Beneficial effects of pelvic floor muscle exercises on sexual function among postmenopausal women: a randomised clinical trial
Soheila Nazarpour A , Masoumeh Simbar B C F , Hamid Alavi Majd D and Fahimeh Ramezani Tehrani E
+ Author Affiliations
- Author Affiliations
A Department of Midwifery, Chalous Branch, Islamic Azad University, Chalous 4661961367, Iran.
B Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran 1996835119, Iran.
C Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran 1996835119, Iran.
D Department of Biostatistics, School of Paramedicine, Shahid Beheshti University of Medical Sciences, Tehran 1971653313, Iran.
E Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran 1985717413, Iran.
F Corresponding author. Email: msimbar@gmail.com
Sexual Health 15(5) 396-402 https://doi.org/10.1071/SH17203
Submitted: 17 November 2017 Accepted: 26 April 2018 Published: 27 July 2018
Abstract
Background: The adverse effects of menopause on sexual function could be mitigated by pelvic floor muscle (PFM) training. This study aimed to investigate the effects of PFM exercises on sexual function in postmenopausal women. Methods: A randomised clinical trial was conducted among 97 Iranian postmenopausal women, aged 40 to 60 years. The participants’ baseline sexual functions were assessed using the Female Sexual Function Index (FSFI) questionnaire. They were then randomly designated to two groups: (1) the intervention group, which received specific instructions on PFM exercises and was followed up on a weekly basis; and (2) the control group, which received general information on menopause. After 12 weeks, the sexual functions of the participants were reassessed. Results: No significant difference was initially observed between the two groups in terms of demographic and socioeconomic characteristics and total scores of FSFI. After the intervention, however, the scores of arousal, orgasm and satisfaction were significantly higher in the intervention group (3.10, 4.36, and 4.84 vs 2.75, 3.89, and 4.36 respectively; P < 0.05). Conclusion: PFM exercises have the potential to improve the sexual function of postmenopausal women and are thus suggested to be included in healthcare packages designed for postmenopausal women.
Additional keywords: Female Sexual Function Index, menopause, pelvic floor muscle exercises, randomised clinical trial (RCT), sexual function.
References
[1] Segen JC. Sexual function. Segen’s Medical Dictionary. New York: Farlex, Inc.; 2012. Available online at: http://encyclopedia.thefreedictionary.com/sexual+function [verified 12 May 2017].[2] Douma S, Doumas M, Tsakiris A, Zamboulis C. Male and female sexual dysfunction: is hypertension an innocent bystander or a major contributor? Rev Bras Hipertens 2007; 14 139–47.
[3] Ghavami H, Sanadyzadeh M. Guide to diagnosis and treatment of sexual dysfunction in women and erectile dysfunction in men. Tehran: Talia; 2012. [In Persian]
[4] Shifren JL. Menopause. In Berek JS, editor. Berek and Novak’s Gynocology, 14th edn. Philadelphia: Lippincott Williams and Wilkins; 2012, pp. 2137–58.
[5] Bloch A. Self-awareness during the menopause. Maturitas 2002; 41 61–8.
| Self-awareness during the menopause.Crossref | GoogleScholarGoogle Scholar |
[6] Milanifar B. Mental health. Tehran: Ghomes publication; 2003. [In Persian]
[7] Addis IB, Van Den Eeden SK, Wassel-Fyr CL, Vittinghoff E, Brown JS, Thom DH. Sexual activity and function in middle-aged and older women. Obstet Gynecol 2006; 107 755–64.
| Sexual activity and function in middle-aged and older women.Crossref | GoogleScholarGoogle Scholar |
[8] Ambler DR, Bieber EJ, Diamond MP. Sexual function in elderly women: a review of current literature. Rev Obstet Gynecol 2012; 5 16–27.
[9] Al-Azzawi F, Palacios S. Hormonal changes during menopause. Maturitas 2009; 63 135–7.
| Hormonal changes during menopause.Crossref | GoogleScholarGoogle Scholar |
[10] Portman DJ, Gass ML. Genitourinary syndrome of menopause: new terminology for vulvovaginal atrophy from the International Society for the Study of Women’s Sexual Health and the North American Menopause Society. Maturitas 2014; 79 349–54.
| Genitourinary syndrome of menopause: new terminology for vulvovaginal atrophy from the International Society for the Study of Women’s Sexual Health and the North American Menopause Society.Crossref | GoogleScholarGoogle Scholar |
[11] Kim H-K, Kang S-Y, Chung Y-J, Kim J-H, Kim M-R. The recent review of the genitourinary syndrome of menopause. J Menopausal Med 2015; 21 65–71.
| The recent review of the genitourinary syndrome of menopause.Crossref | GoogleScholarGoogle Scholar |
[12] Nappi RE, Palacios S. Impact of vulvovaginal atrophy on sexual health and quality of life at postmenopause. Climacteric 2014; 17 3–9.
| Impact of vulvovaginal atrophy on sexual health and quality of life at postmenopause.Crossref | GoogleScholarGoogle Scholar |
[13] de Menezes Franco M, Driusso P, Bø K, de Abreu DC, da Silva Lara LA, de Sá Rosa AC, Ferreira CHJ. Relationship between pelvic floor muscle strength and sexual dysfunction in postmenopausal women: a cross-sectional study. Int Urogynecol J 2017; 28 931–6.
| Relationship between pelvic floor muscle strength and sexual dysfunction in postmenopausal women: a cross-sectional study.Crossref | GoogleScholarGoogle Scholar |
[14] Citak N, Cam C, Arslan H, Karateke A, Tug N, Ayaz R, Celik C. Postpartum sexual function of women and the effects of early pelvic floor muscle exercises. Acta Obstet Gynecol Scand 2010; 89 817–22.
| Postpartum sexual function of women and the effects of early pelvic floor muscle exercises.Crossref | GoogleScholarGoogle Scholar |
[15] Reider B. Role of pelvic floor muscles in female orgasmic response. J Women’s Health Issues Care 2016; 5
| Role of pelvic floor muscles in female orgasmic response.Crossref | GoogleScholarGoogle Scholar |
[16] Baytur YB, Deveci A, Uyar Y, Ozcakir HT, Kizilkaya S, Caglar H. Mode of delivery and pelvic floor muscle strength and sexual function after childbirth. Int J Gynaecol Obstet 2005; 88 276–80.
| Mode of delivery and pelvic floor muscle strength and sexual function after childbirth.Crossref | GoogleScholarGoogle Scholar |
[17] Elbegway AF, Elshamy FF, Hanfy HM. The effect of pelvic floor exercise on sexual function after vaginal delivery. Med J Cairo Univ 2010; 78 27–31.
[18] Klay M, Marfyak K. Use of a continence nurse specialist in an extended care facility. Urol Nurs 2005; 25 101–2, 107–8
[19] Yang C, Hakky TS, Carrion R. Evaluation and treatment of orgasmic dysfunction. In: Lipshultz LI, Pastuszak AW, Goldstein AT, Giraldi A, Perelman MA, editors. Management of sexual dysfunction in men and women. New York: Springer; 2016. pp. 159–70.
[20] Bø K, Talseth T, Vinsnes A. Randomized controlled trial on the effect of pelvic floor muscle training on quality of life and sexual problems in genuine stress incontinent women. Acta Obstet Gynecol Scand 2000; 79 598–603.
| Randomized controlled trial on the effect of pelvic floor muscle training on quality of life and sexual problems in genuine stress incontinent women.Crossref | GoogleScholarGoogle Scholar |
[21] Dean N, Wilson D, Herbison P, Glazener C, Aung T, Macarthur C. Sexual function, delivery mode history, pelvic floor muscle exercises and incontinence: a cross-sectional study six years post-partum. Aust N Z J Obstet Gynaecol 2008; 48 302–11.
| Sexual function, delivery mode history, pelvic floor muscle exercises and incontinence: a cross-sectional study six years post-partum.Crossref | GoogleScholarGoogle Scholar |
[22] Modarres M, Rahimi Kian F, Boriai A. The effect of pelvic floor muscle exercise on the sexual satisfaction of nulliparous women. HAYAT 2012; 18: 10–8. [In Persian]
[23] Mohktar MS, Ibrahim F, Mohd Rozi NF, Mohd Yusof J, Ahmad SA, Su Yen K, Omar SZ. A quantitative approach to measure women’s sexual function using electromyography: a preliminary study of the Kegel exercise. Med Sci Monit 2013; 19 1159–66.
| A quantitative approach to measure women’s sexual function using electromyography: a preliminary study of the Kegel exercise.Crossref | GoogleScholarGoogle Scholar |
[24] Piassarolli VP, Hardy E, Andrade NF, Ferreira Nde O, Osis MJ. Pelvic floor muscle training in female sexual dysfunctions. Rev Bras Ginecol Obstet 2010; 32 234–40.
| Pelvic floor muscle training in female sexual dysfunctions.Crossref | GoogleScholarGoogle Scholar |
[25] Rosenbaum TY. Pelvic floor involvement in male and female sexual dysfunction and the role of pelvic floor rehabilitation in treatment: a literature review. J Sex Med 2007; 4 4–13.
| Pelvic floor involvement in male and female sexual dysfunction and the role of pelvic floor rehabilitation in treatment: a literature review.Crossref | GoogleScholarGoogle Scholar |
[26] Zare Z, Golmakani N, Khadem N, Shareh H, Shakeri MT. The effect of pelvic floor muscle strengthening exercise on quality of sexual life and marital satisfaction in nulliparous women after delivery. IJOGI 2014; 17 21–32. [In Persian]
[27] Chambless DL, Sultan FE, Stern TE, O’Neill C, Garrison S, Jackson A. Effect of pubococcygeal exercise on coital orgasm in women. J Consult Clin Psychol 1984; 52 114–8.
| Effect of pubococcygeal exercise on coital orgasm in women.Crossref | GoogleScholarGoogle Scholar |
[28] Lara LA, Montenegro ML, Franco MM, Abreu DC, Rosa e Silva AC, Ferreira CH. Is the sexual satisfaction of postmenopausal women enhanced by physical exercise and pelvic floor muscle training? J Sex Med 2012; 9 218–23.
| Is the sexual satisfaction of postmenopausal women enhanced by physical exercise and pelvic floor muscle training?Crossref | GoogleScholarGoogle Scholar |
[29] Roughan PA, Kunst L. Do pelvic floor exercises really improve orgasmic potential? J Sex Marital Ther 1981; 7 223–9.
| Do pelvic floor exercises really improve orgasmic potential?Crossref | GoogleScholarGoogle Scholar |
[30] Nazarpour S, Simbar M, Ramezani Tehrani F, Alavi Majd H. Sexual function and exercise in postmenopausal women residing in Chalous and Nowshahr, Northern Iran. Iran Red Crescent Med J 2016; 18 e30120
| Sexual function and exercise in postmenopausal women residing in Chalous and Nowshahr, Northern Iran.Crossref | GoogleScholarGoogle Scholar |
[31] Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, Ferguson D, D’Agostino R. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 2000; 26 191–208.
| The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function.Crossref | GoogleScholarGoogle Scholar |
[32] Wiegel M, Meston C, Rosen R. The female sexual function index (FSFI): cross-validation and development of clinical cutoff scores. J Sex Marital Ther 2005; 31 1–20.
| The female sexual function index (FSFI): cross-validation and development of clinical cutoff scores.Crossref | GoogleScholarGoogle Scholar |
[33] Mohammadi K, Heidari M, Faghih Zadeh S. Validity of the Persian version of Female Sexual Function Index-FSFI scale as the Female Sexual Function Index. J Payesh 2008; 7 269–78.
[34] Fakhri A, Pakpour AH, Burri A, Morshedi H, Zeidi IM. The Female Sexual Function Index: translation and validation of an Iranian version. J Sex Med 2012; 9 514–23.
| The Female Sexual Function Index: translation and validation of an Iranian version.Crossref | GoogleScholarGoogle Scholar |
[35] Ma Y, Qin H. Pelvic floor muscle exercises may improve female sexual function. Med Hypotheses 2009; 72 223
| Pelvic floor muscle exercises may improve female sexual function.Crossref | GoogleScholarGoogle Scholar |
[36] Hisasue S, Kumamoto Y, Sato Y, Masumori N, Horita H, Kato R, et al. Prevalence of female sexual dysfunction symptoms and its relationship to quality of life: a Japanese female cohort study. Urology 2005; 65 143–8.
| Prevalence of female sexual dysfunction symptoms and its relationship to quality of life: a Japanese female cohort study.Crossref | GoogleScholarGoogle Scholar |
[37] Coney P. Menopause. New York: Medscape; 2016. Available online at: http://emedicine.medscape.com/article/264088-overview#showall [verified 22 May 2017].
