Stress Urinary Incontinence Leaves Women Feeling Older and Less Sexy

RED BANK , NJ, November 18, 2003 (NWHRC) - Many women of all ages are affected by a medical condition called stress urinary incontinence (SUI) that they rarely discuss with their health care professional. Results from a survey by the National Women's Health Resource Center (NWHRC), "American Women and SUI: Exposing the Secret," show that all of the women surveyed are concerned that SUI, which is estimated to affect one in three women in the U.S.,¹ impacts some aspect of their lives. More than half have never sought treatment or discussed their symptoms with a physician, and have adopted their own coping strategies, creating further anxiety and strain on their lives and relationships.

The survey results were announced today as part of an awareness-building event to support Bladder Health Week, which is sponsored by the American Foundation for Urologic Disease (AFUD). The national survey explored awareness, attitudes, and the impact of SUI on the lives of women between the ages of 20 to 65+.

More than 25 percent of women surveyed report feeling embarrassed, older than their age, self-conscious, and less sexy because of their SUI symptoms. Respondents further report being concerned that SUI affects their social and family life (30 percent), sexual intimacy and/or their relationship with a partner or spouse (28 percent), their physical activities (25 percent), and their professional life or work (18 percent).

"It's easy to understand why women may feel ashamed and embarrassed to talk about SUI with their health care professional. Women want to feel young and sexy, not the opposite, so they choose not to deal openly with this condition," said Amy Niles, president and CEO of the NWHRC. "Through greater awareness and encouraging dialogue between patients and doctors, we can break down barriers."

Misconceptions about SUI
More than 50 percent of the women surveyed generally associate SUI with "getting older," a common misconception that prevents women from seeking treatment. In reality, the condition affects women across all age groups. The survey showed that 56 percent of responders identified the statement "I feel too young to have urinary incontinence" as the one they related to the most. The majority of women who agreed with this statement (78 percent) were age 35 or older.

Stress urinary incontinence is attributable to a decreased urethral sphincter muscle function (at the bladder outlet) and is the most common form of urinary incontinence. Thirty million (1 in 3) American women over the age of 18² suffer from accidental leakages when they laugh, cough, sneeze, exercise or lift something. The majority of women surveyed (45 percent) believe that stress urinary incontinence is the most under-reported "taboo" medical condition compared to other closely guarded "secret" or "taboo" conditions such as eating disorders (7 percent), sexually transmitted diseases (7 percent), sexual dysfunction (6 percent), depression (9 percent), menopause (10 percent), and overactive bladder (16 percent).

SUI: Coping with a sensitive health issue
Fifty-five percent of the women surveyed alter their lifestyles in order to manage their SUI symptoms. To maintain a normal routine, women with SUI report that they use coping mechanisms like limiting sexual intimacy, bathroom mapping, frequent trips to the bathroom and relying heavily on sanitary pads or panty liners.

Even though SUI takes its toll on the functioning of women who live with it, the survey confirms that many women are reluctant to talk about their symptoms and to seek help or treatment. More than half (54 percent) had never discussed their symptoms with a health care professional, and less than one-quarter had broached the topic with a specialist such as an obstetrician/gynecologist, according to the survey.

This "don't talk/don't tell" attitude is exacerbated by the fact that health care professionals do not bring up the delicate subject of incontinence with their patients, the survey indicates. An overwhelming percentage of women surveyed (70 percent) said that a health care professional had never proactively discussed stress urinary incontinence or provided them with information on the condition.

Childbirth: An unrecognized trigger for SUI
Childbirth is considered a known risk factor for developing SUI symptoms.³ But when those surveyed were asked which conditions they associated with childbirth, 40 percent cited SUI as a condition that they were least familiar with as having any link to childbirth.

"Misconceptions about SUI are understandably common because many women are not discussing their symptoms with their doctor," said Linda Brubaker, MD, Professor of Obstetrics/Gynecology and Urology, Loyola University Health System, Chicago. "Since the condition is so commonly brought on by childbirth, women should not be embarrassed to bring up the subject, especially if the condition persists for any sustained period of time."

Survey methodology
The survey of 267 women ages 20 to 65+ was conducted online via the Web site Healthywomen.org from August 29 to September 24, 2003. It was sponsored by the NWHRC and supported by Eli Lilly and Company and Boehringer Ingelheim Pharmaceuticals, Inc.

About the National Women's Health Resource Center (NWHRC)
The NWHRC is the nation's leading independent nonprofit organization dedicated to providing health and wellness information and resources to women of all ages. Its Web site, www.healthywomen.org, is a one-stop shop for women's health.

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Note to editors: The AFUD forum will be available via webcast beginning Wednesday, November 19, 2003, and will be archived for 90 days. To view the webcast, please log on to http://www.healthywomen.org.

References
¹ Estimated that 29.5 million women have SUI in pure or mixed forms, based on 2000 US census bureau figures and incontinence prevalence rate of 35% as cited in Hampel C, Wienhold D, Benken N, Eggersmann C, Thüroff. Definition of overactive bladder and epidemiology of urinary incontinence.
Urol 1997:50 (S6A):4 -14.
² Ibid.
³ Viktrup L, Female stress and urge incontinence in family practice: insight into the lower urinary tract. International Journal of Clinical Practice, 2002 Nov; 56 (9) 694-700.