BACKGROUND: Regular physical activity usually confers health benefits, but 
high-level sport may induce harmful outcomes, such as pelvic floor dysfunction. 
Urinary incontinence (UI) was previously documented, but few data are available 
about anal incontinence (AI) in female athletes. Our aim was to determine the 
role of high-level sport practice on AI in a young, healthy female population.
METHODS: In this cross-sectional study, we included women aged 18-40 years. 
Self-administered questionnaires were delivered to each female volunteer. Two 
groups were defined: (1) intensive sport (IS) group: high-level sport (>8 hours 
weekly), and (2) nonintensive sport (NIS) group: all other subjects.
RESULTS: Of the 393 women enrolled, 169 were in the IS group and 224 were in the 
NIS group. Women of the IS group were significantly younger than the others 
(21.74±4.28 vs. 24.87±5.61 years, p<0.001) and had less births (0.07±0.31 vs. 
0.20±0.62, p=0.005). The prevalence of AI was statistically higher in the IS 
group than in the NIS group (14.8% vs. 4.9%, p=0.001), as was UI (33.1% vs. 
18.3%, p=0.001). Multivariate analysis showed that IS practice (odds ratio [OR] 
2.99, 95% confidence interval [CI] 1.29-6.87, p=0.010) and body mass index (BMI) 
(OR 1.14, 95% CI 1.01-1.28, p=0.033) were significantly linked to AI when taking 
into account major confounding factors (age and births). In the IS group, AI was 
mainly represented by loss of flatus in 84%.
CONCLUSIONS: High-level sport appears to be a significant independent risk 
factor for AI in healthy young women. These results suggest that preventive 
measures, such as pelvic floor muscle training, may be proposed for this young 
population.