Pelvic Floor and Psychosocial Symptoms in Female Collegiate Athletes: Exploring Nonrelaxing and Relaxing Pelvic Floor Dysfunction

Purpose: The aims of this study were to (1) investigate the prevalence of Pelvic Floor Dysfunction (PFD) in female collegiate athletes (FCAs) in the United States and (2) explore any relationships with psychosocial factors. Methods: The survey included the International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms (ICIQ-FLUTS), Patient Reported Outcomes Measurement Information System (PROMIS) Anxiety and Depression, and the National Institute of Health (NIH) Toolbox Perceived Stress Form. Informed consent was obtained via REDCap with 156 responses. Statistical analysis was performed in SPSS version 29. Results: Of the 156 participants, 29% reported urinary leakage during sports, 38% indicated pain with vaginal insertion, and 83% reported an interest in pelvic floor education and/or treatment. The PROMIS Anxiety T-score and bladder pain were the 2 factors that discriminated pain with vaginal insertion ( P ≤ .048). PROMIS Anxiety, Depression, and NIH Stress were moderately correlated with the ICIQ-FLUTS using Spearman’s correlation ( P < .001). The Chi-square test identified a statistically significant relationship between the question “Do you feel like your athletic performance is impacted by pelvic pain, urinary leakage, or groin pain?” and the PROMIS Anxiety Categories, as well as between the use of a pad/tampon and whether they participate in cheer and/or dance. Discussion: Female collegiate athletes reported PFD symptoms that correlated with psychosocial symptoms and expressed an interest in pelvic floor education and treatment. There is a need for high-quality research studies exploring the relationship between PFD and psychosocial factors in FCAs and screening tools for nonrelaxing PFD to better serve this population.