A scoping review of the evidence for supervised pelvic floor muscle training for improving signs or symptoms of pelvic organ prolapse in post-menopausal women

BackgroundMenopause is considered a risk factor for pelvic organ prolapse (POP). Although level 1 evidence exists for pelvic floor muscle training (PFMT) for reducing POP symptoms in the adult population, it is less clear whether it is as effective in post-menopausal women.ObjectivesThis scoping review investigates supervised PFMT for improving POP signs or symptoms in this population.MethodsSeven databases were searched in December 2023. Five articles were included in the literature review (four RCTs and one SR). Included articles were assessed for quality and risk of bias using the Physiotherapy Evidence Database (PEDro) scale.Major FindingsThe included studies found small but statistically significant results in favour of PFMT compared to controls to improve either POP symptoms or signs in post-menopausal women, with no adverse events from PFMT. Further robust studies are needed.ConclusionClinicians can offer PFMT to post-menopausal patients presenting with POP based on evidence, sound underlying physiological principles, and a lack of adverse events. A sample pelvic floor muscle training program is described, along with recommendations for multi-disciplinary input.