Female triathletes at higher risk for pelvic floor disorders

The study, published in Female Pelvic Medicine and Reconstructive Surgery, found that female triathletes suffered from a high rate of stress urinary and anal incontinence.

"We expected the high rates of urinary incontinence, but did not expect to find such high rates of anal incontinence," said senior author, Colleen Fitzgerald, MD, MS. Dr. Fitzgerald is the medical director of the Chronic Pelvic Pain program and an associate professor in the department of obstetrics and gynecology at Loyola University Chicago Stritch School of Medicine.

"These findings generate a new question as to address the mechanism of injury for why this is occurring, whether it is metabolic or digestive, or due to prolonged impact on the pelvic floor from biking or other unexplained causes," Dr. Fitzgerald said.

Researchers conducted an internet survey of 311 self-identified female triathletes. Results showed a significant prevalence of pelvic floor disorders, with urinary incontinences (37.4 percent) and anal incontinence (28.0 percent) being the most common.

Urgency urinary incontinence (16.0 percent) and pelvic organ prolapse (5.0 percent) were less common. Pelvic girdle pain was noted in 18 percent of these triathletes, but was not indicated as disabling or preventing exercise.

Nearly a quarter of respondents also screened positive for at least one arm of the female athlete triad, a condition characterized by decreased energy, menstrual irregularities and abnormal bone density from excessive exercise and inadequate nutrition.

Loyola researchers conducted a similar study on female athletes in 2014, focusing on runners. In that study, researchers found a similarly high percentage of women complained of urinary incontinence symptoms. The goal of this study was to expand on previous results, incorporating the low impact sport of swimming.

Along with Fitzgerald, co-authors on the study were Johnny Yi, MD, FACOG, then a urogynecology fellow at Loyola and now with Mayo Clinic Arizona, Sandi Tenfelde, PhD, RN, APN, Dina Tell, PhD, and Cynthia Brincat, MD, PhD, FACOG.

"Our goal of this study was not to deter triathletes from participating in their training," Dr. Fitzgerald said. "Exercise in all forms can be healthy and should be encouraged. However, we would recommend that if women are bothered by these symptoms, they should seek medical care from a urogynecologist or female pelvic reconstructive surgery specialist."