Pelvic Floor Distress and Sexual Function Across Self-Reported Primary Exercise Modalities in Physically Active...

High-intensity and high-impact exercise may increase intra-abdominal pressure and loading of the pelvic floor. Although pelvic floor dysfunction (PFD) has been reported among physically active women, findings remain inconsistent, particularly in young nulliparous women. This study examined the relationship between exercise modality, pelvic floor distress, and sexual function in physically active nulliparous women.

A cross-sectional survey was completed by 103 physically active nulliparous women aged 18-30 years. Participants completed the Pelvic Floor Distress Inventory-20 (PFDI-20) and Female Sexual Function Index (FSFI) and reported their primary exercise modality, exercise frequency, and duration. Statistical analyses included Welch's ANOVA with effect sizes (ω²) and Spearman correlation analyses.

Participants engaged in aerobic training (10%), yoga/Pilates (6%), strength training combined with cardiovascular exercise (57%), powerlifting (14%), and CrossFit (14%). No statistically significant differences were detected across exercise modalities for total PFDI-20 scores (p = 0.209, ω² = 0.05) or total FSFI scores (p = 0.883, ω² = 0.00). Likewise, no significant differences were observed across individual PFDI-20 or FSFI domains (all p > 0.05), with effect sizes ranging from negligible to small (ω² = 0.00-0.07). Weak exploratory correlations were identified between pelvic floor distress and selected sexual function domains (ρ = 0.18-0.23, p < 0.05).

No statistically significant differences in pelvic floor distress or sexual function were detected among self-reported exercise modalities in this cohort. These exploratory findings should be interpreted cautiously and warrant confirmation through adequately powered longitudinal studies incorporating objective assessments of pelvic floor function.