Can Pelvic Floor Muscle Training Improve Sexual Function in Women with Pelvic Organ Prolapse? A Randomized Controlled Trial

IntroductionPelvic floor muscle training (PFMT) has level 1 evidence of reducing the size and symptoms associated with pelvic organ prolapse (POP). There is scant knowledge, however, regarding whether PFMT has an effect on sexual function. AimThe aim of the trial was to evaluate the effect of PFMT on sexual function in women with POP. MethodsIn this randomized controlled trial, 50 women were randomized to an intervention group (6 months of PFMT and lifestyle advice) and 59 women were randomized to a control group (lifestyle advice only). Main Outcome MeasuresParticipants completed a validated POP-specific questionnaire to describe frequency and bother of prolapse, bladder, bowel, and sexual symptoms and answered a semi-structured interview. ResultsNo significant change in number of women being sexually active was reported. There were no significant differences between groups regarding change in satisfaction with frequency of intercourse. Interview data revealed that 19 (39%) of women in the PFMT group experienced improved sexual function vs. two (5%) in the control group (P<0.01). Specific improvements reported by some of the women were increased control, strength and awareness of the pelvic floor, improved self-confidence, sensation of a tighter vagina, improved libido and orgasms, resolution of pain with intercourse, and heightened sexual gratification for partners. Women who described improved sexual function demonstrated the greatest increases in pelvic floor muscle (PFM) strength (mean 1610cmH(2)0) and endurance (mean 150 +/- 140cmH(2)0s) (P<0.01). ConclusionPFMT can improve sexual function in some women. Women reporting improvement in sexual function demonstrated the greatest increase in PFM strength and endurance. Braekken IH, Majida M, Ellstrom Engh M, and BO K. Can pelvic floor muscle training improve sexual function in women with pelvic organ prolapse? A randomized controlled trial. J Sex Med 2015;12:470-480.