Urinary incontinence affects up to half of menopausal women, with the highest prevalence observed for stress urinary incontinence (50%), followed by mixed (up to 40%) and urge urinary incontinence (up to 20%). This condition significantly impacts not only the physical but also the psychological well-being of patients, leading to insecurity, shame, depression, and social isolation [1]. Patients’ willingness to perform daily home activities is essential for maintaining independence, while engagement in social and outdoor activities is crucial for emotional well-being. The aim of this study was to identify factors most strongly influencing psychosocial functioning and to assess the relevance of modifiable factors in urinary incontinence severity.

The study included 87 adult women reporting moderate or severe urinary incontinence (stress urinary incontinence – 31%, urge urinary incontinence – 24%, mixed urinary incontinence – 45%). Participants completed self-reported questionnaires, including the Urinary Distress Inventory (UDI-6), Incontinence Quality of Life Questionnaire (I-QOL), and the Incontinence Impact Questionnaire Short Form (IIQ-7). All participants underwent medical history screening and gynecological examination.

Almost half of all patients (47%) report not feeling comfortable to be out of the house for a long time due to UI, 52% disclose that leakage impacts their domestic chores. 
The range of extradomestic activity disturbances were highly affecting social functioning: 82% of women were avoiding physical recreation of certain types due to leakage, 75% of them abstain from or  reduce entertainment activities.

Associations between clinical factors and ordered questionnaire responses were evaluated using ordinal logistic regression; coefficient signs indicated the direction of the association, whereas coefficient magnitudes should be interpreted with caution, as they depend on variable coding and measurement scale.

Among all incontinent patients, higher BMI was significantly associated with increased feelings of helplessness (β = 0.096, p = 0.035). Also, it was observed that women with depression tend to think about urinary incontinence more frequently (β = 1.50, p = 0.027).
In our study, we found no associations between amount of fluid and limiting behaviors, psychosocial impacts or social embarrassment across SUI, UUI and MUI patients. However, in the SUI group (N = 26), the amount of administered fluids tended to be lower in patients with higher overall I-QOL score, although the association did not reach statistical significance (Spearman ρ = -0.348, p = 0.081).
Importantly, patients’ higher BMI had an impact on a greater tendency to avoid social interactions (β = 0.114, p = 0.015).

The daily functioning of incontinent women is influenced by the fear of leakage in the domestic and extradomestic activities. There are modifiable factors that may reduce the risk of ruminations and improve patients' well-being.
Additionally, results show that lack of various forms of activity and social connections may lead to a vicious circle of worsening of the quality of life and escalating anxiety.
Although the current study did not report liquid restriction, the patients’ behavior was consistent with a pattern of deliberate, restricted, and goal-oriented fluid consumption that has already been described in the literature [2].

Modifiable factors—particularly BMI and depressive symptoms—appear to play a key role in both the severity of urinary incontinence and its psychosocial impact, highlighting the importance of integrated, multidisciplinary management strategies

Debus G, Kästner R. Psychosomatic Aspects of Urinary Incontinence in Women. Geburtshilfe Frauenheilkd. 2015 Feb;75(2):165-169. doi: 10.1055/s-0034-1396257. PMID: 25797959; PMCID: PMC4361165.
Pavlovska O, Savelyeva O, Pavlovska K. Fluid intake schedule as a possible risk-stratification factor for urinary incontinence in women during menopause. Prz Menopauzalny. 2025 Dec;24(4):244-250. doi: 10.5114/pm.2025.157952. Epub 2025 Dec 19. PMID: 41694182; PMCID: PMC12895547.