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Symptoms of pelvic organ prolapse in women who lift heavy weights for exercise: a cross-sectional survey

PainSci » bibliography » Forner et al 2020
updated
Tags: etiology, injury, strength, sports, pro, pain problems, exercise, self-treatment, treatment

Three pages on PainSci cite Forner 2020: 1. Chronic Pain and Inequality2. Q&A: Pelvic organ prolapse prevention3. Q&A: Beyond kegels for pelvic organ prolapse prevention

PainSci commentary on Forner 2020: ?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.

This study compared rates of pelvic organ prolapse (POP) in 4000 women who lift weights to those who do not. About 14% had POP symptoms, and there were much more common in women who lifted lighter weights — which suggests at least the possibility that lifting heavier weights is actually protective, rather than being a risk. Several other risk factors were eliminated: body mass index, forceps delivery, cesarean section, hysterectomy, or menopausal status. And so: “Physically active women who lift heavy weights for exercise do not have an increased prevalence of POP symptoms.”

~ Paul Ingraham

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

INTRODUCTION AND HYPOTHESIS: The aim of the study was to determine the prevalence of symptoms of pelvic organ prolapse (POP), defined as the sensation of a vaginal bulge, and associated risk factors in women over 18 years of age who lift light (≤15 kg), moderate (16-50 kg), and heavy >50 kg) weights for exercise, and those who do not lift weights for exercise.

METHODS: Women completed an online survey about risk factors for pelvic floor dysfunctions, physical activity history, and pelvic floor symptoms. A question about a vaginal bulge sensation from the validated Pelvic Floor Distress Inventory (PFDI-20) was used to indicate symptoms of POP. Relationships between symptoms of POP and possible risk factors were assessed through logistic regression analysis.

RESULTS: Of the 3,934 survey participants, the total prevalence of POP symptoms was 14.4% (n=566). Category of weight lifted, age, vaginal parity, history of constipation or hemorrhoids, and family history of POP were significantly associated with symptoms. Physically active women lifting weights ≤15 kg were more likely to report symptoms of pelvic organ prolapse than women lifting weights greater than 50 kg (59.7% vs 15.2%; adjusted odds ratio 2.1; 95% confidence interval1.7-3.4). There was no relationship between POP symptoms and body mass index, forceps delivery, cesarean section, hysterectomy, or menopausal status.

CONCLUSION: Physically active women who lift heavy weights for exercise do not have an increased prevalence of POP symptoms. Advice on the contribution of heavy weight lifting as part of a physical activity regime to the pathophysiology of POP requires further investigation.

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