Correlation Between Osteoporosis & Urinary Incontinence

How Osteoporosis can Affect Your Bladder

Osteoporosis can be defined as ‘a condition in which bones become brittle and fragile from loss of tissue, typically as a result of hormonal changes, or deficiency of calcium and/or vitamin D.’

Osteoporosis can be particularly present in the post-menopausal population. As a women’s body transitions through menopause, there is a drop in both hormones estrogen and progesterone. Estrogen is needed to help with the bone formation so without adequate levels of it, there is a decrease in bone formation, which can ultimately result in osteoporosis.

Women who have undergone menopause also tend to report an increased incidence of urinary incontinence. Both stress incontinence (leaking with any increase in abdominal pressure – laughing, coughing, sneezing, lifting, etc) and urge incontinence (leaking when feeling the urge to urinate) are common.

It is not all coincidence that there is an increase in incontinence with an increase in osteoporosis. Osteoporosis, particularly of the spine, can cause an increase in slumping posture. This slumping posture places increased stress on the abdominal contents, including the bladder. It also places increased pressure on the pelvic floor muscles. With increased pressure at the bladder and pelvic floor, it seems only natural that it would be easier to leak.

Treatment for Urinary incontinence in Women

This can lead to a vicious cycle – post-menopausal women with osteoporosis don’t want to exercise or be as physically active because it can often lead to increased incontinence. However, one of the best treatments for osteoporosis and for improving bone density is regular physical exercise. So, how does one break that cycle? There’s good research to show that physical therapy can be an integral piece in helping both urinary incontinence and osteoporosis.

In a randomized control trial study published by The Journal of North American Menopause Society, it was found that in women of post-menopausal age (55 years or older) also diagnosed with osteoporosis, there was a 75% decrease in incontinence symptoms with 12 weeks of weekly physical therapy sessions as compared to the control group who did not receive any physical therapy. This is a major improvement in a rather short period of time!

It is very important to see a pelvic health physical therapist for your incontinence prior to starting any sort of pelvic floor exercises on your own (ex: Kegels). This way, your PT can fully assess posture, breathing, movement patterns, and pelvic floor muscles. It can be detrimental at least initially to perform Kegels without an assessment as an individual may present with a high-tone pelvic floor or not understand how to properly perform contraction and ultimately causing more harm than good. Your therapist can also work with you to develop a graded strengthening program to help build up bone density and manage osteoporosis.

Unsure of how or where to start? Contact Apex Physical Therapy & Wellness Center to get an appointment set up. We’d love to see you!

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Written by:

Doctor of Physical Therapy, Board Certified Pelvic Rehabilitation Practitioner

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