The relationship between sexual activity and urinary incontinence in older women.
OBJECTIVE
To determine whether continence status is associated with sexual activity in older women.


METHODS
Cross-sectional postal survey.


METHODS
Random selection from a list of respondents to a Canada Post survey.


METHODS
Community-dwelling women aged 55 to 95.


METHODS
The International Consultation on Incontinence Questionnaire Short Form measured the presence, severity, and type of incontinence. Sexual activity and marital status were assessed using single close-ended questions. The Medical Outcomes Study 12-item Short-Form Health Survey was used to query physical and mental health status.


RESULTS
Data from 2,361 women (mean age 71) were available for analysis. Thirty-nine percent reported urinary incontinence (UI), and 27% were sexually active. UI was associated with sexual activity in crude logistic analyses (odds ratio (OR)=0.82, 95% confidence interval (CI)=0.68-0.98) but not in multivariate models adjusted for physical and mental health. Marital status and age were the strongest predictors of sexual activity (OR 8.94, 95% CI=6.89-11.60 for married women; OR=3.09, 95% CI=2.57-3.73 for age <or=70), with significant relationships also observed with physical and mental health (OR=1.04, 95% CI=1.03-1.04 and OR=1.02, 95% CI=1.01-1.04, respectively). Frequency of UI was not related to being sexually active, although greater amounts of urine loss, stress incontinence, and nocturnal incontinence were independently associated with sexual activity (OR=0.53, 95% CI=0.33-0.85; OR=1.40 95% CI=1.01-1.94; and OR=0.24, 95% CI=0.10-0.61, respectively).


CONCLUSIONS
Many older women remain sexually active as they age regardless of continence status. Caution should be exercised in interpreting intervention studies aimed at improving sexual function in incontinent older women if marital status and physical and mental health are not considered.
Tannenbaum
Cara
C
Research Center, Institut Universitaire de Gériatrie de Montréal, Quebec, Canada. cara.tannenbaum@umontreal.ca
Corcos
Jacques
J
Assalian
Pierre
P
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D002170:Canada / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D008603:Mental Health; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012725:Sexual Behavior / Q000502:physiology*; D014549:Urinary Incontinence / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*