Gynecological pre participation examination–a new proposal for female athletes care

Background Female athletes are unaware of the influence of sports practice on health and usually do not report sexual or gynecological complaints during a regular Pre Participation Examination (PPE). Objective To propose a gynecological PPE for female athletes, assessing questions regarding unsupervised sports practice, sexual transmitted diseases, as well as consciousness of the coaches regarding their gynecological health. Design Observational cross-sectional study. Settings/Patients A total of 148 athletes participating in regular and competitive sports at the ‘Olympic Center of Training and Research for youth athletes’ in Sao Paulo – Brazil, during the first semester of 2010. Parents/guardians signed the informed consent form. Intervention The athletes participated in an informative lecture about relevant gynecological questions related to their health and sports practice. Subsequently, the subjects responded to a questionnaire evaluating gynecological features, together with the Incontinence Questionnaire-Short Form (ICIQ-SF) and Eating Attitudes Test (EAT-26). Results The study assessed 148 athletes, mean age of 15.4 ± 2.0 years, reporting 10.9 ± 4.0 h of practice/week. 50% of the participants described irregular menstrual interval, 23.0% ignored the meaning of sexual transmitted diseases and 72.4% had never been to a gynecological appointment. A total of 23.1% of the athletes complained of urine loss and 14.5% should be evaluated by a nutritionist regarding alimentary disturbance or use of diuretics or laxative for weight loss. Moreover, 89.0% ignored the occurrence of urinary incontinence in athletes and the definition of female athlete triad, and 81.9% affirmed that would not mention these questions to their coaches even if this would improve their health or performance. Conclusion The gynecological issues are usually underestimated in the follow up of female athletes. The PPE could be an excellent opportunity to provide a special care to young competitors, improving their knowledge about their body and health and most likely, their goals.