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Why To Do Yoga Today: For Older Women, Less Leakage

In yoga circles, the pelvic floor is the new core.

Let me explain: I've been doing yoga steadily for the past 10 years and recently I've noticed a shift in focus. There's less emphasis on pure "core" work — that is, basically, abdominal toning — and more talk about the pelvic floor, specifically, strengthening this deeper internal region of the body. If you don't get what I'm talking about, just imagine 90 minutes of kegels.

So it comes as no big surprise that a new report suggests targeted yoga can help women over 40 who suffer from urinary incontinence, which can arise from stretched, weakened or too-tight pelvic floor muscles due to childbirth, aging or other reasons.

The yoga study, by researchers at the University of California, San Francisco offers a possible path to alleviate the symptoms of urinary incontinence, notably, accidental pee leakage, without surgery, with has been associated with all kinds of problems.

From the UCSF news release:

In a study scheduled to be published on April 25, 2014 in Female Pelvic Medicine & Reconstructive Surgery, the official journal of the American Urogynecologic Society, UCSF researchers discovered that a yoga training program, designed to improve pelvic health, can help women gain more control over their urination and avoid accidental urine leakage.

"Yoga is often directed at mindful awareness, increasing relaxation, and relieving anxiety and stress," said first author Alison Huang, MD, assistant professor in the UCSF School of Medicine. "For these reasons, yoga has been directed at a variety of other conditions – metabolic syndrome or pain syndromes – but there's also a reason to think that it could help for incontinence as well."

Huang and her colleagues recruited 20 women from the Bay Area who were 40 years and older and who suffered from urinary incontinence on a daily basis. Half were randomly assigned to take part in a six-week yoga therapy program and the other half were not. The women who took part in the yoga program experienced an overall 70 percent improvement – or reduction – in the frequency of their urine leakage compared to the baseline. The control group – or the group that did not start yoga therapy – only had 13 percent improvement. Most of the observed improvement in incontinence was in stress incontinence, or urine leakage brought on by activities that increase abdominal pressure such as coughing, sneezing, and bending over.

Huang and her colleagues believe that yoga can improve urinary incontinence through more than one mechanism. Because incontinence is associated with anxiety and depression, women suffering from incontinence may benefit from yoga's emphasis on mindful meditation and relaxation. But regular practice of yoga may also help women strengthen the muscles of the pelvic floor that support the bladder and protect against incontinence.

"We thought this would be a good opportunity for women to use yoga to become more aware of and have more control over their pelvic floor muscles," Huang said.

Approximately 25 million adults in America suffer from some form of urinary incontinence, according to the National Association for Continence. Up to 80 percent of them are women. Urinary incontinence becomes more common as women age, although many younger women also suffer from it.

"We specifically developed a yoga therapy program that would be safe for older women, including women with minor mobility limitations," Huang said. "So we were partially assessing safety of this program for older women who are at highest risk for having incontinence in the first place."

Not all types of yoga may help with urinary incontinence. The yoga program used in the study was specially designed with input from yoga consultants Leslie Howard and Judith Hanson Lasater, who have experience teaching women to practice yoga in ways that will improve their pelvic health. Still Huang and her colleagues believe that many women in the community can be taught to preserve pelvic muscle strength and prevent incontinence.

"It would be a way for women to gain more control over their pelvic floor muscles without having to go through traditional costly and time-intensive rehabilitation therapy," Huang said.

Headshot of Rachel Zimmerman

Rachel Zimmerman Reporter
Rachel Zimmerman previously reported on health and the intersection of health and business for WBUR. She is working on a memoir about rebuilding her family after her husband’s suicide. 

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