Pelvic Floor Dysfunction in Young Females Associated with High-Impact Physical Activity: Prevalence, Risk Factors, and Preventive Interventions – A Systematic Review

Abstract

Pelvic floor dysfunction (PFD), including urinary incontinence (UI) and pelvic organ prolapse, is a significant yet underreported issue in young female athletes (aged 15–45) participating in high-impact sports. This systematic review synthesizes evidence on the prevalence, risk factors, and effectiveness of preventive interventions for PFD in this population. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive search of electronic databases identified 23 eligible studies. The prevalence of UI was high, ranging from 26.1% in CrossFit athletes to 51.8% in runners, with stress UI being the most common subtype. High-impact sports like running and gymnastics were associated with transient morphological changes to the pelvic floor and reduced muscle endurance. Key risk factors included sport-specific loading patterns, parity, and high training volume. Only one randomized controlled trial compared interventions, finding hypopressive exercises and pelvic floor muscle training (PFMT) to be equally effective. Qualitative studies identified stigma and a lack of education as major barriers to seeking care. High-impact sports significantly increase the risk of PFD in young female athletes. Current evidence supports the need for sport-specific preventive strategies, but methodological heterogeneity and a scarcity of intervention studies highlight the necessity for more standardized, longitudinal research. Addressing psychosocial barriers and integrating PFD education into athletic training are crucial for improving early detection and management.

Affiliated Institutions

• Imam Abdulrahman Bin Faisal University SA
• King Khalid University SA
• Maternity and Children's Hospital SA
• Arabian Gulf University BH
• King Fahad Hospital Jeddah SA
• Armed Forces Hospital SA

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