Impact of urinary incontinence on sexual functioning in community-dwelling older women

Knowledge on the sexual health of patients with urinary incontinence in primary care is scarce; therefore, the impact of urinary incontinence on sexual functioning was examined in community-dwelling older women.

The aim of this study was to provide primary health care professionals with more information on the sexual health of older women with urinary incontinence, which can be used to discuss this sensitive topic during a consultation.

A cross-sectional survey among the 350 women aged ≥55 years participating in a primary care trial on urinary incontinence was conducted.

Among patients with a partner, sexual problems of the sexually active patients were described as well as reasons for not being sexually active. A multivariate logistic regression model was performed to identify factors that are predictors of sexual activity, and odds ratios (ORs) and 95% confidence intervals (CIs) were estimated.

Of all participants with a partner, 68% (95% CI: 61-74) were sexually active. Of these, 25% (95% CI: 17-35) felt restricted in (or avoided) sexual activity because of their urinary incontinence. Urine leakage during sexual activity was present in 26% (95% CI: 19-34). The most frequent reason for not being sexually active was a physical problem of their partner (28%, 95% CI: 18-40); only 5% (95%-CI: 2-13) reported that urinary incontinence was a reason for not having sex. Increasing age was the only independent (negative) predictor of sexual activity (OR: 0.95, 95%-CI: 0.90-1.00).

Most of these older women with urinary incontinence were sexually active, if they had a partner. The main reason for not being sexually active was a partner-related problem. Although for only 5% was urinary incontinence the main reason for not having sex, about 25% of the sexually active women reported a negative influence of urine loss on their sex life. This implies that assessing sexual function is relevant in older women with urinary incontinence.