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Prevalence of urinary incontinence (UI) in midlife is well known, but researchers have paid less attention to this distressing condition in young women who have never been pregnant. Australian investigators conducted a questionnaire-based analysis involving 1002 nulligravid students and nonstudents (mean age, 22.5). Presence of UI as well as psychological well-being were determined.
One third of respondents reported never having been sexually active. Incontinence of any type was reported by 12.6% of participants, slightly more commonly by students than nonstudents. In analysis limited to students, rates of UI varied by sexual history and use of oral contraceptives (OCs): UI rates in women who were sexually active and not using OCs (21.5%) were significantly higher than in those who had never been sexually active and were not using OCs (10.1%) or those who had ever been sexually active and were using OCs (9.7%). Multivariable analysis of OC users showed that those who were ever sexually active were twice as likely to report UI as those who had never been sexually active (P=0.007). Women with UI reported poorer psychological well-being. One half of women with UI reported restricting fluid intake and worrying about odor; more than one third of such women reported using pads.
O'Halloran T et al. Urinary incontinence in young nulligravid women: A cross-sectional analysis. Ann Intern Med 2012 Jul 17; 157:87.
Comment
The authors speculate that the higher prevalence of urinary incontinence in nulligravid, sexually active women could reflect biomechanical effects or changes in urogenital flora. As for the lower prevalence of UI among oral contraceptive users, the authors note the need for more research. However, their findings clearly show that UI is more prevalent in young nulligravid women than has been assumed, and that the symptoms cause psychological distress. In caring for this population, we should inquire about UI just as we do in older women.