Sexual dysfunction, affecting 40%-45% of women, has significant negative impacts on physical and mental health, relationships, self-esteem, and quality of life. Despite its prevalence, it often goes untreated. Multiple factors contribute to sexual dysfunction, including pelvic floor muscle (PFM) issues.

Studies show that women with dyspareunia (pain during sex) often have PFM problems. Physical therapy targeting PFMs improves sexual function, especially in women with pelvic floor disorders like incontinence and pelvic organ prolapse. However, it remains unclear whether PFM treatment directly improves sexual function or merely addresses associated issues like pain and incontinence. That is why a new systematic review aimed to clarify PFMs’ role in sexual function in women without pelvic pain or disorders.

Searches for this systematic review were conducted in various databases and literature sources, using specific terms related to sexual function and PFMs. Studies written in English, French, Spanish, and Portuguese were included without restrictions on publication year. Criteria for study selection were outlined, focusing on women without pelvic pain or disorders, although studies with mixed populations were considered. The review and meta-analysis of eligible studies aimed to provide clarity on the relationship between PFMs and sexual function in women without pelvic pain or disorders.

After searching various databases and sources, 33 studies were included in this systematic review, comprising 14 interventional and 19 observational studies. Among the interventional studies, 8 focused on women with sexual dysfunction, while 6 involved women without sexual dysfunctions. These studies employed various treatments targeting PFMs, such as electrical stimulation and PFM training, over 6 to 12 weeks. Overall, PFM exercises showed some improvement in sexual function, especially in women with orgasmic difficulties. However, some studies didn’t show significant effects compared to control or other treatments.

Observational studies, including cross-sectional and before-and-after studies, highlighted the association between PFM function and sexual function or response. Most studies were of moderate to high quality. Findings suggested a moderately significant association between PFM strength and sexual function, especially in women without sexual dysfunction. However, some studies didn’t provide conclusive correlations. Nevertheless, these studies demonstrated PFM involvement in sexual response, showing increased PFM activity during arousal and orgasm. Still, there were variations in findings across different methods of stimulation.

Overall, these results suggest a link between PFM function and sexual function/response, particularly in women without sexual dysfunction. However, further research is needed to better understand the role of pelvic floor muscles in sexual health and to develop effective interventions.

References:

• Faucher, S., Déry-Rouleau, G., Bardin, M., & Morin, M. (2024). Investigating the role of the pelvic floor muscles in sexual function and sexual response: a systematic review and meta-analysis. The Journal of Sexual Medicine, 21(3), 217–239. https://doi.org/10.1093/jsxmed/qdad175