Abstract
Sexual health is important to the self worth, emotional well being, and overall quality of life of women in midlife. However, urinary incontinence, which is prevalent in this population, has a negative impact on sexual function. The purpose of this article is to review the impact of urinary incontinence on female sexual dysfunction and discuss the impact of urinary incontinence treatment on sexual function. We carried out a literature review on the effect of stress urinary incontinence and urgency urinary incontinence on sexual health and physiological response, including coital incontinence, satisfaction, desire, orgasm, frequency, and partner relationships. We examined the literature regarding changes in sexual function related to non-surgical and surgical interventions for incontinence. Overall, though studies are lacking and of poor quality, treatment of incontinence has been shown to improve sexual function. Both pelvic muscle training and midurethral slings have been shown to improve sexual function in those with stress urinary incontinence. In urgency urinary incontinence, evidence indicates improvement in sexual function after treatment with anti-muscarinic medications. Coital incontinence commonly improves with treatment of the underlying incontinence subtype. Although problems related to sexual health are complex and involve both psychological and physical factors, it is important to consider treatment of urinary incontinence as part of management of sexual dysfunction.
Highlights
Urinary incontinence (UI) is a common condition, with reported prevalence ranging from 28 to 47 % in women during midlife [1, 2]
Common types of incontinence include stress incontinence, urgency urinary incontinence, and mixed incontinence
There is significant data to support that urinary incontinence is detrimental to sexual function, especially in women in midlife
Summary
Urinary incontinence (UI) is a common condition, with reported prevalence ranging from 28 to 47 % in women during midlife [1, 2]. Stress urinary incontinence is the most common type of urinary incontinence, accounting for 52 - 65 % of urinary incontinence in women aged 30 to 60 [4]. Treatment of stress UI is primarily surgical, while urgency urinary incontinence, a common problem that may affect 20 % of middle-aged women [5], is mainly treated with non-surgical options. In those with mixed urinary incontinence, the most bothersome and dominant incontinence type is treated first. Coital incontinence, the leakage of urine during sexual intercourse, may have the most impact on sexual health and commonly occurs in women with any type of incontinence, with an overall prevalence from 11 to 60 % in middle-aged women with UI [6]
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