I was having a discussion recently with my family about pelvic floor dysfunction, in particular stress urinary incontinence (SUI) and the misconceptions surrounding this. SUI is the unintentional loss of urine during movements or activities that increase pressure inside the abdomen and push down on the bladder (ie sneezing, coughing, laughing, lifting). As I have said before, any type of incontinence isn’t normal regardless of age, however SUI is often only thought to affect women after childbirth and in later life during/post menopause. This statement was confirmed by my family and they didn’t think that it was experienced by those that haven’t gone through these stages in their life or wasn’t as bad for them. This surprised me and highlighted that this is something that should be talked about more.
I had recently seen a post about leakage on Facebook and the taboo that surrounds it. It gave insight into women of all ages, discussing their challenges with SUI ranging from 15-49 years old (see link below). There are very few blogs or expression pieces around that discuss the impact that SUI can have across the lifespan. Although child birth and menopause can increase your risk of SUI, there are many other risk factors such as constipation, asthma, diabetes, chronic cough, obesity and history of high impact exercise that can lead to SUI, irrespective of age. Having pelvic floor muscles that are too tight and unable to relax can also lead to bladder leakage.
Regardless of age, SUI can have a significant impact on mental health and quality of life. Education needs to be provided to young women about their pelvic floor health and break down the stigma behind it. This is certainly an issue for young female athletes. Depending on the training demands and requirements on the sport, there is a high prevalence of SUI in athletes. It is thought that this is due to the abdominal muscles contracting without proper pelvic muscle activation to support the bladder and urethra. A systematic review showed that 58.1% of women competing in high impact sport (ie. Gymnastic, Basketball, Tennis) reported SUI, 30.46% of those who engage in medium impact sports (ie. Judo, Softball, track and field) and 12.64% of low impact sports athletes (ie. Cycling, Swimming). This can turn young women off competing or engaging in sport, limiting their physical activity, as very few discuss this with their doctors, trainers or collegues. Some may only experience SUI during training or competition, and may not report symptoms during ADLs. This doesn’t mean that you shouldn’t do impact exercise, but be aware of any symptoms and if there is a common cause. The pelvic floor can be trained to do what you need it to, but you need to dedicate time to it. If you are in a high impact sport and having no symptoms currently, its worth practicing pelvic floor exercises to help prevent any issues down the road.
No matter the age, women should feel that they can be open to talk about any issues that are affecting their bodies. There is a lot of support out there for women, its just knowing who to talk to. You just need to start the conversation.
Systematic Review : https://link-springer-com.ezproxy.library.uq.edu.au/article/10.1007/s00192-018-3629-z
