Persistent noncancer pelvic pain (also called chronic pelvic pain) is a problem that affects an estimated 6% to 40% of women worldwide. In addition to causing pain that is in or perceived to be in the pelvic structures, this condition is often associated with sexual dysfunctions such as dyspareunia (pain during sex), orgasmic dysfunction, and lowered desire, arousal, and lubrication.

Chronic pelvic pain can be caused by several different medical conditions including vulvodynia, genito-pelvic pain/penetration disorders, endometriosis, and interstitial cystitis/bladder pain syndrome. However, it is possible that there are similarities in the pelvic floor muscle tone and function of women with any of these conditions.

A recent systematic review and meta-analysis examined the results of 21 studies that compared the pelvic floor muscle tone in women with and without chronic pelvic pain to determine if there were any significant differences between the two groups.

While these studies measured different pelvic floor muscle tone properties, when grouped together they gave a general overview of pelvic floor muscle tone in women with chronic pelvic pain and those without. Ultimately, the findings seemed to confirm that there are significant differences in some pelvic floor muscle tone parameters between women with and without persistent noncancer pelvic pain.

For example, the women with chronic pelvic pain had increased pelvic floor muscle tone and higher resistance to the applied pressure and slow stretch of the pelvic floor muscles by an index finger than the women without chronic pelvic pain.

These women were also shown to have higher stiffness of the pelvic floor muscles and reduced pelvic floor muscle flexibility.

Lastly, the women with chronic pelvic pain showed higher myoelectrical activity in both the superficial and deep pelvic floor muscles, as measured by electromyography (EMG). Myoelectric activity shows the active component of pelvic floor muscle tone, or the contraction of the smooth muscles in this area.

Understanding the differences in pelvic floor muscle tone between women with and without chronic pelvic pain is the first step toward potentially finding better treatment options for those who are living with these often debilitating conditions.

These findings can also guide the types of interventions that are used such as focusing on pelvic floor muscle relaxation for women with high resistance and high myoelectric activity or increasing the elasticity of the pelvic floor muscles and vaginal tissues for women with low pelvic floor flexibility.

References:

• Kadah, S., Soh, S. E., Morin, M., Schneider, M., Heron, E., & Frawley, H. (2023). Is there a difference in pelvic floor muscle tone between women with and without pelvic pain? A systematic review and meta-analysis. The Journal of Sexual Medicine, 20(1), 65-96. https://doi.org/10.1093/jsxmed/qdac002