Pelvic Organ Prolapse Symptoms in Female Runners: A Cross Sectional Study

Female participation in long-distance running has been increasing, raising concern about pelvic floor-related symptoms in this population. However, data on pelvic organ prolapse (POP) symptoms, particularly during running, remain limited. We hypothesized that higher training volume would be associated with greater prevalence of POP symptoms. This study aimed to determine the prevalence of POP symptoms and associated factors among Brazilian female runners.

In this cross-sectional study, participants were recruited at road-running events and completed a questionnaire on demographics, health history, training characteristics, and other physical activities. POP symptoms were assessed by two questions: (1) "Do you notice a bulge or lump in your vagina in daily life situations, outside of physical exercise?" and (2) "Do you feel a sensation of pressure, bulge, or lump descending in your vagina while running?"

Three hundred and one women met inclusion criteria (mean age 37.2 years). Twenty-three percent reported POP symptoms during running; 58% had a history of pregnancy, with mean values of 0.77 cesarean and 0.36 vaginal deliveries. Average weekly running distance was 28.6 km, and 76% performed additional physical activity (mean 1.98 sessions/week). POP symptoms were significantly associated with weekly running distance (OR 1.03; 95% CI 1.01-1.05) and additional activities (OR 1.53; 95% CI 1.22-1.91), while cesarean delivery was inversely associated (OR 0.42; 95% CI 0.28-0.62).

POP symptoms were more frequent during running than in daily life. Weekly running distance and engagement in additional physical activity were significant predictors, whereas cesarean delivery appeared protective.