Weight loss and pelvic floor dysfunction

Weight loss and management of pelvic floor dysfunction (1)

Advise women with a body mass index (BMI) over 30 kg/m2 that weight loss can help with the following symptoms associated with pelvic floor dysfunction:

• urinary incontinence
• overactive bladder
• pelvic organ prolapse.

Do not wait for women to lose weight before starting other pelvic floor dysfunction management options.

A 3% to 5% weight reduction can decrease urinary incontinence episodes by about 50%

Notes:

• evidence showed that in women with a BMI over 30 kg/m2, weight loss helped with urinary incontinence and overactive bladder
• evidence did not show any effect from weight loss on symptoms of pelvic organ prolapse - however, the NICE committee still believe that weight loss may be beneficial in the early stages of pelvic organ prolapse, because less weight would press on the pelvic organs and this could improve symptoms
• the NICE committee recommended against delaying other management options until women have lost weight because:
  • there was no evidence on the impact of weight loss for many symptoms of pelvic floor dysfunction and
  • there are other interventions that could benefit women with pelvic floor dysfunction

For more details then consult the full NICE guideline.

Reference:

1. NICE. Pelvic floor dysfunction: prevention and non-surgical management. NICE guideline NG210. Published December 2021
2. Aoki Y et al. Urinary incontinence in women. Nat Rev Dis Primers. 2017 Nov 16;3:17097.