Impact of Eating Disorders on Women's Bladder and Pelvic Floor Health

In a recent interview, Aleece Fosnight, MSPAS, PA-C, CSC-S, CSE, IF, MSCP, HAES, a prominent figure in the field of sexual health, discussed the significant relationship between eating disorders and urinary incontinence in women. The discussion centers on how conditions such as anorexia nervosa, bulimia nervosa, and other specified feeding or eating disorders lead to bladder dysfunction, particularly among elite female athletes. This connection is underscored by alarming statistics indicating that approximately 50% of women with disordered eating experience stress urinary incontinence, while about 20% face urge incontinence.

Fosnight, who is the founder of the Fosnight Center for Sexual Health and serves as a medical advisor for Aeroflow Urology, elaborated on the physiological ramifications of long-term eating disorders. According to her, chronic malnutrition can result in hormonal disturbances, notably hypoestrogenism, which adversely affects the pelvic floor muscles and lower urinary tract tissues. This condition bears resemblance to hormonal declines typical in perimenopause and menopause, leading to increased risks of incontinence due to weakened pelvic floor support.

Additionally, Fosnight pointed out that electrolyte imbalances and dehydration can impair the detrusor muscle function and the neural control of the bladder. This results in symptoms such as urgency and increased frequency of urination. The impact of bowel health is also significant; constipation, which is common among individuals suffering from malnutrition, can exert additional pressure on the bladder, complicating normal voiding processes.

Fluid intake behaviors associated with eating disorders, whether through restriction or excessive consumption, can further exacerbate bladder irritation and related symptoms. Fosnight emphasized that psychological factors, including a heightened need for control and anxiety, often lead to dysfunctional voiding habits and increased pelvic floor muscle tone. This psychological dimension is particularly prevalent among female athletes, complicating their bladder health even further.

The implications of these findings are profound. Women suffering from eating disorders may face compounded health issues that extend beyond the physical, intertwining with mental health challenges that require comprehensive treatment approaches. As healthcare providers gain awareness of this intricate connection, it becomes imperative to address both the physical and psychological aspects of care in managing eating disorders and their associated complications.

In the broader context, the relationship between eating disorders and urinary health is not just a women's health issue but a public health concern demanding attention from multiple disciplines, including urology, psychology, and nutrition. Future research and clinical practices must prioritize a multidisciplinary approach to effectively address these intertwined health challenges.

This urgent need for integrated care underscores the importance of ongoing education and training for healthcare professionals in recognizing the signs of eating disorders and their potential effects on bladder and pelvic health. As Fosnight's insights illustrate, the path to improving women's health in this area necessitates an understanding of how eating disorders can influence urinary health and a commitment to providing holistic care that encompasses both medical and psychological support.