Does a Regular Menstrual Tampon or an Intravaginal Pessary Mitigate Urine Leakage While Running Among Females Who Experience Exercise-Induced Urinary Incontinence?

Abstract

Exercise-induced urinary incontinence (EI-UI), urine leakage experienced predominantly during exercise, affects nearly 40% of females who participate in high-impact activities and is a common barrier to exercise participation. In this randomized assessor-blind crossover trial, 30 adult females with EI-UI completed three standardized treadmill protocols: one without intervention, one with a self-fitted Uresta® pessary, and one with a regular menstrual tampon, with the latter two administered in randomized order. The primary outcome was the EI-UI Severity Index, a composite of self-reported leakage frequency and perceived volume during the run. Secondary outcomes included pad weight gain during the run, exercise-induced pelvic floor tissue strain assessed via transperineal ultrasound imaging, and user self-reported experience. Both devices significantly reduced EI-UI Severity Index scores compared to no intervention, with the pessary offering significantly greater symptom reduction compared to the tampon. The pessary significantly reduced pad weight gain while the tampon did not. Neither device influenced the extent of exercise-induced pelvic floor tissue strain. These findings support the use of the self-fitted Uresta® pessary and a regular menstrual tampon as effective, self-administered conservative management strategies for EI-UI in active females, with the pessary being superior to a menstrual tampon.