Why do the numbers of women with incontinence increase with age?

Tasha Mulligan MPT Health Pro
  • Many women begin to experience mild symptoms of incontinence or occasional urine leakage as they age. Why does the incidence increase with age? The answer may be different for every woman, but there are several factors that I want to talk about in this piece.


    The first factor may be hormones. As we age we see a gradual decline in our estrogen levels and the rate at which we lose estrogen increases after menopause. The lower levels of estrogen lead to decreased strength of connective tissue within our bodies. Connective tissue is found within bone, muscles, ligaments, and tendons. So as these tissues thin out we lose strength in a lot of support structures within our body, including the ligaments that help hold the natural curves in our spine, our arm and leg muscles, and our pelvic floor muscles. Remember our pelvic floor muscles have a lot of responsibility, working against gravity every day to close off our pelvic outlet. They give support to our bowel, bladder, and uterus and they control the passage of solids, liquids, and air from our body. As this tissue thins, these responsibilities may become too much, leading to urine leakage.

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    The second factor may be the constant pull of gravity. This consistent force on our bodies effects us in several ways, such as varicose veins, exaggerated curves in our spine, and it also pulls on our pelvic organs which can lead to incontinence. As gravity pulls our bowel, bladder, and uterus out of their normal position in our pelvis, this puts added pressure on our pelvic floor muscles.


    The third factor for many women may be injury to their pelvic floor muscles as well as ligaments supporting their pelvic organs during pregnancy and childbirth. This trauma may produce immediate effects or it may be more subtle, and produce symptoms of incontinence years down the road when paired with one or more of the other factors we have discussed.


    The fourth factor is decreased activity level, which happens as we sit more throughout our days for our jobs or for relaxation. The lower our activity level, the more muscle atrophy throughout our bodies, including our pelvic floor. This is the one factor that we have most control over. Although it is natural to see a decrease in muscular strength and endurance as we age, studies have shown the ability to blunt these effects with exercises specific for any give muscular area.


    As we age we have to work against a number of natural factors that may lead to incontinence. Take comfort in knowing that we can control the effects with regular exercise and specific strengthening exercises for our pelvic floor and surrounding musculature. The great news is that exercise doesn't cost a thing, just a little bit of our time and focus.

Published On: November 16, 2009