The relationship between experiencing symptoms and associating them to pelvic floor dysfunction (PFD) among Latinas in the United States of America is unknown but remains foundational to timely diagnosis. This study examined symptoms of urinary (UI) or fecal incontinence (FI) and pelvic organ prolapse (POP), in community-dwelling Latinas in Los Angeles, and assessed whether cultural and psychosocial factors could determine self-identification of PFDs.

We did a cross-sectional survey of community dwelling Latinas (median age = 50) in Los Angeles using standardized surveys, including measures of acculturation; Latino and mainstream cultural values; knowledge, attitudes, behaviors and beliefs about PFDs; the Pelvic Floor Distress Inventory-20 (PFDI-20); and measures of stress and discrimination. Descriptive statistics, univariate and multivariate logistic regression were performed to identify variables associated with self-identification of PFDs.

Of 197 women, 19% had bothersome symptoms compatible with prolapse, 33% with UI, and 14% with FI. Among the 70% of women who denied having a PFD, 39% reported at least one bothersome PFD symptom on the PFDI-20. Lower independence, higher religiosity, and higher perceived stress were independently associated with higher likelihood of PFD self-identification (p<0.05). Higher values of independence were less likely in women who were unsure (OR=0.38; 95%CI=0.17–0.81, p=0.01).

In this study, the prevalence of symptoms compatible with PFDs among community dwelling Latinas, as determined by the PFDI-20, was significantly higher than the prevalence of women who self-identified as having a PFD when asked if they thought they had one. Whereas 15% of women recognized having PFDs, and 15% were unsure, we observed that 63% reported at least one PFD symptom and 39% reported at least one bothersome symptom (moderate to severe symptom). Specifically, 19% had symptoms compatible with bothersome POP, 33% with bothersome UI, and 14% with bothersome FI symptoms. Among the 70% of women in this study who denied having a PFD when asked if they thought they had one, 60% reported having at least one PFD symptom on the PFDI-20, and 32% endorsed at least one bothersome symptom. We observed that the amount of bothersome PFDI-20 symptoms, age, and the degree of identification with Hispanic culture were the key determinants of self-identification of PFD. Moreover, we found that higher value of religion and lower value independence, as well as high perceived stress scores were key determinants of being unsure about having a PFD.

Despite the considerable prevalence of PFD symptoms among Latinas in Los Angeles, most do not self-identify them or are unsure. This discordance seems driven by severity of symptoms and/or values of independence and religiosity, or stress. Interventions to raise awareness and recognize symptoms are needed to improve self-identification and earlier detection of PFDs among Latinas.