Regular high-intensity physical activity in early adulthood may increase the risk of urinary and fecal incontinence in middle-aged women

According to a recent study conducted at the University of Jyväskylä (Finland), early adulthood physical activity is associated with symptoms of pelvic floor disorders in middle-aged women.

The prevalence of pelvic floor disorders increases as women approach menopausal years. In addition to hormonal changes, several factors contribute to pelvic floor disorders, including natural aging of the connective tissue, reproductive history, lifestyle, as well as factors increasing the pressure in the abdominal cavity.

“Physical activity has many health benefits, however, its benefits relative to the functional ability of pelvic floor have been challenged,” says doctoral researcher Mari Kuutti from the Faculty of Sport and Health Sciences of the University of Jyväskylä. “While exercise strengthens pelvic floor muscles, it may also overload and stretch the muscles.”

The objective of the newly published study was to investigate the association of early and middle-adulthood physical activity with symptoms of pelvic floor disorders. The disorders studied were stress urinary incontinence, urge urinary incontinence, fecal incontinence, constipation and defecation difficulties, and pelvic organ prolapse.

Pelvic floor disorders are common

Over half of the participants of the study had symptoms of pelvic floor disorders. Most common was stress urinary incontinence. The study revealed that current physical activity was not associated with the occurrence of the symptoms of pelvic floor disorders.

“Middle-aged women with early adulthood history of competitive sports were more likely to experience symptoms of urge urinary incontinence but not symptoms of stress urinary incontinence, fecal incontinence, constipation or defecation difficulties, or pelvic organ prolapse,” Kuutti says, summarizing the results. “In addition, women with history of regular physical activity were more likely to experience symptoms of fecal incontinence but no other symptoms of pelvic floor disorders.”

Awareness of the impact of modifiable life habits, such as physical activity, on the functional ability of the pelvic floor may lead to a significant reduction in human burden and improvement of the overall health of middle-aged women.

“Pelvic floor disorders can be prevented and rehabilitated, therefore there is no need to be shy when seeking professional help,” says chief physician, urogynecologist Pauliina Aukee from Hospital Nova of Central Finland. “Exercising according to a personalized exercise program made by a physiotherapist is safe and effective.”

The research is part of the ERMA study, the participants of which included over 1,000 women between the ages of 47 and 55 living in the Jyväskylä region. Earlier and current physical activity as well as demographical factors (age, body mass index, education, and physical workload) and gynecological factors (gestations, parity, menopausal status, and hysterectomy) were self-reported with questionnaires.

Reference:

Mari A. Kuutti, Matti Hyvärinen, Markku Kauppinen, Sarianna Sipilä, Pauliina Aukee, Eija K. Laakkonen published: 19 January 2023 https://doi.org/10.1111/1471-0528.17397