Young women hit, and hurt by, urinary incontinence

Urinary incontinence (UI) affects young, nulligravid women and significantly impacts their psychological well-being, a recent survey found.

Researchers surveyed about 1,000 Australian women, ages 16 to 30, at university campuses and off-campus medical clinics. The mean age of the participants was 22.5 years. Overall, 12.6% of them reported having urinary incontinence (95% CI, 10.5% to 14.7%), with slightly more students than nonstudents reporting the problem (13.2% vs. 10.6%). Incontinence was highest among students who were sexually active and not using combined oral contraceptives (21.5%; 95% CI, 16.7% to 27.3%).

This study, published in the July 17 Annals of Internal Medicine, may be the first to examine urinary incontinence in nulligravid women, and it shows that the problem is fairly common, the authors said. The association with sexual activity could result from biomechanical effects or altered urogenital tract flora, they suggested. Previous research on incontinence and contraceptive use has produced conflicting results, but major previous studies did not take sexual activity without contraceptive use into account.

The effect of incontinence on the surveyed women's self-reported well-being was significant. Affected women scored worse on measures of anxiety, depression, positive well-being and self-control. The difference in well-being between women with and without incontinence in this study was similar to differences reported in previous research by young women with and without invasive breast cancer. The results show that “the consequences of UI for young women are not limited to bothersome symptoms but include adverse effects on behavior and psychological well-being,” the authors wrote.

The study's findings are likely conservative estimates of urinary incontinence, given the relative healthiness of the studied population, the authors noted. They called for further investigation of the prevalence of incontinence in nulligravid women and the apparent relationship with sexual activity and contraceptive use.