Physical Activity May Improve Incontinence in Women

Women with urinary incontinence who are engaged in moderate physical activity may have a reduced likelihood of stress, urge, and mixed incontinence compared with women who don’t engage in physical activity, according to a study presented by Michelle Kim, MD, of the Massachusetts General Hospital in Boston, at the 2021 American Urological Association Annual Meeting.

In the United States, urinary incontinence represents a significant cause of morbidity among women. Previous research suggests engagement in regular physical activity may be associated with improvements in muscle strength and flexibility, but few studies to date have identified whether physical activity can improve pelvic floor muscles and subsequently, improve incontinence.

The study by Dr. Kim and colleagues was a retrospective analysis of 30,213 women older than 20 years of age who were included in the 2008 to 2018 National Health and Nutrition Examination Survey (NHANES) cycles and answered questions regarding urinary incontinence and engagement in physical activity. The researchers conducted a multivariate logistic regression analysis to examine the association between physical activity levels and incontinence. The analysis of this association was adjusted for age, body mass index, diabetes, menopause, parity, race, and smoking.

In the 2008 to 2018 NHANES cohort, approximately 23% of women had stress incontinence, 23% had urge incontinence, and another 8% of women had mixed incontinence (patient-reported endorsement of both stress and urge incontinence). Overall, the participants who reported incontinence were significantly older than women who didn’t report incontinence (p<0.001 for all).

Women who reported engagement in moderate recreational physical activity were significantly less likely to report stress incontinence (odds ratio [OR], 0.79; 95% CI, 0.62-0.99) or urge incontinence (OR, 0.66; 95% CI 0.48-0.90) compared with women who didn’t report moderate physical activity.

There was a trend toward associations between certain workplace-related physical activities and incontinence, but these associations didn’t reach statistical significance. In contrast, the researchers noted a significant inverse association between time spent engaged in both leisure- and work-related moderate intensity activities and stress incontinence, urge incontinence, and mixed incontinence.

Associations were also found between time spent engaged in moderate intensity work and stress incontinence (OR=084; 95% CI, 0.70-0.99) and urge incontinence (OR=0.84; 95% CI, 0.72-0.99). In addition, the investigators observed an association between time spent walking/biking and urge incontinence (OR=0.65; 95% CI, 0.48-0.89) as well as time spent in vigorous recreational activity and mixed urinary incontinence (OR=0.37; 95% CI, 0.16-0.86). Time spent in engaged in moderate recreational activity correlated with urge incontinence (OR=0.66; 95% CI, 0.48-0.90).