Nearly half of New Zealand women experience incontinence, but shouldn't have to suffer in silence, a new University of Otago, Wellington study shows.
Researchers used data from the New Zealand Health Survey Adult Sexual and Reproductive Health module 2014/15 to estimate the prevalence of incontinence and explore its associations with age, body mass index (BMI), parity and ethnicity.
Published in today's New Zealand Medical Journal, results show 43.5 per cent of women surveyed aged 16-74 reported at least some incontinence. This increased to 50 per cent for women aged 50-74.
Co-author Professor Jean Hay-Smith, of the Department of Medicine, says women find incontinence can be taboo or embarrassing and lower their quality of life.
Many plan their daily activities around dealing with it, stop exercising, and some are socially isolated.
"Further, managing urinary incontinence with incontinence products is a substantial economic and environmental cost," Professor Hay-Smith says.
"Women may believe urinary incontinence is 'part and parcel' of childbearing or ageing.
"This belief, along with the apparent reluctance and lack of confidence in health professionals to ask about urinary incontinence, means that many women do not access any help or support when there are effective non-surgical and non-pharmaceutical treatments available."
Professor Jean Hay-Smith
As part of the Sexual and Reproductive Health survey, women aged under 75 years were asked two questions about the frequency (daily, weekly, monthly) and amount (ranging from 'a few drops' to 'enough to wet the floor') of incontinence.
Of the 2472 women with any incontinence, 41 per cent had this less than monthly, 44 per cent of them experienced this weekly, and 15 per cent daily.
While it was most common in women aged 50 and over, incontinence was also prevalent in those aged 16-29 (21 per cent).
"As our population ages this means there will be more people with this condition; if this need isn't met then that creates further inequity in addressing the health needs of women," Professor Hay-Smith says.
"In addition, if urinary incontinence is not addressed in women under 75 years and these high rates continue, or increase after 75 years, then there are many more implications for older persons' health services."
While there is no link between incontinence and ethnicity, Professor Hay-Smith says Māori women may still experience inequity in the health system, such as lack of access to care and living in areas without continence services.
There should be more public health messaging to remind women incontinence is not inevitable, let them know they are not alone and inform them of the options for improving symptoms and quality of life, she says.
"Health professionals need help to be more confident to ask women about this condition at multiple points across their lifespan and not wait for women to raise it.
"We also need to do a much better job of preventing urinary incontinence through enabling young women, pregnant women, peri-menopausal women, and physically active women who engage in high impact activities to care for their pelvic floor.
"And, given urinary incontinence affects women across their lifespan, and is more common with ageing, with diabetes, and obesity we need a health system that is organised and resourced to support that need – not necessarily with expensive surgeries or drugs – but with people who know how to support women with evidence-based self-management that will help many of them."
