Impact of pelvic floor muscle strength on female sexual function: retrospective multicentric cross-sectional study.

INTRODUCTION AND HYPOTHESIS: The female pelvic floor muscles (PFM) play an important role in sexual function. We hypothesize that there is a relation between PFM strength and sexual function in women with and without sexual dysfunction. METHODS: Retrospective multicentric cross-sectional study including women with and without sexual dysfunction [Female Sexual Function Index (FSFI) cutoff point < 26.55], analyzed by age range, considering demographic, clinical, anthropometric and PFM strength [Modified Oxford Scale (MOS)] data. Chi-square, Mann-Whitney test and linear regression (ranks) were used, with 5% significance (SAS 9.4). RESULTS: Out of 1013 medical records, 982 women with an average age of 45.76 (± 15.25) were included in the study. Of these, 679 (69.14%) presented FSFI score < 26.55, while 303 (30.86%) presented FSFI ≥ 26.55. It was identified that the higher scores were among white women, < 45 years old, single, with higher education, family income > 4 minimum wages, body mass index < 25 kg/m2, lower parity, regular physical activity practitioner and higher PFM strength (MOS: 4-5). Desire, arousal, lubrication and orgasm domains were higher among women with MOS 4-5, while satisfaction and pain domains were higher among those with MOS 3-5. CONCLUSION: Demographic, clinical and anthropometric conditions can influence both PFM strength and female sexual function. Our findings demonstrate that women with higher PFM strength present fewer complaints about sexual dysfunction.

Interventional treatment for myofascial pelvic floor pain in women: systematic review with meta-analysis.

INTRODUCTION AND HYPOTHESIS: Female myofascial pain (MFP) of the pelvic floor muscles (PFM) is a subtype of chronic pelvic pain associated with urinary, anorectal, and sexual symptoms, such as dyspareunia. Treatment remains poorly discussed, and we hypothesized that different treatments could improve outcomes versus placebo or no treatment. METHODS: A systematic review (CRD 42020201419) was performed in June 2020 using the following databases: PubMed, Cochrane Library, Web of Science, Embase, Scopus, BVSalud, Clinicaltrials.gov , and PEDro, including randomized clinical trials related to MPF of PFM. Primary outcome was pain after treatment, and secondary outcomes were quality of life and sexual function. Risk of bias and quality of evidence (GRADE criteria) were evaluated. Meta-analysis for continuous variables was performed (mean difference between baseline and treatment and post-treatment mean between groups). RESULTS: Five studies were included (n = 218). Final mean VAS score (GRADE: very low) after 4 weeks of treatment (p = 0.14) and the mean difference from baseline and 4 weeks (p = 0.66) between groups were not different between the intervention and control groups. Quality of life according to the SF-12 questionnaire (GRADE: very low) followed the same pattern. However, sexual function (GRADE: low) according to the total FSFI score (MD = -5.07 [-8.31, -1.84], p < 0.01, i2 = 0%) and the arousal, orgasm, and pain domains improved in the intervention groups when the mean difference from baseline and 4 weeks was compared with controls. CONCLUSION: Pain and quality of life after 4 weeks of heterogeneous intervention differed between the intervention and control groups in sexual function: FSFI in studies improved in almost all domains. VAS (in three studies) and SF-12 (in two studies) failed to demonstrate differences.