Continence

Strengthen your inside - young women and the importance of the pelvic floor

A report of a health promotion pilot project aimed at developing and evaluating strategies for raising awareness and preventing the development of continence problems in young women who attend gymnasiums

Sarah Brown, Christine Ferlazzo, Vicki Tsianakas,
Women's Health Victoria, 2002,
Book 44 pages ISBN 0 9577744 7 8

The Strengthen Your Inside! project, undertaken by Women’s Health Victoria, was funded by the Federal Government’s Department of Health and Aged Care as part of the National Continence Management Strategy (NCMS). The information contained here is a summary of some of the key elements of the report. Copies of the full report are available electronically in full text (PDF 550KB) or by phoning Women's Health Victoria on 9662 3755 or by email whv@whv.org.au.

Our project was concerned with raising awareness of continence-related issues and preventing ‘stress incontinence’ in young women by promoting regular use of pelvic floor exercises (PFE).

The program was designed to work in an innovative service delivery area, namely that of women-only gymnasiums, by providing education and information on continence issues to a targeted group. The project’s approach was designed to address continence issues with fitness professionals and their clients.

Some of the key points identified from the literature review:

Women of all ages can experience involuntary loss of urine when stress or pressure is placed on the pelvic floor if their pelvic floor muscles are not strong

Prevalence rates for young women experiencing urinary incontinence vary between three per cent and 51 per cent.

In studies of physically active women, prevalence rates are quite high. Thirty-five per cent of female physical education students aged 18-27 years and 28 per cent of nulliparous women who exercise may experience some degree of incontinence.

Participation in sport and exercise has been shown as an independent risk factor for incontinence.

High-risk activities are those forms of exercise and sport that mostly involve substantial jumping and running that generate repeated and excessive increases in intra-abdominal pressure that are transmitted to the bladder.

There is substantial evidence supporting pelvic floor exercises, which involve the voluntary contraction of the pelvic floor muscles, as a preventive intervention for stress incontinence in women of all ages.

Some of the findings from the project:

Overall, young women’s understanding of the role of the pelvic floor and bladder control is good with the exception that only a small percentage held the accurate belief that certain exercises could aggravate bladder control issues.

The majority of young women are not familiar with the term ‘Kegel’ exercises (Kegel refers to the name of the person who devised the exercises).

Thirty per cent of the young women involved in our project had experienced bladder leakage and this is similar to the prevalence rates identified in other studies of physically active young women.

Approximately one half of the young women had learned how to perform pelvic floor exercises as a result of the project, which demonstrates that women are receptive to such health promoting activities in the gymnasium setting.

Both the women and fitness instructors expressed that a women-only environment was seen as an important factor for learning pelvic floor exercises, particularly because continence promotion is of a delicate nature.

Some implications for future practice:

Pelvic floor exercises and continence promotion need to be reinforced to all women, at all ages, in a variety of settings.

School nurses, health practitioners and fitness instructors are in a prime position to introduce health-promoting messages in all non-clinical settings and health and fitness assessments.

Pelvic floor exercises should be taught as a matter of course in all types of fitness classes and taught on a one-to-one basis at each new individual program prescription.

It is important that accessible language is used when delivering the continence promotion message.

Go to Continence introductory page.