Urinary incontinence (UI) is a significant health concern affecting millions of women in the United States. Over the past two decades, the prevalence of UI among women has increased, with estimates from National Health and Nutrition Examination Survey (NHANES) data in 1999–2000 reporting UI in 38% of U.S. women, rising to 61.8% in 2015–2018 data. [1,2] The COVID-19 pandemic disrupted data collection, leaving a gap in updated prevalence estimates. This study analyzes post-pandemic NHANES data from 2021–2023, providing new insights into UI prevalence and examining associated risk factors among U.S. women.

We conducted a descriptive analysis using publicly available NHANES data from August 2021 to August 2023. [3] NHANES is a program managed by the National Center for Health Statistics (NCHS) that collects health and nutrition data from a nationally representative sample of the U.S. population. Our study included women aged 20 and older who completed the interview with valid responses to UI-related questions. 2,834 respondents met inclusion criteria. UI subtypes were categorized as stress UI, urgency UI, and mixed UI. NCHS-defined weights were applied to account for complex survey design. To estimate the total number of U.S. women affected by UI, we integrated prevalence estimates with data from the American Community Survey. Multivariable logistic regression was used to evaluate the association between UI subtypes and various risk factors, with adjusted odds ratios reported. Statistical significance was defined as p<0.05.

The overall prevalence of urinary incontinence (UI) among U.S. women aged 20 and older was 63%, affecting an estimated 79.5 million women. Mixed UI was the most commonly reported subtype (29.2%), followed by stress UI (23%) and urgency UI (10.8%).

Regarding symptom severity, 55.7% of women with mixed UI, 31.3% of those with urgency UI, and 24.5% of those with stress UI reported “moderate” to “very severe” symptoms.

Among women younger than 50, current or past pregnancy and multiparity were strongly associated with increased odds of stress UI (Figure 1). Obesity was linked to higher odds of stress UI in both younger women (OR: 1.45 [1.11–1.91]) and those aged 50 and older (OR: 1.78 [1.26–2.52]). In older women, prediabetes, COPD, and cardiovascular conditions were associated with increased odds of UI, with varying associations across subtypes (Figure 2). Depression and functional impairment were consistently linked to an increased risk of UI across age groups.

The prevalence of UI among U.S. women remains high at 63%, consistent with pre-pandemic estimates and emphasizing the ongoing burden of UI on women’s health. The impact of UI is substantial, as at least one in four affected women experience moderate to very severe symptoms, significantly impairing quality of life. The strong link between pregnancy and multiparity with UI underscores the critical intersection of reproductive and urological health. Chronic disease burden in older women plays a major role in UI risk, as prediabetes, COPD, and cardiovascular conditions significantly increased the odds of UI, highlighting the long-term impacts of aging and multimorbidity. Additionally, mental health and functional status are key risk factors, reinforcing the value of multidisciplinary approaches to care.

Urinary incontinence remains a highly prevalent and burdensome condition among U.S. women, with post-pandemic prevalence estimates aligning with pre-pandemic data. Older women exhibit stronger associations with modifiable risk factors, highlighting the importance of preventive strategies to mitigate disease burden. Early screening, weight management, and targeted interventions for mental health and mobility may help address key risk factors for UI, ultimately improving long-term outcomes in both urologic and overall health. Given the growing shortage of urologists in the U.S., ensuring access to multidisciplinary care is essential to improving quality of life for affected women.

Anger JT, Saigal CS, Litwin MS; Urologic Diseases of America Project. The prevalence of urinary incontinence among community dwelling adult women: results from the National Health and Nutrition Examination Survey. J Urol. 2006;175(2):601-604. doi:10.1016/S0022-5347(05)00242-9
Patel UJ, Godecker AL, Giles DL, Brown HW. Updated Prevalence of Urinary Incontinence in Women: 2015-2018 National Population-Based Survey Data. Female Pelvic Med Reconstr Surg. 2022;28(4):181-187. doi:10.1097/SPV.0000000000001127
Centers for Disease Control and Prevention. NHANES August 2021-August 2023. [Internet]. 2025 [cited 2025 April 2]. Available from: https://wwwn.cdc.gov/nchs/nhanes/continuousnhanes/default.aspx?Cycle=2021-2023