Does pelvic floor muscle training improve female sexual function? A systematic review
- 1.3k Downloads
Introduction and hypothesis
We performed a review of the literature reporting on the effects of pelvic floor muscle training (PFMT) on female sexual function (SF).
Pubmed (from 1946 to December 2014), Ovid Medline (from 1946 to December 2014), CINAHL (from 1937 to December 2014), PsycINFO (from 1805 to December 2014), Scopus and Cochrane Central Register of Controlled Trials were searched by two independent reviewers. Randomised controlled trials (RCTs) investigating the impact of PFMT on women’s SF published in English were included. Methodological quality was scored using the PEDro scale. Data were analysed qualitatively and interpreted.
A total of 1341 women were included in the eight RCTs covered by this review. The studies were published between 1997 and 2014. Methodological scores were between 4 and 7. The sample included derived from heterogeneous populations of women. In only one study was SF the primary outcome measure. Pelvic floor dysfunction was an inclusion criterion in the majority of studies. Most studies reported a significant improvement in SF score after PFMT between control and intervention groups.
Although most studies indicated an improvement of at least one sexual variable in women with pelvic floor dysfunction, and one study demonstrated an improvement in SF in postpartum women selected independently of their continence status, the results need to be interpreted with caution. High-quality RCTs specifically designed to investigate the impact of PFMT on women’s SF are required.
KeywordsFemale Sexual function Pelvic floor muscle training Physiotherapy
We thank all Urogynecology Department staff of the Mercy Hospital for Women, Melbourne, VIC, Australia and especially to Christine Murray and Elizabeth Thomas.
The first author received a scholarship from São Paulo Research Foundation (FAPESP- 2012/215239).
Conflict of Interest
- 9.Dumoulin C, Hunter KF, Moore K, Bradley CS, Burgio KL, Hagen S, Imamura M, Thakar R, Williams K, Chambers T (2014) Conservative management for female urinary incontinence and pelvic organ prolapse review 2013: Summary of the 5th international consultation on incontinence. Neurourol Urodyn. doi: 10.1002/nau.22677 Google Scholar
- 11.Handa VL, Whitcomb E, Weidner AC, Nygaard I, Brubaker L, Bradley CS, Paraiso MF, Schaffer J, Zyczynski HM, Zhang M, Richter HE (2011) Sexual function before and after non-surgical treatment for stress urinary incontinence. Female Pelvic Med Reconstr Surg 17:30–35PubMedCentralCrossRefPubMedGoogle Scholar
- 12.Liebergall-Wischnitzer M, Paltiel O, Hochner Celnikier D, Lavy Y, Manor O, Woloski Wruble AC (2012) Sexual function and quality of life of women with stress urinary incontinence: a randomized controlled trial comparing the Paula method (circular muscle exercises) to pelvic floor muscle training (PFMT) exercises. J Sex Med 9:1613–1623CrossRefPubMedGoogle Scholar
- 15.Hagen S, Stark D, Glazener C, Dickson S, Barry S, Elders A, Frawley H, Galea MP, Logan J, McDonald A, McPherson G, Moore KH, Norrie J, Walker A, Wilson D (2014) POPPY Trial Collaborators. Individualised pelvic floor muscle training in women with pelvic organ prolapse (POPPY): a multicentre randomised controlled trial. Lancet 383:796–806CrossRefPubMedGoogle Scholar
- 20.Willans A (2014) The role of pelvic floor muscle exercise in the treatment of female sexual dysfunction. J Assoc Chart Physiotherapists Women’s Health 115:22–29Google Scholar
- 21.Howick J, Chalmers I, Glasziou P, Greenhalgh T, Heneghan C, Liberati A, Moschetti I,Phillips B, Thornton H, Goddard O, Hodgkinson M. The Oxford Levels of Evidence 2″. Oxford Centre for Evidence-Based Medicine. http://www.cebm.net/index.aspx?o=5653
- 23.Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, Monga A, Petri E, Rizk DE, Sand PK, Schaer GN (2010) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J 21:5–26CrossRefPubMedGoogle Scholar
- 27.Patrick DL, Martin ML, Bushnell DM, Yalcin I, Wagner TH, Buesching DP (1999) Quality of life of women with urinary incontinence: further development of the incontinence quality of life instrument (I-QOL). Urology 53(1):71–6.Google Scholar
- 35.Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376CrossRefPubMedGoogle Scholar
- 36.Laycock J et al (1994) Clinical evaluation of the pelvic floor. In: Pelvic Floor Re-education, 1st edn. Springer-Verlag, London, pp 42–48Google Scholar
- 44.De Souza A, Dwyer PL, Rosamilia A, Hiscock R, Lim YN, Murray C, Thomas E, Conway C, Schierlitz L (2012) Sexual function following retropubic TVT and transobturator Monarc sling in women with intrinsic sphincter deficiency: a multicentre prospective study. Int Urogynecol J 23:153–158CrossRefPubMedGoogle Scholar