Depression and anxiety linked to urinary incontinence, study claims
Urinary incontinence can be an uncomfortable reality for many women, particularly in the months after pregnancy and birth, but new research has revealed just how much this could impact mental health.
The study, published in Urogynecology, by scientists at UT Southwestern Medical Center, aimed to identify factors associated with persistent (ie, 12 months postpartum) urinary symptoms, including stress urinary incontinence (SUI) and urgency urinary incontinence (UUI), and explore their association with mental health.
Researchers assessed over four hundred mothers, with health disparities, 12 months after they gave birth as part of validated surveys designed to assess urinary dysfunction, anxiety, and depression.
They looked for links between the conditions and with other factors, such as demographic and economic data, maternal age, number of previous births, body mass index, foetal birth weight and mode of delivery.
Results revealed that urinary incontinence was common, with around a third (32.5%) of participants experiencing stress urinary incontinence, when urine leaks out at times when your bladder is under pressure; for example, when you cough or laugh.
Around one in six (16.5%) had urgency urinary incontinence, when urine leaks as you feel a sudden, intense urge to pass urine, or soon afterwards. And one in nine had overall bothersome urinary symptoms.
The findings suggested that neither stress urinary incontinence or urgency urinary incontinence in these participants was linked to traditional factors, such as delivery of large babies or complicated births.
However, stress urinary incontinence was significantly associated with both a higher body mass index at birth and elevated scores on the depression questionnaire.
Urgency urinary incontinence was associated with both a higher number of previous births and elevated scores on the anxiety questionnaire.
The study also showed that generally bothersome urinary symptoms had a link to both a higher number of previous births and elevated anxiety scores.
"The study looked at women who don't have access to many resources and found that postpartum urinary incontinence is connected to mental health," Dr Elise Dallas, women's health GP at The London General Practice says of the research.
"Factors like feeling depressed, anxious, having a higher body mass index, and giving birth before can contribute to this condition."
Dr Dallas says the study could help to encourage healthcare professionals to inquire about urinary incontinence and mental health at post-birth appointments.
"It's important to address both postpartum care and mental health to treat these issues effectively," she adds.
The stigma surrounding urinary incontinence
Dr Sarah Jenkin, from The Door W4, says stress urinary incontinence can be debilitating and have a major impact on confidence and mental health.
"Women are embarrassed and frightened of speaking about this to anyone and can often develop anxiety and fear of leaving their home and plan their movements around availability and access to toilet facilities," she explains.
The stigma surrounding the condition also has a knock-on impact on mental wellbeing.
"People who experience this condition can feel alone, embarrassed, and have trouble connecting with others," Dr Dallas explains. "These negative feelings can lead to mental health problems like feeling sad or anxious. The fear of being judged or feeling ashamed can stop people from seeking help and make their mental health worse."
Thankfully, if you're dealing with urinary incontinence, there are things you can do to manage and improve it:
Talk to a doctor
Dr Dallas suggests making an appointment with a doctor who specialises in urinary incontinence or urogynaecologist. "They can examine your symptoms, give you a proper diagnosis, and suggest the right treatments," she suggests.
Share your concerns
Don't hesitate to talk openly with your doctor about how urinary incontinence is affecting your mental health. "Being honest will help them create a treatment plan that covers both the physical and emotional aspects of your condition," Dr Dallas explains.
Find support
Dr Dallas recommends connect with support groups or online communities where you can talk to others who are going through similar challenges. "Sharing your experiences and getting support from people who understand can bring comfort and helpful advice," she adds.
Do pelvic floor exercises
Practice exercises that strengthen the muscles controlling urination, like Kegels. "Regularly doing these exercises can improve bladder control and lessen urinary incontinence symptoms," Dr Dallas explains.
Make lifestyle changes
Certain changes to your daily life can also help manage urinary incontinence. "Maintaining a healthy weight, avoiding things that irritate the bladder (like caffeine and alcohol), and sticking to a regular bathroom schedule can all make a difference," Dr Dallas says.
"Remember, it's important to seek professional help and support to address urinary incontinence and its impact on mental health," Dr Dallas continues. "So if your doctor doesn't bring it up in the postnatal appointment you should! Our goal is to empower you to regain control over your bladder function and ensure your wellbeing."
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