Pelvic floor dysfunctions in female cheerleaders: a cross-sectional study


Introduction and hypothesis

Cheerleaders perform high-impact maneuvers that can be associated with pelvic floor dysfunction. We hypothesized that female cheerleaders would report more symptoms of pelvic floor dysfunction and fewer symptoms of premenstrual syndrome than nonathletic women.


This cross-sectional study included high-performance female cheerleaders and young nonathletic, nulliparous, and normal-weight females. Demographics, sports practices, and pelvic floor dysfunction data were collected through an electronic questionnaire. Urinary symptoms were collected through the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) and King’s Health Questionnaire. Intestinal symptoms were collected through the use of Criterion F of item C3, referring to functional constipation of Rome III and Fecal Incontinence Severity Index. Data on sexual function were collected through the Female Sexual Function Index. Data on pelvic organ prolapse were obtained through the International Consultation on Incontinence Questionnaire-Vaginal Symptoms (ICIQ-VS). In addition, questions about premenstrual syndrome—dysmenorrhea, irritability, headache, tiredness, fluid retention, and constipation—were collected through the Menstrual Symptom Questionnaire. The comparison between groups of the quantitative variables was performed using the Mann-Whitney U test. Odds ratios (OR) and 95% confidence intervals (CI) were estimated for comparison between groups on the occurrence of pelvic floor muscle dysfunction symptoms. A significance level of 5% was adopted.


A total of 156 women (78 cheerleaders and 76 nonathletes) completed the electronic questionnaire. Anal incontinence was the most prevalent symptom of pelvic floor muscle dysfunction. Cheerleaders were 2.3 times more likely to report symptoms regarding anal incontinence than nonathletic women. For the other symptoms of pelvic floor dysfunction, no statistical differences between the groups were found. Cheerleaders reported fewer symptoms of tiredness and constipation during the premenstrual period than did nonathletic women.


Pelvic floor dysfunction, particularly anal incontinence, appears to be more prevalent among cheerleaders than among nonathletic women. In addition, cheerleaders demonstrated fewer symptoms of tiredness and constipation during the premenstrual period.

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We thank the support of the União Brasileira de Cheerleading (UBC) for their assistance in disseminating this research.


Funding for this study was provided by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil, Finance Code 001.

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Correspondence to Patricia Driusso.

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IV Congresso Brasileiro de Fisioterapia em Saúde da Mulher. Belo Horizonte, Minas Gerais, Brazil, 5/31/2018

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Carvalho, C., da Silva Serrão, P.R.M., Beleza, A.C.S. et al. Pelvic floor dysfunctions in female cheerleaders: a cross-sectional study. Int Urogynecol J 31, 999–1006 (2020).

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  • Anal incontinence
  • Athletes
  • Cheerleading
  • Epidemiology
  • Pelvic floor muscle
  • Urinary incontinence
  • Women’s health