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The strength of the pelvic floor muscles contributes to a better female sexual function.
Abstract
Objectives
Strong evidence indicates that pelvic floor muscle training (PFMT) increases pelvic floor muscles' strength (PFMS) and improves stress urinary incontinence and female sexual function.
The study aims to examine the association between pelvic floor muscle strength and female sexual function in healthy nulliparous women.
Methods
Forty-five sexually active women aged 22-35 years participated in the study. All women completed the FSFI questionnaire, validated in the Greek language. Two examiners evaluated pelvic floor muscle strength using both, the Modified Oxford Grading Scale and the Peritron manometer. Women formed two groups using the median values of Peritron manometer measurements of the total population. Group A included 21 females with weak pelvic floor contraction (≤ 41,1 cm H20), and Group B included 24 females with a strong pelvic floor (>41,2 cm H20). The results were analyzed with Mann-Whitney U tests for FSFI results and Spearman's correlation for the Modified Oxford Grading Scale and Peritron manometer values.
Results
There was no significant difference between the two groups concerning the participants’ demographic characteristics. Women with a strong pelvic floor (Group B) exhibited higher statistically significant results (p<0.001) in desire (Group A:3.11±0.14 vs Group B:3.91±0.21), arousal (4.08±0.53 vs 4.99±0.41), orgasm (4.22±0.36 vs 5.37±0.69), satisfaction (4.22±0.36 vs 5.37±0.69), lubrication (4.12±0.43 vs 5.01±0.49) and total FSFI score (27.12±1.09 vs 31.71±1.26). There was no statistically significant difference in the pain domain. There was also a strong correlation between PFMS evaluated with Modified Oxford Grading Scale and PFMS assessed Peritron manometer values (r=0.69).
Conclusions
The strength of the pelvic floor muscles is an essential factor concerning better female sexual function
Conflicts of Interest
No Conflicts of Interest
... In general, the use of PFMT seems to contribute to the sexual improvement of incontinent women. According to Zachariou et al (2022) (24) and Franco et al (2021) (25) , increasing the strength of the pelvic floor muscles is an essential factor in improving female sexual function. In addition, it is likely that when treating urinary incontinence using a gold standard technique (1,10,11) , the patient's anxiety, insecurity, and fear of losing urine during sexual intercourse will decrease, which may consequently improve function. ...
... In general, the use of PFMT seems to contribute to the sexual improvement of incontinent women. According to Zachariou et al (2022) (24) and Franco et al (2021) (25) , increasing the strength of the pelvic floor muscles is an essential factor in improving female sexual function. In addition, it is likely that when treating urinary incontinence using a gold standard technique (1,10,11) , the patient's anxiety, insecurity, and fear of losing urine during sexual intercourse will decrease, which may consequently improve function. ...
This study is aimed at comparing the effectiveness of pelvic floor muscle training (PFMT) and Pilates on the improvement of urinary incontinence (UI), strength, and endurance of the pelvic floor muscles (PFMs), and the impact of UI on the quality of life in postmenopausal women.
Forty postmenopausal women were randomly divided in to two groups: PFMT (n = 20) and Pilates (n = 20). The participants were followed for 12 weeks, three times a week on nonconsecutive days. UI was assessed using the pad test and the voiding diary, PFM strength and resistance using bidigital assessment and manometry, and the impact of UI on quality of life using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), before and after the 3-month treatment.
There was a significant intra-group improvement in both groups for the pad test, mean daily urinary loss, and ICIQ-SF. The strength was significantly improved only in the PFMT group, and the endurance in both groups. Peak strength manometry was significantly improved only in the Pilates group, and the mean strength manometry in both groups. There was also an improvement in both groups for peak endurance manometry and mean endurance manometry. In the inter-group comparison, there was a significant improvement only in muscle strength, which was positive for group.
There was no difference between Pilates and PFMT for the management of women in post-menopause with stress urinary incontinence, provided that voluntary contraction of the PFMs is performed. However, further randomized clinical trials need to be carried out.
... In general, the use of PFMT seems to contribute to the sexual improvement of incontinent women. According to Zachariou et al (2022) (24) and Franco et al (2021) (25) , increasing the strength of the pelvic floor muscles is an essential factor in improving female sexual function. In addition, it is likely that when treating urinary incontinence using a gold standard technique (1,10,11) , the patient's anxiety, insecurity, and fear of losing urine during sexual intercourse will decrease, which may consequently improve function. ...
... In general, the use of PFMT seems to contribute to the sexual improvement of incontinent women. According to Zachariou et al (2022) (24) and Franco et al (2021) (25) , increasing the strength of the pelvic floor muscles is an essential factor in improving female sexual function. In addition, it is likely that when treating urinary incontinence using a gold standard technique (1,10,11) , the patient's anxiety, insecurity, and fear of losing urine during sexual intercourse will decrease, which may consequently improve function. ...
Introdução: Uma porcentagem significativa de mulheres na pós-menopausa sofre de incontinência urinária (IU), que pode prejudicar a função sexual. O treinamento dos músculos do assoalho pélvico (PFMT) é o principal tratamento para melhorar a IU e também pode ser usado para melhorar a função sexual. Por outro lado, outras formas de intervenção, como os exercícios de Pilates, que requerem ativação dos músculos do assoalho pélvico, têm sido sugeridas como um possível adjuvante nos desfechos relacionados à IU. Objetivos: Verificar a eficácia do TMAP vs. Pilates na função sexual em mulheres pós-menopáusicas com IU. Métodos:40 mulheres na pós-menopausa com IU foram randomizadas em dois grupos: PFMT (n = 20) e Pilates (n = 20). As intervenções em ambos os grupos foram realizadas durante 12 semanas, três vezes por semana, durante 30 minutos. A função sexual foi avaliada por meio do questionário Índice de Função Sexual Feminina (FSFI). Os testes Mann-Whitney e Wilcoxon U foram usados para comparações inter e intragrupos, respectivamente. Resultados: Não houve diferença na comparação intergrupos, para nenhum domínio do FSFI (p > 0,05). Houve diferença significativa intragrupo, em ambos os grupos, nos domínios desejo, lubrificação e escore total, com tamanhos de efeito variando de pequeno a grande. Também houve resultados intragrupo significativos para os domínios orgasmo e dor no grupo TMAP, com tamanho de efeito pequeno. Conclusão:Não houve evidência de que o TMAP seja diferente do Pilates na função sexual de mulheres pós-menopáusicas com IU, portanto, a escolha entre o TMAP ou o Pilates pode ser baseada nas preferências e nos custos da paciente ou do profissional de saúde.
... While a previous study also reported mild urine leakage after BoNT/A injections [25], this was the first study reporting difficulties in achieving climax as an adverse event of the treatment. As higher PFM strength is associated with better sexual function and particularly with a greater facility to achieve climax [32], this adverse event could be explained by BoNT/A's chemical denervation of motor units in the muscle, which thus became unable to contract and develop strength. As both adverse events were mild and transient, this study adds to previous findings that confirmed BoNT/A injected in limited doses can be safely used to treat vestibulodynia [33]. ...
The studies carried out to date on vulvodynia treatment with botulinum neurotoxin type A (BoNT/A) have followed generic injection protocols and reported contradictory outcomes on its effects. The aim of the present study was thus to propose a protocol for injecting BoNT/A into targeted painful points, to comprehensively assess the clinical effect of BoNT/A treatment and identify the risk/protective factors for successful treatment. Thirty-five vestibulodynia patients were treated with submucosal injections of incobotulinumtoxinA and assessed 8, 12 and 24 weeks after their treatment. Their clinical and pelvic statuses were assessed from self-reported questionnaires (Visual Analogue Scale (VAS), Female Sexual Function Index (FSFI), Marinoff’s Dyspareunia Scale (MDS), Hospital Anxiety and Depression Scale (HADS), Catastrophizing Scale (CS)), physical examinations and surface electromyography (sEMG). The patients reported a reduction in provoked vestibulodynia (<VAS, p < 0.01), improved sexual function (>FSFI, p < 0.01; <MDS, p = 0.01) and psychological status (<HADS, p < 0.01), and lower pelvic floor hyperactivity at rest (<sEMG amplitude, p = 0.01). Factors such as smoking, painful comorbidities, vulvar pain sensitivity and sexual function were significantly associated with successful treatment. The results indicate the beneficial effects of BoNT/A in treating vestibulodynia and reinforce the importance of adapting the treatment according to its clinical presentation and the patient’s medical background.
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