A 12-week study shows that low-impact yoga and exercise can significantly reduce urinary incontinence episodes in older women, offering a safe, accessible alternative to medications
It’s more likely than not that personal trainers will work with female clients who deal with incontinence issues, which could be an obstacle on their path to the fitness and wellness goals. Recent research supports the belief that solutions are available, and exercise may be one of them.
A recent study led by Stanford Medicine and the University of California, San Francisco, has found that low-impact exercise programs, such as yoga and general stretching, significantly reduce urinary incontinence episodes in older women. The research, published in Annals of Internal Medicine on August 27, provides promising alternatives for women seeking non-pharmacological treatments.
A Underreported & Common Issue
Urinary incontinence affects more than half of middle-aged women and up to 80% of women over 80 and can interfere with daily activities and significantly impact quality of life. The study examined the effects of a 12-week low-impact yoga program and found a 65% reduction in incontinence episodes among participants.
“We were testing the kind of yoga that just about anyone can do, with modifications for different physical abilities,” said Dr. Leslee Subak, chair of obstetrics and gynecology at Stanford Medicine and the study’s senior author. “What I love about it is that it’s safe, inexpensive, doesn’t require a doctor and is accessible wherever you live.”
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The research set out to find cost-effective and accessible solutions for a problem that is often stigmatized and underreported. According to Subak, incontinence is mistakenly viewed as an inevitable part of aging, though treatments are available.
“Incontinence is not only common, but it also interferes with people’s lives,” Subak noted. “It takes away independence. Many women avoid staying with their children or grandchildren due to the fear and embarrassment of an accident.”
credit: MixMedia
Study Parameters
The study involved 240 women between the ages of 45 and 90, all experiencing daily incontinence. Participants were divided into two groups: one practicing 16 hatha yoga poses aimed at strengthening the pelvic floor, and the other group performing general stretching and strengthening exercises.
Both groups attended two 90-minute exercise sessions weekly and were asked to practice independently for at least an hour per week.
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Both the yoga and the control groups experienced significant improvements. Participants in the yoga group reported an average of 2.3 fewer daily incontinence episodes, while those in the general exercise group saw a reduction of 1.9 episodes per day. These results are comparable to the 30% to 70% improvement rates seen with medications for incontinence, according to the researchers.
Subak emphasized the importance of regular activity, which is good news for fitness professionals who work with this population.
“One of the take-home messages from this study is ‘Be active!’ I’m impressed that exercise did so well and that yoga did so well,” Subak added.
The benefits of physical activity, including yoga, extend beyond managing incontinence. As the study’s lead author, Dr. Alison Huang, professor at UCSF, pointed out, being physically active helps reduce the risk of other health issues, such as falls and bone fractures, which can be exacerbated by conditions like incontinence.
The study was funded by the National Institutes of Health, with contributions from researchers at Yale University and San Francisco State University.
Twenty minutes, twice a week — that’s the promise behind The Exercise Coach, where artificial intelligence and robotics are helping people rethink what a workout can look like.
“We always start with a leg press, and we get a really good workout on those hamstrings, the quads, the glutes,” said Erica Bennett, trainer at The Exercise Coach.
The workouts are designed for all ages and fitness levels, but many clients are 40 and older. That’s where maintaining strength, balance and muscle mass often becomes a bigger focus.
The proprietary “Exerbotic” machines first measure your strength and range of motion.
“The machine will then use that to create the workout for you, so that you are always spending the most time under tension and the right amount for you,” said Bennett.
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The goal is to keep muscles working continuously while the machine adjusts resistance and movement by staying within the lines of the digital graph above you.
“That’s reducing some of that wear and tear on the joints. That’s creating a little bit of a safer experience, especially for somebody who’s looking at some age-related muscle loss,” said Bennett.
Owner Chris Geiser says the technology is what first caught his attention.
“I love data, I love systems, and this had both of those, but also allowed us to help transform people’s lives, have an impact on their health,” said Geiser.
While the tech drives the workout, every session is still guided by a coach.
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The workout may be short, but it doesn’t feel easy.
The studio also incorporates balance and cognitive training to help clients maintain stability and coordination as they age.
“We don’t need to accept a casual decline of muscle mass. We can keep it up with the right level of intensity and the right frequency,” said Geiser.
For anyone who’s fallen out of an exercise routine, Geiser has a simple invitation.
“You might be surprised what your body can still do. We invite you to give it a shot,” he said.
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The Exercise Coach studio at 8425 Seasons Parkway in Woodbury, Minnesota, opens Friday.
One-on-one coach-led training is $35 to 45 dollars per session.
Scratch the surface, and you might think women have the upper hand when it comes to longevity. According to data from the Office for National Statistics, here in the UK, we live an average of 3.9 years longer than men.
Look a little closer, however, and there’s a catch. Thanks to a longstanding lack of investment in women’s health research, our underrepresentation in clinical trials and fewer treatment options designed for our bodies, we spend 25%more of our lives in ill health than men.
“For decades, hormonal fluctuations were viewed as a ‘complicating factor’ for data,” explains Elliott Roy-Highley, medical director at preventative health studio, Unbound. “As a result, modern medicine suffers from a massive sex-disaggregated data gap.”
That’s why, for women particularly, the question of longevity is not just one of living longer. Instead, our focus has to shift to ways we can stay healthier whilst we’re living: a concept known as healthspan.
The good news is that improving this metric doesn’t require expensive supplements or complicated therapies (just look at Blue Zone populations if you don’t believe me). Research shows quite clearly that a factor like regular exercise is one of the most powerful forms of health insurance we have.
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“A high level of cardiorespiratory fitness reduces the risk of dying from any cause by 53%,” explains Roy-Highley, pointing to a 2024 study in the British Journal of Sports Medicine, “whilst a high level of strength is associated with 31% reduced risk of death from any cause.”
With that in mind, we asked GP and leading longevity doctor, Dr Rhea Kotecha, to share the non-negotiable forms of exercise she believes we should prioritise in order to age well.
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For her thoughts, read on. And whilst you’re here, I recommend checking out our guides to the best longevity workouts, how to hack your longevity from home and the daily longevity habits doctors use themselves. We’ve also got a useful guide to musclespan and the habits we can all borrow from the Blue Zones.
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I’m A Longevity Doctor – These Are The Six Types Of Exercise Every Woman Should Be Doing For Healthy Ageing
How does exercise affect longevity?
When I posed this question to Dr Kotecha, her response was emphatic. “Exercise,” she says, “is the closest thing we have to a longevity drug.”
It’s a glowing endorsement for the role that movement plays in the ageing process, one repeatedly evidenced by research. “The least fit participants had roughly five times the mortality risk of the fittest,” Dr Kotecha says, referencing a 2018 study of over 122,000 adults. “To put that in perspective, being unfit was a bigger risk than being a smoker.”
But what about the risk of too much exercise? Is there a danger that we could go too far? “In theory, yes, but in practice, rarely,” says Dr Kotecha. “The risks live at the extreme end, where years of relentless overtraining can drive up stress hormones, suppress immunity and, in women, switch off the menstrual cycle and erode bone.”
Though this is critical to be aware of, Dr Kotecha says that it’s far more common for women’s health to be compromised by too little exercise. And, she says, in reality “it’s almost never the exercise itself that harms you, but the absence of recovery.”
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Are the longevity benefits of exercise different for men and women?
Due to variations in our biology, muscular and hormonal profiles, it makes sense that exercise would have a different impact on male and female bodies. And in the case of longevity, it turns out things look pretty good for us.
“Essentially, we can do more with less,” says Dr Kotecha, who shares a 2024 study published in the Journal of the American College of Cardiology, which found that women needed to exercise for around 140 minutes a week to reap maximum survival benefits, compared to 300 minutes for men. “What this means is that women get a far better return on investment,” Dr Kotecha explains.
Should your exercise habits change as you age?
It’s not all plain sailing, however. Because as we reach menopause, Dr Kotecha says our biology shifts and this impacts how we need to train. “When oestrogen withdraws, the protection it provides to our bone, muscle and cardiovascular system withdraws with it,” she explains. “This is where training has to step up to fill the gap.”
That doesn’t mean that our exercise routine has to dramatically change in midlife, nor that we have to push our bodies to breaking point. But it does mean that keeping up our fitness in a variety of ways is essential as we age. “What changes across the decades is not which pillars you train, but how you divide the budget between them,” says Dr Kotecha, who says her non-negotiable advice is to remain an all-rounder. “Think of it as a line from performance to preservation. Train now for the answer you want in the future.”
6 types for exercise for staying healthier and living longer, according to top experts:
So, how do we become this exercising all-rounder? According to Dr Kotecha, these six forms of movement are the keys to unlocking healthier ageing.
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1. Strength and resistance training
“Muscle is the organ of longevity,” says Dr Kotecha. “It is your metabolic engine, your glucose sink, your fall insurance and, after menopause, one of your only remaining levers on bone health.”
For that reason, she recommends lifting two to three times a week. “You don’t need to live in the gym,” she reassures, citing research which shows the maximum benefit for longevity lands at roughly 30-60 minutes of resistance training a week. “But you do need to lift things which are genuinely heavy, with the last couple of repetitions feeling hard.”
2. Functional Fitness
Functional fitness, which equates to movement patterns that we use in our day-to-day life, should form a core part of your strength training, says Dr Kotecha. “We want to train the body as one connected system, not as a collection of muscles taking turns on machines. We’re looking for the kind of strength that lets you carry the shopping, a toddler and a suitcase up the stairs. These are the tests of strength that really matter.”
Some of her favourite moves include Turkish get-ups and the farmer’s carry. “These moves build grip, core, coordination and real-world strength all at once,” she explains when asked why she loves them.
The Dumbbell Turkish Get-Up – YouTube
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3. Explosive power
“This is the one almost everyone skips,” says Dr Kotecha, who warns that the impact of neglecting to train for power can be detrimental. “As we lose fast-twitch fibres, we lose stability, increasing our risk of falls and fractures, which in turn increase the risk of mortality and a loss of independence in later life.”
The good news, she says, is that explosive power can be done in small doses and ticked off as part of another session. “You only need about five minutes, but those five minutes might buy you decades of staying on your own two feet,” she explains. “Box jumps, jump squats, hops and a few short sprints are all forms of training explosive power.”
4. Zone two cardio
On the other end of the intensity scale is steady, conversational-pace cardio- think brisk walking, easy cycling or light jogging.
“Nobody posts about this kind of fitness, but everybody needs it,” says Dr Kotecha, who recommends between two and a half and four hours a week of this kind of exercise.
5. HIIT
High intensity interval training has been a contentious topic for women’s training over the years, with debates over whether it has a positive or negative effect on our stress levels and hormonal health.
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The reality, though, is that it’s not an all-or-nothing approach. “The classic mistake is turning everything into a high-intensity session,” says Dr Kotecha. “But short, hard intervals raise your VO2 max efficiently, and VO2 max is one of the strongest survival predictors we have.”
Her recommendation? One to two sessions a week.
6. Stability and balance
It’s far from the most exciting part of an exercise routine, but Dr Kotecha says stability and balance work is highly underrated. “A few minutes of single-leg work, balance drills and mobility most days is possibly the most important thing you will ever do,” she says. “It could be the difference between a stumble and a fracture.”
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Is exercise more important than nutrition for longevity?
It’s tempting to want to rank the things we can do for our health into neatly prioritised boxes. But as Dr Rhea Kotecha, GP and longevity physician, clearly explains, when it comes to nutrition and exercise, one shouldn’t exist without the other.
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“The clinical truth is that you cannot outtrain a poor diet and you cannot out-eat a sedentary body,” she says. “How you train and what you eat are the two strongest, most modifiable levers you have on how long and how well you live, and they only reach their full power together. There is no green powder, no collagen sachet and no supplement that substitutes for being strong and aerobically fit. The basics are boring, and they are also undefeated.”
A fitness expert and chairman of Gategold Limited, Sir Goodluck Obi, has proffered solutions to rampant cases of sudden deaths of some high profile Nigerians in public places. Obi blamed the incidents on lack of awareness on regular health checks, lack of exercise and lifestyle issues.
Obi told journalists that, ”I became a fitness buff when I took ill some years ago and I went to the USA for treatment.
”The doctor carried out thorough checks and concluded that I should go and do exercise for some time and comeback.
”I complied. After I returned to the doctor, ççhe said I should intensity the exercise for four days and come back to see him. I repeated this routine.
”Finally, he gave me a clean bill of health without administering any treatment. That was what opened my eyes and gave birth to the vision of promoting fitness as a key regimen for long life and wellness. This happened around 2007. That was the beginning of Gategold. It was set up to promote longevity, and healthy life style”.
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According to Obi, his business is not just about making money. “Gategold is the vehicle I use to promote my calling for healthy living because I benefited from it myself.”
He revealed that prior to the launch of the Gategold company,he was a successful automobile spare parts dealer.
‘I left a thriving business to promote this vision; a calling indeed that benefits humanity’, he added.
Obi gave insights into human health challenges.’I am not a medical doctor, but by experience, I know that you can be slim and not be healthy. You may look and feel good and not be healthy.
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He noted that children exercise themselves by playing, running around, jumping and all that, which helps them grow into healthy adults.
‘For one to stay healthy, you must listen to the voice of your body and react accordingly, before it’s too late’, he added.
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