Studies have shown that decreased estrogen hormone levels during menopause cause obesity by inducing an increase in visceral and subcutaneous adipose tissue and total body adipose tissue, and obesity causes urinary incontinence. The aim of this study was to determine the frequency of urinary incontinence and the effects of health beliefs on coping methods of obese women in the menopause period.
Hypothesis: Menopausal women's health beliefs about urinary incontinence and kegel exercise affect their coping with incontinence

This study is a descriptive correlational study. The inclusion criteria for this study were being a menopausal woman aged 45-55 years with a BMI >30 and above and volunteering to participate in the study. This study was completed with 247 women who met the inclusion criteria. Descriptive Characteristics Form, Urogenital Distress Inventory and Urinary Incontinence, Frequency of Use of Non-Drug Coping Methods for Urinary Incontinence Scale and Health Belief Scale for Kegel Exercise were used to collect data. Descriptive statistics, t-test and correlation analysis were used to evaluate the data. Ethics committee approval is obtained before starting the study. All processes of the study were conducted in accordance with the principles of the Declaration of Helsinki.

The average age of the participants was 50.8±5.6 years and 92.5% were married. 43.7% of the participants stated that they had at least one urinary incontinence problem in the last one year. Only 21.4% of the participants stated that they did kegel exercises. It was found that women who entered menopause had higher perceptions of the severity, benefit and self-efficacy of urinary incontinence and kegel exercise than those who did not. It was found that the perception of the severity of urinary incontinence and kegel exercise was associated with the frequency of use of non-drug coping methods, and the use of non-drug coping methods was associated with incontinence quality of life.

It is known that urinary incontinence is highly prevalent in menopausal women. In this study, it was determined that almost half of the women in any of the menopausal periods experienced incontinence problems. Especially women in menopause seem to take the problems that may arise in case of experiencing urinary incontinence more seriously. The major concepts of the health belief model are benefit and barrier perception. The perception of high benefits and low barriers indicates that the possibility and motivation to start protective behaviors may be high. In this study, it was determined that menopausal women had high perceptions of benefits and self-efficacy. It is seen that the perception of seriousness among health beliefs is associated with non-pharmacological coping methods, and women who think that they may have problems after urinary incontinence apply non-pharmacological coping methods more to prevent incontinence as their perception of seriousness increases. Non-drug coping with urinary incontinence was found to be associated with quality of life. In general, it is known that physician referral due to urinary incontinence is low. Therefore, it is thought that women frequently use non-drug coping methods to improve their quality of life.

Urinary incontinence is frequently seen in menopausal women. Knowing the health beliefs about urinary incontinence and kegel exercise and the frequency of use of non-pharmacologic coping methods will be guiding in preventive applications to be made in this direction. In particular, perceptions of benefit and self-efficacy among health beliefs are important determinants in the adoption and implementation of preventive behaviors. It may be recommended that physicians, nurses and other healthcare professionals working in this field should take this issue into consideration.

Aydin Avci, I., Öz Yildirim, Ö., Yildirim, E., & Bulgak, M. (2022). Non-medication coping strategies for urinary incontinence in older adults: factors associated with frequency of use. International Urogynecology Journal, 1-7.
Avci, I, A. & Yildirim, Ö. Ö. (2019). Validity Reliability Study of Health Belief Scale for Urinary Incontinence and Kegel Exercise. 4th International Symposium on Innovative Approaches in Health and Sports Sciences, Samsun,Turkey.
I. Milsom & M. Gyhagen (2019) The prevalence of urinary incontinence, Climacteric, 22:3, 217-222, DOI: 10.1080/13697137.2018.1543263