Postpartum sexual function of women and the effects of early pelvic floor muscle exercises

Objective. To evaluate the effects of early pelvic floor muscle training after vaginal delivery on sexual function. Design. Prospective randomized study. Settings. Urogynecology clinic of a tertiary medical center in Istanbul, Turkey. Population. Total of 75 primiparous women. Methods. Pelvic floor-muscle strength was assessed during rest and straining in primiparous women in their 4th postpartum month, after which the women were randomized into training (n = 37) and control (n = 38) groups. Patients were re-evaluated in the 7th postpartum month. Main outcome measures. Female sexual function and pelvic muscle strength scores. Results. Desire, pain and total female sexual index scores were significantly higher in the 7th month compared to 4th month in both groups (p < 0.05). However, sexual arousal, lubrication, orgasm, and satisfaction scores were improved in the 7th month in the training group (paired t-test, p < 0.001), but not significantly in the control group (p > 0.05). All domains except satisfaction were significantly higher in the training group compared with the controls. Pelvic floor-muscle strength was found to be increased in the 7th month in the training group (Wilcoxon rank test, Z = 4.123, p < 0.001), whereas there was no significant difference between the 4th and 7th month measurements in the controls (p > 0.05). Conclusion. Pelvic floor-muscle training improves pelvic floor-muscle function, and starting after the puerperal period, exercise appears to have positive effects on female sexual function.