More than third of women playing football and camogie experience urinary leakage

By Cate McCurry, PA

More than one third of women playing Gaelic football and camogie experience urinary leakage during training and match play, research has found.

Urinary leakage – a form of incontinence – remains a hidden struggle for many female athletes, largely due to embarrassment and stigma, a report found.

Dublin City University’s research, published in Science and Medicine in Football, explores how menstrual cycle-related symptoms, hormonal contraceptive use, and indicators of pelvic floor dysfunction affect players of ladies Gaelic football and camogie.

Among players not using hormonal contraceptives, 97.7 per cent reported menstrual cycle–related symptoms, most commonly abdominal cramping (84 per cent) and fatigue (82.2 per cent).

Around 85 per cent believe their menstrual cycle affects onfield performance, with 59 per cent indicating a negative impact.

Approximately 37 per cent of athletes experienced urinary leakage during training or matches, suggesting potential pelvic floor concerns. A high proportion also experience urinary urgency (47.8 per cent) and genital pain (43.4 per cent).

Dr David Nolan, assistant professor of Sport and Exercise Sciences at the DCU School of Health and Human Performance, said urinary leakage is a current taboo in women’s sports.

He said: “There’s more and more data being gathered, more studies coming out showing that active young sports women are experiencing urinary leakage at a significant rate, very high prevalence in gymnastics, in strength sports.

“But now in field sports, you get more data that it’s affecting up to one third of our players.

“From working in female sport myself, I knew there was a prevalence of it, but I didn’t expect it to be that high. This is probably the issue of why it’s not spoken about more, and why players probably don’t speak about it as much as they themselves probably don’t realise that it’s as commonplace.

“If they think that it’s something that’s not affecting their teammates as much as them, they’re probably less likely to speak because they don’t know how common it actually is.”

He added: “The common symptoms are the urinary leakage, then urinary urgency, so the strong desire to go to the bathroom. You can have prolapse within the vagina, and then you can have anal incontinence linked to it.

“The most common symptoms, though, would be the urine leakage and the urinary urgency. The sad and frustrating thing about them suffering in silence is with physiotherapy and just exercise interventions, we can significantly reduce those symptoms.”

He said the effects can lead to women dropping out of their sport.

He added: “We do have evidence to show that it’s linked to drop out in sport and again, because there can be potential shame or stigma around it and a source of embarrassment.

“So players might, in extreme cases, drop out of sports, or be less motivated to train. It can occur mostly in high impact, high kind of stress sports and performance – so they might be hesitant to push themselves hard or to engage in intense activities for fear of of this embarrassment.”

The new peer-reviewed study of ladies’ Gaelic footballers and camogie players in Ireland has thrown new light on the issue.

Some 455 female Gaelic games athletes across both club and inter-county level were surveyed.

The study asked players about their menstrual cycles, use of hormonal contraceptives, like the contraceptive pill, and any pelvic floor dysfunction symptoms.

Firstly, the survey confirmed that menstrual-related symptoms are highly prevalent.

Among players not using hormonal contraceptives, 97.7 per cent reported at least one menstrual-related symptom each month.

The most common complaints were abdominal cramping (experienced by 84 per cent of players) and fatigue or low energy (82 per cent).

Perhaps not surprisingly, a large proportion – about 59 per cent perceived a mostly negative impact on how they play, citing issues like pain, heavy bleeding, or sluggishness during certain cycle phases.

The study also looked at hormonal contraceptives.

Just over half of the Gaelic players (51.7 per cent) were on some form of hormonal contraception, with the pill by far the most popular choice (used by about 69 per cent).

Some 62 per cent of the athletes using hormonal contraceptives reported side effects, including fatigue (37.2 per cent) and experiencing mood swings or low mood (35.0 per cent).

About one in three contraceptive-users (31.6 per cent) even felt that their contraception was impacting their athletic performance.

However, issues around the pelvic floor is an aspect of women’s health that athletes and coaches rarely discuss, the research found.

“Pelvic floor dysfunction” is an umbrella term for problems like urinary incontinence (leakage), urgency (sudden intense need to go), or pelvic organ prolapse.

The stereotype is that these issues only impact older women or those who have had children.

In this research, the average age of players surveyed was just 23.6 years old, and most had likely never given birth as the average first-time mother in Ireland is 31.5.

Despite this, a considerable number of these young athletes reported troubling pelvic floor symptoms.

The authors behind the report recommend enhanced education and support for athletes, coaches, and support staff on menstrual health, contraceptives, and pelvic floor health – as well as individualised symptom management strategies, integrating physiological monitoring with athlete feedback.