Female Triathletes May Have Greater Risk for Pelvic Disorders

Eating disorders and brittle bones also among risks found in recent study

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Training for triathlons puts a lot of physical stress on the body. For female triathletes, special issues may arise that are often overlooked.

A recent study found that female triathletes had an increased risk for pelvic floor disorders (abnormal functioning of the bladder, reproductive organs or intestines due to weak pelvic muscles), decreased energy, menstrual irregularities and abnormal bone density.

The researchers discovered that, although many female athletes experienced these symptoms, they were often ignored. Researchers recommended that health providers pay special attention to the health needs of their female athlete patients.

"Discuss your risk of pelvic disorders with your OB-GYN."

The lead authors of this study were Johnny Yi, MD, and Colleen Fitzgerald, MD, from the Loyola University Medical Center in Chicago.

The study included 311 female triathletes who took a pelvic health survey. They were all 18 or older and came from seven different areas of the US.

"There has been a surge in popularity of high-impact sports such as triathlons, but little has been known until now about the prevalence of pelvic health and certain other issues associated with endurance training and events," Dr. Fitzgerald said in a press statement.

A triathlon is a sporting event that involves swimming, biking and running certain distances one after another.

Ninety percent of the women were white, and most were between the ages of 35 and 44 years old. Approximately 82 percent were training for a triathlon when they took the survey.

Overall, the average training regimen involved four days of running, three days of cycling and two days of swimming per week.

The pelvic health survey screened for the following pelvic disorders:

  • Urgency urinary incontinence, which occurs when a person feels a strong and sudden need to urinate, the bladder spasms and urine is lost
  • Stress urinary incontinence, which occurs when a person urinates uncontrollably during physical activities like coughing, sneezing, laughing or exercising
  • Anal incontinence, which happens when a person can’t control when she releases stools due to uncontrollable bowel movements
  • Pelvic organ prolapse, which happens when the muscles supporting a woman's pelvic organs (reproductive organs, bladder and intestines) weaken, allowing the organs to slip out of place

The findings showed that approximately one-third of the women had a pelvic disorder.

Out of those with a pelvic disorder, 16 percent reported having urgency urinary incontinence, 37 percent reported having stress urinary incontinence, 28 percent reported bowel incontinence and 5 percent reported having pelvic organ prolapse.

Dr. Yi and team determined that training mileage and intensity were not associated with an increased risk for pelvic disorders.

Seventy-five percent of the women then took a survey on the female athlete triad — a condition that many female athletes are at risk for that has three different components: disordered eating such as anorexia or bulimia, irregular menstrual period and brittle bones.

The triad is a serious condition that can have lifelong health consequences and can even be fatal. Female athletes may experience one, two or all of the components of the triad.

The researchers found that 22 percent of the women who completed the survey on the triad reported low energy from disordered eating, 24 percent reported menstrual irregularities and 29 percent screened positive for brittle bones. Overall, 24 percent of the women screened positive for at least one part of the triad, meaning that approximately 1 out of 4 of the women had the condition.

According to the researchers, there was no association between any of the pelvic floor disorders and the triad.

"While both pelvic floor disorders and the female athlete triad are prevalent in female triathletes, both are often ignored," Dr. Yi said in a prepared statement. "Doctors should be aware of how common these conditions are in this group of athletes and treat patients appropriately to avoid long-term health consequences."

This study was presented July 24 at the American Urogynecologic Society 2014 Scientific Meeting. The researchers reported no conflicts of interest.

Review Date: 
July 23, 2014
Last Updated:
July 25, 2014