998)
BrownWJ et al.
Leisure time physical activity in Australian women: relationships with well-being and symptoms
Research Quarterly for Exercise and Sport
(2000)
ChiarelliP et al.
Leaking Urine: prevalence and associated risk factors in Australian women
Neurourology and Urodynamics
(1999)
Commonwealth Deptartment of Environment, Sports & Territories
Active and Inactive Australians: assessing and understanding levels of physical activity
(1995)

There are more references available in the full text version of this article.

Cited by (99)

'I just don't trust my pelvic floor': Examining the bio-social barriers to maternal health and physical activity participation in a sample of mothers' from New Zealand
2023, SSM - Qualitative Research in Health
Maternal physical activity participation is associated with a range of positive mental and physical health outcomes. While a range of psycho-social and practical barriers to women's participation have been identified, little research has examined how these intersect with the physiological barriers posed by birthing injuries and the physical changes wrought by pregnancy and childbirth. In this study we address this gap using data collected through in-depth interviews with 20 women in Aotearoa New Zealand seeking to engage in regular exercise following childbirth. Guided by a socio-material conceptual framework, we examine women's physical activity engagement as bio-social phenomena. We pay particular attention to how women describe and navigate challenges posed by physiological considerations such as pelvic floor dysfunction, fatigue, the energetic demands of breastfeeding, and lingering birthing injuries. We argue these physical barriers are largely glossed over by policies, programmes and existing research that focus on motivating mothers to return to or become physically active. We suggest more sophisticated conceptual approaches are needed that explicitly acknowledge the overlapping biological and social dimensions of maternal physical activity in order to better support women through the complex postpartum period and beyond through enhanced resources, information, and general social awareness.
Physiotherapy management of urinary incontinence in females
2020, Journal of Physiotherapy
Regular exercisers have stronger pelvic floor muscles than nonregular exercisers at midpregnancy
2018, American Journal of Obstetrics and Gynecology
Citation Excerpt :
In the present study, general regular exercise training was not associated with a reduced prevalence of UI. This is in line with results of former studies showing a high prevalence of UI in general exercisers20 and in elite athletes.3,4 However, some studies have reported different results.14,21,22
Today all healthy pregnant women are encouraged to be physically active throughout pregnancy, with recommendations to participate in at least 30 minutes of aerobic activity on most days of the week in addition to performing strength training of the major muscle groups 2–3 days per week and also pelvic floor muscle training. There is, however, an ongoing debate whether general physical activity enhances or declines pelvic floor muscle function.
The objectives of the study were to compare vaginal resting pressure, pelvic floor muscle strength, and endurance in regular exercisers (exercise ≥30 minutes 3 or more times per week) and nonexercisers at midpregnancy. Furthermore, another objective was to assess whether regular general exercise or pelvic floor muscle strength was associated with urinary incontinence.
This was a cross-sectional study at mean gestational week 20.9 (±1.4) including 218 nulliparous pregnant women, with a mean age of 28.6 years (range, 19–40 years) and prepregnancy body mass index of 23.9 kg/m² (SD, 4.0). Vaginal resting pressure, pelvic floor muscle strength, and pelvic floor muscle endurance were measured by a high-precision pressure transducer connected to a vaginal balloon. The International Consultation on Incontinence Questionnaire Urinary Incontinence Short Form was used to assess urinary incontinence. Differences between groups were analyzed using an independent-sample Student t test. Linear regression analysis was conducted to adjust for prepregnancy body mass index, age, smoking during pregnancy, and regular pelvic floor muscle training during pregnancy. The significance value was set to P ≤ .05.
Regular exercisers had statistically significant stronger (mean 6.4 cm H₂O [95% confidence interval, 1.7–11.2]) and more enduring (mean 39.9 cm H₂Osec [95% confidence interval, 42.2–75.7]) pelvic floor muscles. Only pelvic floor muscle strength remained statistically significant, when adjusting for possible confounders. Pelvic floor muscle strength and not regular general exercise was associated with urinary continence (adjusted B, –6.4 [95% confidence interval, –11.5 to –1.4]).
Regular exercisers at midpregnancy have stronger pelvic floor muscles than their sedentary counterparts. However, pelvic floor muscle strength and not regular general exercise was associated with urinary incontinence. There is a need for additional studies in elite athletes and women performing more strenuous exercise regimens.
Sports Medicine and the Pelvic Floor
2023, Current Sports Medicine Reports
Sports and Fitness Activities
2023, Textbook of Female Urology and Urogynecology: Clinical Perspectives
Examining the factors associated with functional capacity of community-dwelling older adults using the ICF framework: a cross-sectional study from the Frailty in Brazilian Older Adults Study (FIBRA)
2023, Physiotherapy Theory and Practice

View all citing articles on Scopus

View full text

Too wet to exercise? Leaking urine as a barrier to physical activity in women

Physical Activity patterns of Australian adults: results of the 1999 national physical activity survey

Single blind, randomised controlled trail of pelvic floor exercises, electrical stimulation, vaginal cones, and no treatment in the management of genuine stress incontinence in women

British Medical Journal

Constraints, social support and active leisure among mothers with young children

Leisure Sciences

Women?s Health Australia: recruitment for a national longitudinal cohort study

Women and Health

Leisure time physical activity in Australian women: relationships with well-being and symptoms

Research Quarterly for Exercise and Sport

Leaking Urine: prevalence and associated risk factors in Australian women

Neurourology and Urodynamics

Active and Inactive Australians: assessing and understanding levels of physical activity