Pelvic Floor Knowledge and Dysfunction in Female Athletes

The pelvic floor is a complex structure composed of bones, connective tissue, muscles, and nerves that supports the pelvic organs and provides voluntary control and resting tone of the sphincters. Closely related to continence, sexual function, core stabilization, and posture, the pelvic floor muscles-particularly the levator ani with its type 1 and type 2 fibers-ensure both resting tone and rapid responses to sudden increases in intra-abdominal pressure. In women, pelvic floor dysfunctions (including urinary and anal incontinence, pelvic organ prolapse, defecatory and sexual dysfunctions) occur especially during pregnancy, childbirth, and menopause and adversely affect quality of life. Recently, research on pelvic floor muscles and dysfunctions in female athletes has grown, with competing hypotheses suggesting that these muscles may be strong yet overloaded and weakened due to excessive training. Sports that increase intra-abdominal pressure, such as running, weightlifting, and gymnastics, may stress the pelvic floor and elevate dysfunction risk. Various studies have shown high prevalences of urinary and anal incontinence and pelvic organ prolapse in athletes, alongside generally low pelvic floor awareness. However, few studies have examined the relationship between physical activity level, type, and duration with pelvic floor dysfunction and awareness together. The present study aims to investigate the effects of physical activity, demographic characteristics, and sporting experience on pelvic floor dysfunctions and pelvic floor knowledge in female athletes.