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Physical Therapies

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Sexual Function and Pelvic Floor Dysfunction

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Abstract

Introduction: Chronic pelvic pain (CPP) and female sexual dysfunctions are complex syndromes. The sensation and intensity of pain often do not correspond with the identified lesion location, but instead are felt elsewhere in the body leading to muskuloskeletal, myofascial disorders and sexual dysfunction (SD). Although CPP physical aspects are prevalent, they are often underdiagnosed and undertreated, because of lack of understanding of its origin and distribution. Frequently, patients experience pelvic pain as psychological distress resulting in physical complaints leading clinicians to prescribe medication or surgical intervention to correct or alleviate these symptoms often with insufficient results. Because pelvic floor muscle disorders contribute highly to (C)PP and female SD, there is rationale for physiotherapy. However, physiotherapy is widely underused. Hypothesis: Although still an untapped resource, physiotherapy should have its place in the multidisciplinary approach of these health problems. Methods: A computer-aided and manual search and methodological quality assessment were carried out for meta-analyses, systematic reviews and RCTs published between 1990 and 2019 investigating classification, assessment and (physiotherapeutic) treatment of pelvic pain and/or female SD defined by the keywords below. Expert-opinion has been sought using interviews. Results: Up to now, because of lack of sufficient relevant medical information, referral data and test results, focused physiotherapy was difficult to administer adequately. Recently, more and more quality studies indicate significant clinical effects of physiotherapy for CPP and female SD. Experts advocate a multidisciplinary approach including physiotherapy. Conclusions: Because of its holistic approach, physiotherapy can contribute significantly to the multidisciplinary assessment and treatment of CPP and female SD.

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Manuscript related to the 13th Ulf Umsten lecture on the 22nd of June, during the 42th IUGA Annual Meeting, Vancouver, Canada.

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Acknowledgements

I would like to express my gratitude to Sohier Elneil, PhD MD gynaecologist, Bert Messelink, MD, urologist and sexologist, Fetske Hogen Esch, pelvic physiotherapist, Maura Seleme, PhD pelvic physiotherapist, Nucelio Lemos, PhD MD gynaecologist for their advices and contribution in the realization of this chapter.

Conflict of Interest Statement: none.

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  1. Pelvic Care Center Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands

    Bary Berghmans

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Correspondence to Bary Berghmans .

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  1. Urogynaecology Department, King’s College Hospital, London, UK

    Angie Rantell

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Berghmans, B. (2021). Physical Therapies. In: Rantell, A. (eds) Sexual Function and Pelvic Floor Dysfunction. Springer, Cham. https://doi.org/10.1007/978-3-030-63843-6_13

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