Urinary incontinence, particularly postpartum and post-menopausal, is a condition many women experience. Despite its prevalence, it is important to debunk the myth that urinary incontinence is a normal consequence of childbirth and aging. Understanding its commonality and the effectiveness of conservative management, particularly pelvic floor physical therapy, is essential for addressing and treating this issue.

The Prevalence of Postpartum Urinary Incontinence

Postpartum urinary incontinence is a widespread issue, affecting a significant number of women after childbirth. Studies indicate that up to 38% of women experience urinary incontinence during pregnancy, and about 30% continue to suffer from it postpartum. Despite these high numbers, it is crucial to recognize that while common, urinary incontinence is not a normal condition and should not be accepted as an inevitable part of motherhood.

The Prevalence of Urinary Incontinence in Peri-Menopause

Peri-menopause, the transition period leading up to menopause, is characterized by fluctuating hormone levels, particularly estrogen. These hormonal changes can weaken the pelvic floor muscles and affect bladder function, leading to urinary incontinence. Studies show that approximately 30-60% of peri-menopausal women report experiencing urinary incontinence. Despite these high numbers, it is important to recognize that urinary incontinence is not a normal condition and can be treated.

Why Urinary Incontinence is Abnormal

Urinary incontinence is often perceived as a natural outcome of childbirth and aging due to the significant physical changes and stress the body undergoes during pregnancy and delivery and then as hormones change later in life. However, this condition is abnormal and indicates dysfunction in the pelvic floor muscles and support structures. Accepting urinary incontinence as normal can lead to untreated symptoms, reduced quality of life, and unnecessary suffering.

Effective Conservative Management

The good news is that conservative management of urinary incontinence has proven to be highly effective. Various non-invasive methods can significantly improve symptoms and restore normal bladder function. Here are some key conservative management strategies supported by literature:

  1. Lifestyle Modifications: Adjustments such as weight management, fluid intake regulation, and dietary changes can reduce the severity of incontinence.
  2. Bladder Training: Techniques that involve scheduled voiding and delayed urination can help retrain the bladder to hold urine for longer periods.
  3. Pelvic Floor Muscle Training (PFMT): Regular exercises to strengthen the pelvic floor muscles can dramatically improve bladder control.
Understanding Urinary Incontinence

Pelvic Floor Physical Therapy: The Primary Treatment Intervention

Among conservative management techniques, pelvic floor physical therapy (PFPT) stands out as the primary treatment intervention for postpartum urinary incontinence. PFPT focuses on assessing and rehabilitating the pelvic floor muscles, which play a critical role in bladder control. Here’s how it works and why it’s effective:

  1. Individualized Assessment: A pelvic floor physical therapist conducts a thorough assessment to identify specific weaknesses or dysfunctions in the pelvic floor muscles.
  2. Tailored Exercise Programs: Based on the assessment, the therapist designs a customized exercise program aimed at strengthening and coordinating the pelvic floor muscles.
  3. Biofeedback and Manual Therapy: Techniques such as biofeedback help patients become more aware of their pelvic floor muscles, while manual therapy can address muscle imbalances and tension.
  4. Education and Support: Patients receive education on proper pelvic floor function and techniques to prevent future issues, alongside ongoing support and monitoring.

Evidence Supporting Pelvic Floor Physical Therapy

Numerous studies have demonstrated the effectiveness of pelvic floor physical therapy in treating urinary incontinence. Research highlights include:

  • A systematic review published in the Cochrane Database of Systematic Reviews found that women who engaged in pelvic floor muscle training were 17 times more likely to report improvement or cure of their symptoms compared to those who did not perform the exercises.
  • Another study in the International Urogynecology Journal showed that pelvic floor physical therapy significantly reduced the frequency and severity of urinary incontinence episodes.


While urinary incontinence is a common postpartum/menopausal condition, it is not normal and should not be accepted as an unavoidable consequence of childbirth or aging. Conservative management, particularly pelvic floor physical therapy, offers effective solutions for treating this condition. By seeking appropriate treatment, women can regain control of their bladder function, improve their quality of life, and prevent future issues. If you or someone you know is experiencing urinary incontinence, consider consulting a pelvic floor physical therapist to explore the benefits of personalized, evidence-based care.

About the Author

Dr. Sarah Koehl is a Doctor of Physical Therapy looking to make a difference in the health and well-being of the people in her community. She loves to educate patients to empower them in taking control of their health and reaching their goals including those with acute and chronic orthopedic conditions, pelvic floor dysfunction, and neurological conditions.