Symptomatology and knowledge regarding pelvic floor dysfunctions and influence of gender stereotypes in female athletes.

Pelvic floor dysfunctions (PFD) are highly prevalent among females who do athletics, a sport requiring jumping, strength, and running. Although educational approaches are useful options, the educational need for this particular population remains unknown. The objective of the present study was to describe the level of knowledge regarding PFD and its relationship with symptomatology and gender stereotypes in female athletes in Spain. A total of 255 female athletes completed an anonymous online survey to explore their knowledge regarding urinary incontinence (UI), pelvic organ prolapse (POP), anal incontinence (AI), and sexual dysfunction (SexD), as well as their PFD symptoms and gender stereotyped beliefs related to sport. Educational level and sports characteristics (training volume, experience, and athletic modality) were also explored. Participants demonstrated a low level of knowledge in terms of POP (52.5%), AI (64.0%), and SexD (40%), but not for UI (70.8%). The proportion of PFD complaints was 63.5% for dyspareunia, 51.8% for urine leakage, 42.4% for pelvic pain, 17.3% for AI, and 9.0% for POP, with no associations with knowledge (p > 0.05). Lower knowledge about UI and SexD was related to greater gender stereotypes (p < 0.05) and rejection of professional healthcare (p = 0.010). As a conclusion, the level of knowledge about PFD was low in female athletes who train and compete in athletics in Spain, mainly with regard to sexual dysfunction. Although 63.5% of athletes had dyspareunia and 51.8% urinary leakages, symptomatology was not associated with level of knowledge. However, a lower level of knowledge was associated with more stereotyped beliefs and rejection of professional healthcare for PFD. These findings confirm the need to design appropriate educational interventions to disseminate information on all the types of PFD, particularly sexual contents. The potential influence of gender stereotypes makes it appropriate to include the gender perspective in these interventions.

Therapeutic exercise to improve pelvic floor muscle function in a female sporting population: a systematic review and meta-analysis.

BACKGROUND: Despite the high prevalence of pelvic floor dysfunction (PFD) among women who participate in sports, and the efforts made to affect these pathologies through pelvic floor muscle (PFM) training, its effects on PFM function remain unclear. OBJECTIVE: To evaluate the effects of therapeutic exercise programmes on PFM function and quality of life in female athletes and physically active women. DATA SOURCES: The following databases were searched: MEDLINE, SCIELO, LILACS, SPORTDiscus, SCOPUS, CINHAL, SCIELO, PEDro, ScienceDirect and COCHRANE from January 2010 to May 2020. STUDY SELECTION: Study selection criteria included clinical trials that recruited either female athletes or physically active women, and evaluated the effects of therapeutic exercise programmes on PFM function. DATA SYNTHESIS: Ten studies met the eligibility criteria, capturing a total of 246 participants, of which 180 were apparently healthy individuals and 66 suffered from PFD. RESULTS: Meta-analysis revealed significant improvements in maximal voluntary contraction of the PFMs and reduction of urine leakage after the exercise programmes, although no effects were found for vaginal resting pressure. LIMITATIONS: Most of the studies reviewed had a small sample size and a high risk of bias. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS: Data suggest the benefits of therapeutic exercise on PFM function, PFD symptoms and quality of life after therapeutic exercise programmes in women who participate in sports. Incorporating therapeutic exercises designed to increase PFM function into physical activity routines could be beneficial for both healthy women and those suffering from PFD. However, due to the stated limitations, firm conclusions cannot be made. Systematic Review Registration Number PROSPERO CRD42020167243.