Female sexual dysfunction symptoms are improved by pelvic floor muscle training (PFMT), according to a recent study published in the American Journal of Obstetrics & Gynecology.1
Takeaways
- Pelvic floor muscle training (PFMT) is associated with improved sexual function, including enhanced arousal, lubrication, and orgasm in women.
- A systematic review and analysis of randomized controlled trials revealed that PFMT positively impacts various aspects of sexual function for many women.
- The Female Sexual Function Index is used to assess improvements, with significant gains reported in several domains like arousal, satisfaction, and pain reduction.
- PFMT not only improves sexual function but also enhances body acceptance, communication, and reduces symptoms such as dyspareunia and coital incontinence.
- Despite positive findings, the evidence's certainty is very low, indicating a need for more rigorous studies to better understand the impact of PFMT on female sexual dysfunction.
PFMT has been proposed as a treatment method for female sexual dysfunction with the hypothesis that increased pelvic floor muscle (PFM) strength would be correlated with improved orgasm ability and orgasm intensity. Increased blood flow to PFMs may also improve arousal and orgasms.
While female sexual dysfunctions present in 38% to 63% of individuals, multiple factors contribute to these conditions being underestimated. Additionally, there is little data supporting the hypotheses about PFMT improving sexual function.
Other methods have shown efficacy for sexual dysfunction treatment.2 A phase 2b study found that Sildenafil Cream, 3.6% (Sildenafil Cream; Daré Bioscience) is effective for treating female sexual arousal disorder, a condition defined by failure to achieve genital arousal during sexual activity.
Sexual function can be evaluated using the Female Sexual Function Index (FSFI). Domains of the FSFI include desire, arousal, lubrication, orgasm, pain, and satisfaction.1
Investigators conducted a systematic review to evaluate the impact of PFMT on sexual function. Randomized controlled trials were included in the analysis with a population of women with or without sexual dysfunction, intervention of PFMT alone or in combination with other modalities, and comparator of another treatment method or placebo.1
Sexual function was reported as the primary outcome, with sexual dysfunction defined as, “disturbances in sexual desire and psycho-physiological changes that characterize the sexual response and cause marked distress and interpersonal difficulty.” PFMT included any program with voluntary, repeated PFM contraction.
The PubMed, Ovid Medline, CINAHL, Embase, BVSalud, Scopus, and Cochrane Library databases were evaluated for literature by an experienced research assistant. Titles and abstracts were independently screened by 2 reviewers, with a third resolving disagreements.1
Data extraction was performed by 2 independent reviewers. Extracted data included authors, year of publication, country, study period, sample size, intervention, follow-up period, outcomes, dropout rate and adherence, and results.
There were 21 articles included in the qualitative synthesis and 4 in the quantitative synthesis. Significant heterogeneity was reported for outcome measures and intervention types. Pelvic floor dysfunction was the only dysfunction reported in 10 studies, and only 1 study included women with sexual dysfunction.1
Eleven trials reported sexual function as the primary outcome. Descriptions of the progression of the exercise were reported by 27%, the level of exercise by 18.2%, and adherence by 54.5%. Interventions ranged from PFMT alone to PFMT with other therapies.
A statistical difference in sexual function outcomes between groups was reported in 54.5% of studies, with each favoring PFMT in at least 1 aspect of sexual function. PFMT was associated with improvements in arousal, lubrication, orgasm, pain, satisfaction, sexual worry, pleasure for partners, number of sexually active women, and emotion.1
Additional outcomes improved by PFMT included sexual vaginal function/vaginal laxity sensation, body acceptance and rejection, communication, dyspareunia, impairment of sex life by urinary symptoms, coital incontinence, and sexual quality of life.
Contradictory results were reported among postpartum women. Improvements were found for sexual desire, arousal, orgasm, and body acceptance from PFMT in one study, while another reported improvements in arousal, lubrication, and orgasm.1
One study found no differences in sexual function symptoms between PFMT and control groups. For FSI scores, PFMT was associated with a score improvement of 1.49 for arousal, 1.55 for orgasm, 1.46 for satisfaction, 0.74 for pain, and 7.67 for overall FSI score. However, certainty of evidence was very low.
These results indicated improved sexual function from PFMT in a varied female population. However, the effect size of the intervention is unclear, highlighting a need for additional research to clarify uncertainties.1
Reference
- Homsi Jorge C, Bø K, Chiazuto Catai C, Gustavo Oliveira Brito L, Driusso P, Kolberg Tennfjord M. Pelvic floor muscle training as treatment for female sexual dysfunction: a systematic review and meta-analysis. American Journal of Obstetrics & Gynecology. 2024;231(1):51-66.E1. doi:10.1016/j.ajog.2024.01.001
- Krewson C. Phase 2b study indicates Sildenafil Cream effective against female sexual arousal disorder. Contemporary OB/GYN. November 2, 2023. Accessed July 9, 2024. https://www.contemporaryobgyn.net/view/phase-2b-study-indicates-sildenafil-cream-effective-against-female-sexual-arousal-disorder
