New studies reveal that participating in low-impact exercise classes for 12 weeks can significantly decrease daily occurrences of urinary incontinence by over 50%.
Women in their later years experiencing urinary incontinence may find relief through consistent low-impact exercise, as yoga alongside stretching and strengthening routines shows promising results in recent research published on August 27 in Annals of Internal Medicine.
The study, directed by researchers at Stanford Medicine and the University of California, San Francisco, forms part of a broader initiative aimed at discovering low-risk and affordable solutions for treating one of the prevalent health issues women encounter as they age.
Participants who engaged in a 12-week low-impact yoga program reported a roughly 65% reduction in incontinence episodes. Likewise, women in a control group participating in a combination of stretching and strengthening exercises noted similar improvements over the same timeframe. Researchers indicated that these outcomes are comparable to the effectiveness of medications designed for incontinence treatment.
“We focused on a yoga approach that is accessible to almost everyone, with modifications for different abilities,” stated Leslee Subak, MD, the lead researcher and chair of obstetrics and gynecology at Stanford Medicine. “It’s fantastic that it’s safe, affordable, doesn’t necessitate a doctor’s prescription, and is available anywhere.” Given that the trial occurred partly during the COVID-19 pandemic, many participants attended their yoga or exercise sessions online, allowing them to practice in their own homes, she added.
The study’s primary author is Alison Huang, MD, who holds professorships in medicine, urology, and epidemiology and biostatistics at UCSF.
Urinary incontinence affects over half of middle-aged women and up to 80% of women aged 80 and older, often leading to issues such as social isolation and an increased risk of bone fractures from falls. However, solutions exist.
“One of the barriers is the stigma surrounding incontinence; it’s often not discussed openly,” Subak remarked, the Katharine Dexter McCormick and Stanley McCormick Memorial Professor III. “There’s a misconception that it’s a normal part of aging. While very common, it’s not unavoidable, and there are effective treatment options available.”
Tackling a widespread issue
Incontinence should receive adequate treatment because of its significant impact on individuals’ daily lives.
“It compromises independence,” Subak said. “My patients often tell me, ‘I can’t stay over with my kids or grandkids for fear of wetting the bed, but talking about this is too humiliating.'”
Many patients may shy away from activities that could enhance their quality of life, such as exercising or socializing, and may be more susceptible to nursing home admissions and severe health issues like hip fractures.
“Incontinence and overactive bladder contribute significantly to the risk of falls and fractures in older women,” Subak explained. “If you have to rush to the bathroom at night in the dark, it increases the likelihood of tripping and breaking a hip.”
While some risk factors for incontinence, like aging or childbirth, can’t be altered, others can be managed.
“A lot of my research has concentrated on the roles of weight management and physical activity as effective treatments,” Subak said. Her interest in yogic approaches arose from patients reporting positive changes.
Physical activity is beneficial
The research involved a comparison of two 12-week exercise regimens: 121 participants practiced yoga, while 119 were part of a general physical conditioning control group. All participants experienced urinary incontinence symptoms at least once daily and were aged between 45 and 90, with an average age of 62.
In the yoga sessions, participants engaged in 16 hatha yoga poses aimed at strengthening the pelvic floor, participating in two 90-minute classes weekly. The pelvic floor muscles support pelvic organs, including the bladder and urethra. Participants were also encouraged to practice yoga for at least an hour each week outside of class and to keep a practice log.
The control group spent equal time in exercise classes focused on general stretching and strengthening exercises that did not target the pelvic floor. They, too, were asked to practice for an additional hour weekly and maintain a practice log.
The study started with in-person classes but switched to an online format due to COVID-19 lockdown measures.
Participants documented instances of urine leakage and categorized whether each incident was urgency incontinence (triggered by an overactive bladder) or stress incontinence (resulting from abdominal pressure during actions like coughing or sneezing). They also filled out standardized questionnaires regarding their bladder health.
At the outset of the study, participants experienced an average of 3.4 daily incontinence episodes, comprising 1.9 urgency-related events and 1.4 stress-related events.
By the conclusion of the 12-week programs, those in the yoga group generally noted 2.3 fewer incontinence episodes daily, while the control group recorded 1.9 fewer. Both methods proved to be equally effective in reducing incontinence episodes by around 60%, providing meaningful improvements, according to Subak. Women interested in these techniques can look for low-impact Iyengar yoga or similar exercise classes locally or online, with instructors likely able to tailor sessions to individual physical needs.
“I’m amazed by the substantial impact of exercise and how well yoga performed,” Subak added. “A key takeaway from this study is ‘Stay active!'”
Other non-surgical treatments for incontinence, including medications, generally lead to a 30% to 70% enhancement in symptoms, she noted.
If a patient asked about the potential of yoga for managing incontinence, “I would certainly encourage them to give it a try,” Subak said. “It’s very low risk, and there could be benefits not just for incontinence but also for overall health and wellness.”
The study was supported by the National Institutes of Health (grants R01AG050588, R01DK116712-04S1, and K24AG068601), with additional contributions from researchers at Yale University and San Francisco State University.
