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

Hanoof   Alqhatani; Saeed Abdullah Saeed Alqahtani; Rawabi Fahad  Alghamdi; Rayan Ali  Ahmed; Rawan sultan  al hufayyn; Norah Abdullah Ahmad  Alothman; Maha Obaidallah M  Alharthi; Meshaal Mohammad M  Alqahtani; Tahani Mathna Fahad   Altaifi; Nora Alhussein Ali  Almonawar; Amjaad Mohammad Abdulhamed    Althagafi; Rashed Mohammed M  AlQahtani

doi:10.54293/smhj.v6i1.184

Authors

Hanoof Alqhatani Urogynecology consultant and Assistant professor , King Khalid University, collage of medicine,Abha, KSA.
Saeed Abdullah Saeed Alqahtani Obstetric and Gynecology Resident, Abha Maternity and Children's Hospital (MOH), KSA.
Rawabi Fahad Alghamdi Obstetric and gynecology King Fahad Hospital, KSA.
Rayan Ali Ahmed Resident, Department of Obstetrics and Gynaecology, Imam Abdulrahman Bin Faisal University, Dammam, KSA.
Rawan sultan al hufayyn Obstetric and Gynecology Resident, Najran Maternity and Children's Hospital (MOH), KSA.
Norah Abdullah Ahmad Alothman Medical intern, College of Medicine, King Khalid University, Abha , KSA.
Maha Obaidallah M Alharthi Medical intern, College of Medicine, King Khalid University, Abha , KSA.
Meshaal Mohammad M Alqahtani Medical intern, College of Medicine, King Khalid University, Abha , KSA. https://orcid.org/0009-0007-1704-5159
Tahani Mathna Fahad Altaifi Obstetric and gynecology Resident, Alhada Armed Forces Hospital, KSA. https://orcid.org/0009-0004-2288-0667
Nora Alhussein Ali Almonawar Medical intern , collage of medicine , king Khalid university, Abha , KSA.
Amjaad Mohammad Abdulhamed Althagafi Obstetric and Gynecology Resident, taif Maternity and Children's Hospital (MOH), KSA.
Rashed Mohammed M AlQahtani Medical intern Arabian Gulf University, KSA. https://orcid.org/0009-0005-9683-6025

DOI:

https://doi.org/10.54293/smhj.v6i1.184

Keywords:

pelvic floor dysfunction, urinary incontinence, female athletes, high-impact exercise, prevention, 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.