April 29, 2019

Shining a Spotlight on Women’s Bladder Health

urology toilet paper

By Ansley Waters, SWHR Science Programs Intern

Women and girls are disproportionately affected by bladder health issues like urinary incontinence and urinary tract infections, which can significantly disrupt daily life. Yet many women are hesitant to talk to their health care providers due to lack of awareness and stigma around bladder conditions.

Urological health across a woman’s lifespan is an important but often overlooked topic in women’s health. SWHR convened an Interdisciplinary Network on Urological Health in Women to generate open dialogue and identify knowledge gaps and barriers to treatment and care for a variety of urological conditions that disproportionately or differently affect women.

For example, women are at increased risk for urinary tract infections (UTIs) compared to men, and over half of women will experience a UTI in her lifetime. Women are more likely than men to experience urinary incontinence (UI), and while UI tends to peak during menopause, it also affects a quarter of women aged 18-44. Cytocele (also known as a prolapsed or dropped bladder) is a urological disorder specific to women caused by a weakening of the pelvic floor.

Prevention is the optimal route when it comes to bladder conditions. Individuals can improve their bladder health with a healthy diet, regular physical activity, and adequate water intake.

SWHR’s Network on Urological Health in Women also recommends increased education on bladder health, especially for students and teachers as bladder problems developed in childhood may follow individuals into adulthood and decrease their quality of life.

To more closely examine current bladder health education and school bathroom policies, SWHR recently conducted a survey of school nurses on these topics. Less than 8% of nurses surveyed reported that their schools have a written policy on student bathroom use, more than a third said students had insufficient time to use the bathroom during breaks, and three-quarters were aware of students with bladder or bowel problems. Only a few schools provided education to students and teachers on bladder health.

More schools and educators should recognize the importance of healthy toileting habits in childhood and implement policies to improve student bladder health. Holding in urine during schools hours may lead to increased risk for UTIs, weakening of the pelvic muscles, and bladder leakage, all of which also present future health concerns.

Health care provider vigilance and early diagnosis are also crucial elements for bladder health. The chair and co-chair of SWHR’s Network on Urological Health, Drs. Elizabeth Mueller and Margot Damaser, recommended the annual well-woman visit as an excellent opportunity for providers to evaluate patients for bladder conditions. When assessing patients, providers must be cognizant of and account for the effects of sex differences in bladder health.

SWHR’s Network on Urological Health outlines these differences and the need for a better understanding of the role of biological sex in normal and abnormal urological function in a recently published a peer-reviewed paper. The paper highlights evidence of clear sex differences in the lower urinary tract, including variations in cellular composition, hormones, musculature, and microbiomes, demonstrating how sex is a risk factor for certain bladder disorders.

Visit SWHR’s website to learn more about the work of the Interdisciplinary Network on Urological Health in Women.