Objective To investigate associations of early and middle adulthood physical activity (PA) with symptoms of pelvic floor disorders (PFD), i.e., stress urinary incontinence (SUI), urge urinary incontinence (UUI), fecal incontinence (FI), constipation or defecation difficulties (CDD), and feeling of pelvic organ prolapse (POP) among middle-aged women.

Design A cross-sectional, observational study with retrospective PA assessment.

Setting University Research Laboratory.

Sample A random population sample of 1098 47-to-55-year-old Finnish women.

Methods Early adulthood PA, current PA, and demographical and gynaecological variables were assessed using self-report questionnaires. Logistic regression analyses were applied to study associations of PA variables with symptoms of PFDs. Potential confounding effects of demographical and gynaecological variables were controlled in multiple logistic regression models.

Main outcome measures Structured questionnaire-assessed retrospective PA assessment at the age of 17–29, current PA at middle age, and prevalence of symptoms of SUI, UUI, FI, CDD and POP.

Results Current PA was not independently associated with the occurrence of the symptoms of PFDs. Middle-aged women with early adulthood history of competitive sports were more likely to experience symptoms of UUI (OR 2.16, 95% CI 1.10–4.24, p=0.025) but not symptoms of SUI, FI, CDD, or POP, while women with history of regular PA were more likely to experience symptoms of FI (OR 4.41, 95% CI 1.05–18.49, p=0.043) but no other symptoms of PFDs.

Conclusions Competitive sports during early adulthood may increase the risk of UUI at middle age. Regular PA during early adulthood may increase the risk of FI.