Age and phytoestrogen use, but not resilience, influence urinary incontinence in postmenopausal women.

Background: The aim of this study was to determine factors involved in urinary incontinence (UI), and psychological resilience in postmenopausal women.

Methods: In this cross-sectional study, 137 postmenopausal women (aged 50-75 years) filled out the 4-item International Consultation on Incontinence Questionnaire short form (ICIQ-SF), the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10), the 10-item Connor-Davidson Resilience Scale (CD-RISC), and a questionnaire containing personal data. We designed a directed acyclic graph (DAG) to identify covariates related to urinary incontinence and resilience in postmenopausal women.

Results: The mean age of all surveyed women was 58.7±5.1 years, the majority were Caucasian (92.7%). There was an inverse correlation between item-1 ICIQ-SF scores and CD-RISC Scores. Women with severe UI had a higher median total ICIQ-SF score and lower total CD-RISC Scores as compared to those with nil or mild (P<0.05 for both). Odds ratios of sociodemographic and clinical characteristics indicate that phytoestrogen use (OR: 10.80; 95% CI 2.42-48.13) and economic problems (OR: 2.46; 95% CI 1.22-4.93) were associated with UI. However, a multivariable logistic model only identified urinary incontinence significantly associated with phytoestrogen use and age (P<0.05). The effect of other variables was attenuated in the model when controlling for population confounders, and significance was not achieved.

Conclusions: Urinary incontinence was significantly associated with economic problems, phytoestrogen use, and depressive symptoms compared to women without urinary complaints. The multivariable logistic model confirmed age and phytoestrogen use as causal factors for urinary incontinence.