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Consequences of incontinence for women during the menopausal transition and early postmenopause: observations from the Seattle Midlife Women’s Health Study

Woods, Nancy Fugate PhD, RN, FAAN; Mitchell, Ellen Sullivan PhD

Menopause: The Journal of The North American Menopause Society: September 2013 - Volume 20 - Issue 9 - p 915–921
doi: 10.1097/GME.0b013e318284481a
Original Articles

Objective Although urinary incontinence becomes more prevalent as women age, little is known about the outcomes of urinary incontinence in midlife women. Our aim was to determine the effects of urinary incontinence (stress and urge) on mood (depressed mood, anxiety), perceptions of self (self-esteem, mastery, perceived health), attitudes toward midlife (attitudes toward aging, attitudes toward menopause), and consequences for daily living (interference with relationships, interference with work, sexual desire, physical activity, awakening at night, social support, stress), taking into account the effects of aging

Methods A subset of Seattle Midlife Women’s Health Study participants (n = 299, with up to 2,206 observations) provided data during the late reproductive stage, early menopausal transition, late menopausal transition, and early postmenopause, including menstrual calendars, annual health questionnaire since 1990, and symptom diaries. Multilevel modeling (R program) was used to test models accounting for urinary incontinence outcomes.

Results Stress urinary incontinence and urge urinary incontinence were significantly associated with lower self-esteem (P = 0.01 and P = 0.001, respectively) and mastery (P < 0.001, stress urinary incontinence and urge urinary incontinence), with age included in the models as a measure of time. Urinary incontinence’s effects on mood symptoms, attitudes toward aging, attitudes toward menopause, perceived health, and consequences for daily living were not significant (P > 0.05).

Conclusions Urinary incontinence during the menopausal transition and early postmenopause seems to affect perceptions of self—but not mood, attitudes toward midlife, or consequences for daily living—in this midlife population. Appropriate therapies for urinary incontinence during midlife may promote higher levels of self-esteem and a greater sense of mastery by older women.

From the University of Washington, School of Nursing, Seattle, WA.

Received September 1, 2012; revised and accepted December 20, 2012.

Funding/support: Data reported here were collected with support from National Institute of Nursing Research grants P50-NU02323, P30-NR04001, and R01-NR0414. Data analysis for this article was supported by a grant from Pfizer Pharmaceuticals.

Financial disclosure/conflicts of interest: N.F.W. reports board membership in Procter and Gamble.

Address correspondence to: Nancy Fugate Woods, PhD, RN, FAAN, University of Washington, Seattle, WA. E-mail:

© 2013 by The North American Menopause Society.