Urologic Diseases Research Updates
Winter 2009

Research News

Pelvic Floor Disorders Affect Almost a Quarter of U.S. Women

Nearly 25 percent of U.S. women are affected by pelvic floor disorders, according to a study funded by the National Institutes of Health.

The Pelvic Floor Disorders Network (PFDN)—a collaboration of U.S. health care providers and researchers working to improve the care and daily lives of women with pelvic floor disorders—submitted questions about pelvic floor disorders for inclusion in the 2005–2006 National Health and Nutrition Examination Survey (NHANES). NHANES is a periodic survey of the U.S. population conducted by the Centers for Disease Control and Prevention’s National Center for Health Statistics.

Almost 2,000 women—all 20 or older and not pregnant—answered questions about symptoms of pelvic floor disorders and underwent standardized physical examinations. The results, reported in the September 17, 2008, Journal of the American Medical Association, are the first to document the extent of pelvic floor disorders in a nationally representative sample.

The study was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the Office of Research on Women’s Health, with additional funding from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

The three main pelvic floor disorders are urinary incontinence (UI), fecal incontinence, and pelvic organ prolapse (POP). Pelvic floor disorders arise when the muscles and ligaments that form a sling across a woman’s pelvic opening weaken or are injured. In POP, organs such as the uterus, bladder, and bowel collapse onto the vagina and cause a bulge through the vaginal canal, which can cause discomfort. All three disorders can make physical activity difficult and interfere with sexual function.

Age, Weight, and Childbirth

Overall, about 24 percent of women reported moderate to severe symptoms of at least one pelvic floor disorder, according to the study. About 16 percent experienced UI, 9 percent experienced fecal incontinence, and 3 percent experienced POP.

“Pelvic floor disorders affect a substantial proportion of women and increase with age,” said lead study author Ingrid Nygaard, M.D., professor of urogynecology at the University of Utah School of Medicine.

According to the study, pelvic floor disorders affect about 10 percent of women ages 20 to 39, 27 percent of women ages 40 to 59, 37 percent of women ages 60 to 79, and nearly half of women age 80 or older.

Weight plays a role, too. Pelvic floor disorders affect 15 percent of underweight women, 26 percent of normal-weight women, and 30 percent of overweight and obese women, according to the study.

Pelvic floor disorders also correlate with the number of times a woman has given birth. Prevalences of UI and POP were twice as high among women who had twice given birth vaginally compared with women who had never given birth vaginally, according to the study.

“The study results underscore the need to identify the causes of pelvic floor disorders and the means to prevent and treat them,” said NICHD Director Duane Alexander, M.D.

The NIDDK Information Clearinghouse has free publications about pelvic floor disorders at www.kidney.niddk.nih.gov/kudiseases/a-z.asp#p. For information about the PFDN, go to www.nichd.nih.gov/health/topics/Pelvic_Floor_Disorders.cfm.

NIH Publication No. 09–5743
March 2009

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