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Call for awareness that urinary incontinence can affect sexual desire and function

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Urinary incontinence in later life can negatively impact on the sexual health of both men and women, sparking the need for both “taboo” subjects to be discussed by health professionals in consultations, according to UK researchers.

Their new study findings have revealed a mixed picture on the impact of urinary incontinence on sexual activities, difficulties and satisfaction for both older men and women.

“Health professionals should be aware of the potential impacts on quality of life and wellbeing”

David Lee

It found women with urinary incontinence reported declines in sexual activity and arousal, as well as increased concern about their frequency of sexual activity and ability to become sexually aroused.

Meanwhile, men with urinary incontinence reported declines in sexual desire, increased erectile and orgasm difficulties, and concern about these sexual functions.

The study, one of the first of its kind, was carried out by academics from Manchester Metropolitan University and was published in the journal BJU International.

It used data from the English Longitudinal Study of Ageing (ELSA). Questionnaire responses were included from 3,805 individuals aged 50-90+ living on topics about ageing, health and sexuality.

Researchers found 20% of women and 7% of men reported having urinary incontinence in the last 12 months, although these proportions increased markedly with age.

They highlighted that their study explored the link between urinary incontinence and sexual health among generally healthy, community-dwelling older adults.

“We need to reinforce the importance of asking about sexual health in clinical assessment”

David Lee

Previous research on the issue had tended to focus on non-representative groups or patients attending genitourinary clinics, they noted.

The new study showed incontinence was most consistently linked with greater reported declines in sexual activity and function, and also worries about the frequency of sexual activities and function.

Significant associations between incontinence and reported difficulties achieving orgasm were observed in both sexes, as well as functional difficulties like vaginal dryness and erectile difficulties.

Higher levels of depression were also strongly related to both urinary incontinence and poorer sexual health.

The researchers suggested that this may be partly driven by negative effects of urinary incontinence on quality of life due to leakage, odour, anxiety and embarrassment.

Lead study author Dr David Lee said: “While not life-threatening, urinary incontinence is associated with social isolation, depression and reduced quality of life.

“And sexual health and satisfaction are increasingly recognised as positive indicators of quality of life and emotional well-being in older people,” he noted.

Manchester Metropolitan University, Manchester

David Lee

David Lee

Dr Lee said: “Healthcare professionals should be aware of the potential impacts on quality of life and wellbeing, and recognise that sexual activity and satisfaction are key factors in this equation.

“We need to reinforce the importance of asking about sexual health in clinical assessment, given the ‘taboo’ nature of both issues,” he said.

He added: “An increased recognition of the close relationship between incontinence and sexual health could result in more inclusive treatment options being offered to improve both outcomes.”

The ELSA study was funded by the US National Institute on Ageing and a consortium of UK government departments including the Department of Health and Social Care.

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