title: Pelvic floor symptoms and lifestyle factors in older women.
abstract: OBJECTIVE
  To measure the prevalence of pelvic floor symptoms in noncare-seeking older women and the association between symptoms and lifestyle factors.
  
  
  METHODS
  Women enrolled at one site of the Women's Health Initiative Hormone Therapy clinical trial completed a questionnaire, modified from the Pelvic Floor Distress Inventory, on bladder, bowel, and prolapse symptoms. Individual symptoms and symptom groups were examined in a cross-sectional analysis.
  
  
  RESULTS
  In the 297 women who participated, mean age was 68.2 years, mean body mass index (BMI) was 30.2 kg/m(2), and median vaginal parity was 3. The median number of symptoms endorsed was 3 (range 0-18). The most prevalent symptoms were stress urinary incontinence (51.2%), urge urinary incontinence (49.2%), urinary frequency (29.0%), straining for bowel movements (25.0%), a sense of incomplete bowel movements (34.8%), and involuntary loss of gas (33.0%). The symptom groups most frequently endorsed were stress urinary incontinence, overactive bladder, obstructive voiding, and obstructive colorectal groups (>/=1 symptom per group in 51.2%, 61.3%, 40.8%, and 48.3%, respectively). In analyses adjusted for age, BMI, caffeine ingesting, smoking, and exercise, older women more frequently reported incomplete bladder emptying (adjusted OR 3.4, 95% CI 1.3, 9.2), weak urinary stream (adjusted OR 6.4, 95% CI 2.0, 20.0), intermittent urinary stream (adjusted OR 4.0, 95% CI 1.6, 10.4), and a feeling of incomplete bowel movements (adjusted OR 2.7, 95% CI 1.2, 5.9). Women who exercised weekly had less fecal urgency (adjusted OR 0.3, 95% CI 0.2, 0.8). Coffee drinking was associated with difficulty emptying the bladder (adjusted OR 8.6, 95% CI 1.4, 55.0) and weak stream (adjusted OR 5.3, 95% CI 1.5, 19.0).
  
  
  CONCLUSIONS
  Pelvic floor symptoms, especially urinary incontinence and irritative and obstructive urinary and bowel symptoms, are common in older women. Some symptoms are associated with potentially modifiable lifestyle factors.
authors.affiliation: Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA. catherine-bradley@uiowa.edu
authors.forename: Catherine S
authors.initials: CS
authors.lastname: Bradley
authors.forename: Colleen M
authors.initials: CM
authors.lastname: Kennedy
authors.forename: Ingrid E
authors.initials: IE
authors.lastname: Nygaard
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D015444:Exercise; D005242:Fecal Incontinence / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D006304:Health Status; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D016017:Odds Ratio; D017773:Pelvic Floor; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014549:Urinary Incontinence / Q000453:epidemiology* / Q000517:prevention & control*; D014550:Urinary Incontinence, Stress / Q000453:epidemiology / Q000517:prevention & control; D016387:Women's Health