Prevalence of Urinary Incontinence and Other Pelvic Floor-Related Symptoms in Female Professional Dancers
Winder B, Lindegren K, Blackmon A. Journal of Dance Medicine & Science. 2023 March; 27(1): 50-55.
Take-Home Message
Three in 10 professional dancers report pelvic floor-related symptoms. Healthcare professionals working with these individuals should screen for urinary incontinence, educate their patients about urinary incontinence, and have a plan to refer patients as needed.
Background
In the general population, pelvic floor-related symptoms such as urinary incontinence (urge or stress-related) are common diagnoses. At least 1 in 4 female athletes experience urinary incontinence. However, we know little about how common it is among dancers or its impact.
Study Goal
The authors conducted an online survey study to assess the prevalence of pelvic floor-related symptoms within the professional dance community.
Methods
The authors developed an anonymous online questionnaire about various topics, including demographics, back and hip pain, dance training and cross-training, menstruation, pelvic health, oral contraceptive use, and bowel movements. The authors shared the survey via email and social media postings. The survey assessed urinary incontinence with the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form. Their target audience was professional female dancers at least 18 years old that trained or performed for at least 25 hours/week.
Results
A total of 208 female professional dancers between the ages of 18 and 41 completed the survey. Almost 35% of all participants and 33% of individuals without a history of pregnancy reported urinary incontinence. Among these participants, 32% reported urge-related symptoms, 53% reported incontinence with coughing or sneezing, and 54% reported incontinence with physical activity or exercise. The authors also found that 8% of individuals reported symptoms potentially indicative of pelvic organ prolapse, and 45% reported pain with sexual activity. The authors also assessed menstrual dysfunction evident within the population with symptoms such as cycle irregularity, heavy bleeding, amenorrhea, and irregularity associated with changes in exercise intensity.
Viewpoints
At least one in three professional dancers experience urinary incontinence. Hence, healthcare professionals working with professional dancers should screen for pelvic floor dysfunction. These findings are based on people who completed an online survey. Therefore, it can be hard to tell if these numbers over or underestimate the true prevalence of urinary incontinence. Investigators could monitor professional dancers over time to get a better reflection of how common urinary incontinence is among dancers. Despite this limitation, it is compelling data because these numbers match the estimates from other female athletes and highlight a need for clinicians to be aware of urinary incontinence in this population. It would be interesting to know if this was their first time reporting symptoms if they are actively managing these issues, their perception of the condition, and if these symptoms impact their performance.
Clinical Implications
The prevalence of urinary incontinence among professional dancers is similar to other high-level female athletes. Healthcare professionals working with professional dancers should educate their patients about urinary incontinence and screen patients to ensure prompt referral to a physical therapist, occupational therapist, gynecologist, or urogynecologist if necessary.
Questions for Discussion
How often do you screen athletes for pelvic floor dysfunction in your setting, and how do you go about this screening process?
How comfortable do you feel about the referral process or prescribing a pelvic floor exercise program for individuals who may report pelvic floor dysfunction?
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