Paula Method Compared to Pelvic Floor Muscle Training (PFMT), for Urinary Stress Incontinence

The Effectiveness of Circular Muscle Exercise (the Paula Method) as Compared to Pelvic Floor Muscle Training (PFMT), for Urinary Stress Incontinence (SUI) in Menopausal Women: A Randomized Controlled Trial

The Investigators decided to examine whether the Paula method is more effective than Pelvic Floor Muscle Training (PFMT) in terms of urinary leakage amount, as it measured by pad test in menopause women without an hormonal therapy. In addition to the pad test and two urinary incontinence questionnaires, we will use other assessment tools such as; quality of life and sexual function which have been found to correlate significantly with pad test results. These results may indicate that menopausal women with Stress Urinary Incontinence may be more successful controlling incontinence if they will practice the Paula method as compared to PFMT.

All subjects allocated to this group will receive one group lesson, 45 minute sessions once a week for twelve weeks. All will be encouraged to practice daily for 15-45 minutes at home. The teachers will be followed a set exercise list.

All subjects allocated to this group will receive one group lesson, 45 minute sessions once a week for twelve weeks. All will be encouraged to practice daily for 15-45 minutes at home. The teachers will be followed a set exercise list .

To examine whether the Paula method intervention is more effective than PFMT in reducing urinary leakage in menopausal women with SUI

1) Baseline 2) After 12 weeks of exercise intervention 3) 12 months after completion of the intervention

1) Baseline 2) After 12 weeks of exercise intervention 3) 12 months after completion of the intervention

1) Baseline 2) After 12 weeks of exercise intervention 3) 12 months after completion of the intervention

1) Baseline 2) After 12 weeks of exercise intervention 3) 12 months after completion of the intervention

Inclusion Criteria: women after menopause (12 months with no period) aged 40 or more have a positive pad test leakage of 1-50 grams no systemic or local hormonal therapy literate in Hebrew and/or English Exclusion Criteria: women suffering from illnesses which limit physical activity (cardiac, respiratory, psychiatric or neurological disorders) pelvic surgery within the last 6 months post hysterectomy or oophorectomy genital prolapse grade 3 or higher