Due to the unique demands of sport participation on the body, female athletes are at increased risk for pelvic floor dysfunction (PFD) and relative energy deficiency in sport (RED-S). A high number of female athletes suffer from PFD, especially urinary incontinence. Several biomechanical and physiological risk factors may play a role in the development of PFD in female athletes. RED-S has been shown to be associated with PFD. The goal of this commentary is to discuss RED-S as a risk factor for PFD and propose a mechanism for this relationship.