Aug. 29, 2000 -- Urinary incontinence is a common problem for many older women. Frequent, uncontrolled leaking of urine from the bladder causes many women to avoid activities that were once enjoyable, including exercise and sex.
A variety of treatment options are available for women with this problem, including urinating on a timed schedule to "retrain" the bladder, surgery, and pelvic floor muscle exercises. The latter, known as Kegel exercises, involve strengthening weakened pelvic muscles by contracting and releasing them.
"The real issue with [Kegel exercises] is it takes a fair amount of effort on the patient's part," says urologist Jenny Franke, MD, of Vanderbilt University School of Medicine in Nashville. "When I examine a patient, part of that examination involves seeing whether they can isolate the pelvic floor and contract those muscles, and, if they're able to do that, I have some written instructions, and I give them some little techniques to help them remember to do the exercises."
Franke says simple, self-adhesive notes left on the dashboard of your car or on your TV can be a big help. "I try to get them to use what I would otherwise consider wasted time: sitting at a stoplight or watching a commercial. They can do their exercises during that time and then it becomes a routine."
A new study from Norway shows that the exercises help women get back to doing social or physical activities that they enjoy.
The 59 women in the study were randomly assigned to either Kegel exercises or a group that did not do the exercises at all. The women's average age was about 50 years.
In addition to a weekly exercise class and a monthly evaluation, the women in the study were instructed to do the Kegel exercises three times per day in sets of eight to 12. They were to hold each contraction for six to eight seconds with a rest period of six seconds between contractions. The authors note that not all women will benefit from Kegel exercises. Nevertheless, for those who find the exercises beneficial, experts say it takes six to 12 weeks of doing them regularly to notice a difference in bladder control.
The researchers say before doing the exercises, over 87% of women reported that urinary incontinence prevented them from participating in some physical activities. That number greatly improved in the women who did the exercises.
And, improvement in incontinence also can translate into improvements in sex life. After six months of doing Kegel exercises, one-third fewer women reported that incontinence interfered in their sex life, write Kari Bø, PhD, and colleagues from the Norwegian University of Sport and Physical Education in Oslo.
Pain with intercourse also was affected. At the start of the study, 33% of women assigned to the exercises and 20% of those not assigned reported pain during sex. After treatment, those figures dropped to about 10% in the exercise group and rose to 33% in the control. Leakage of urine during intercourse also improved in the women who did the exercises.
Franke, who was not involved in the study, says the findings are important for patients, even though many women with incontinence don't talk about sexual problems with their doctors.
"Most women, even to a female physician, don't talk a lot about sexual satisfaction," she tells WebMD. "It doesn't surprise me that the Kegel [exercises] led to improved sexual satisfaction, and I think this is probably a relatively new finding."
The study was published in the July issue of a Scandinavian medical journal, Acta Obstetricia et Gynecologia Scandinavica.