Do Physical and Psychological Health Impact Sexual Function in Women with Urinary Incontinence? Study Investigates
Urinary incontinence (UI) affects up to half of women in and around menopause. Women with UI tend to report more difficulty having and enjoying sex. In fact, women with UI are more likely to abstain from sex or experience lower sexual desire. UI can come in various forms:
- Urge UI: a sudden, strong need to urinate that can cause accidental leakage.
- Stress UI: involuntary urination triggered by pressure on the bladder. This is common in women who have given birth or have a weak pelvic floor.
In both peri- and post-menopause, sexual dysfunction (SD) and UI can negatively affect women’s quality of life.
Researchers in California examined whether sexual function is influenced more by bladder symptoms, physical health, or mental health. Data from a larger study was used. This specific sample included 240 patients with an average age of 62 years. The patients also suffered from stress UI, urge UI, or a mix of both.
The patients were evaluated using well-established questionnaires and physical tests. These were standardized to test for urinary symptoms, physical function, mental health, and sexual function.
About half (55%) of the women were sexually active, and the other half (45%) were not. All of them experienced UI at least daily, and the types of UI were about even between all the women:
- 9% Urge UI
- 1% Stress UI
- 8% a mix of both Urge and Stress UI
Looking Beyond Urinary Incontinence
The biggest finding was that UI did not consistently affect sexual function. They may both be associated with menopause symptoms, but it appears to be less common for UI to cause SD.
Physical function also did not contribute much to sexual function. However, the study sample did not include women with mobility issues.
The research revealed that mental health may be the largest contributor to sexual function. Specifically, depression was associated with worse sexual activity, poorer quality of sex, and less sexual satisfaction. This was true for both sexually active and inactive women.
Anxiety also played a larger role in sexual dysfunction. However, this was not as strong in sexually active women. Researchers say this may stem from anxiety over the effects of UI. They suggest that women who are not sexually active may be more anxious about accidental leakage during sexual activity, potentially leading to their avoidance of sex.
Because of this, researchers suggest that a lower frequency of UI incidents may only help improve sexual function if also associated with improvements in mental health. This follows a theory that the neurobiological effects of depression may influence the control of leakage.
The results of this study are supported by previous research. However, this is the first study to look at the effects of UI, physical abilities, and mental health on sexual function in menopausal women. Researchers recommend that a multidisciplinary care approach is needed. That is, combining treatment for UI and mental health may be effective at improving sexual function.
Key Takeaways
- UI and sexual dysfunction are common during and after menopause.
- Previous research has investigated UI and sexual function. This study explored whether urinary symptoms, physical function, or mental health were most strongly associated with sexual function.
- UI and physical function were less strongly associated with sexual function than mental health.
- Mental health had the biggest effect on sexual function, with depression showing the strongest association.
- Researchers recommend future studies that move beyond a bladder-focused model and consider other variables such as menopause, partners, and relationship quality.
- If UI is causing distress or is acting as a deterrent from sex, it may be beneficial to speak with a sexual health provider.
Resources
Yang, N., Shatkin-Margolis, A., Subak, L. L., Chesney, M., Lisha, N. E., Schembri, M., Ackerman, A. L., & Huang, A. J. (2026). Beyond the bladder: Incontinence-specific, physical, and psychological contributors to sexual function in women with urinary incontinence. The Journal of Sexual Medicine, 23(7). https://doi.org/10.1093/jsxmed/qdag175
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