Being overweight is a long-established risk factor for women who suffer stress incontinence. New research has shown that when it comes to involuntarily urinating when you cough, sneeze or laugh, it’s not just carrying weight that adds to those ‘whoops’ moments, but where the weight is distributed.
Doctors in the US recently reported on a three-year study of nearly 1500 women in the Health, Aging, and Body Composition Study.
The research looked at those with stress incontinence and urge incontinence, another condition when there is an overwhelming and often frequent need to urinate. In both scenarios, body mass index (BMI) was shown to greatly affect the incidence of urinary incontinence. Obesity exerts greater pressure on the urethra and the study indicated that those with the highest BMIs (typically 24.9 and above) and the greatest proportion of body fat, were twice as likely to experience urinary incontinence problems compared to those with the lowest BMI and body fat.
Happily, there are several options that address the symptoms. Losing weight is a no-brainer. The US study found that those women who reduced their body fat by 5% experienced a 50% reduction in new or on-going stress urinary incontinence.
Know your body composition
Understanding your body composition is a valuable and practical step. The DEXA scan at Twenty-five Harley Street is a low level intensity x-ray, which scans and assesses the amount of fat stored around the trunk of the body – the key area indicated in this upsetting condition. Not only will you be clear on how carrying extra weight is impacting on this particular issue, the scan can alert you to other health risks such as heart problems and type 2 diabetes.
Don’t dismiss exercise
Meanwhile, a study in Finland, of 647 women aged 48-55 years old, linked urinary incontinence with sedentary and low exercise lifestyle and in this group 39% of participants were affected by exertion-related incontinence. Of course, the paradox is that for women already suffering, the risk of a leak then becomes a barrier to being active, the very thing that could help. Chicken-and-egg.
Time to get a grip
Most women are aware of their pelvic floor. Its role in keeping the core strong and stomachs flat is well documented. But a toned pelvic floor is also essential for stemming urinary incontinence. When the muscle mass that supports the bladder is reduced or slack and there is little grip strength, a leak is more likely.
The Finnish study concluded that women need encouragement from health professionals to exercise and engage the pelvic floor in ways that will not lead to a leak. Says urogynaecologist Pauliina Aukee: ‘Include exercises that support core and pelvic floor management without intense bouncing movements and which don’t place too much of a burden on the pelvic floor. This will allow people to exercise in an enjoyable way even after going through the menopause.’
Want to know whether the pelvic floor is? Try stopping mid-stream when you use the loo – nothing makes you more aware the muscles involved and how to isolate them than this exercise.
However, don't do this too much as it may damage the bladder. Pilates is also excellent for isolating and strengthening core muscles.
An extra boost
Another option for women who want to improve stress incontinence is vaginal rejuvenation with the MonaLisa Touch laser treatment. Studies have shown it improves vaginal atrophy and menopausal dryness, another happy effect is it improves symptoms of stress incontinence. This laser delivers fractional CO2 laser energy to the area and aims to reshape and improve the tone and tissue elasticity of the vagina walls by stimulating new tissue to grow. Quick to administer, one to three sessions is all it takes to have a lasting effect, though a top up is suggested annually. One study reported improvements of 90% in vaginal laxity.
You can phone to discuss a consultation for a DEXA scan or to find out more about the MonaLisa Touch at Twenty-five Harley Street day clinic on 020 3883 9525, or email firstname.lastname@example.org
The time of a woman’s life when her ovaries stop releasing an egg (ovum) on a monthly cycle, and her periods ceaseFull medical glossary