Female Sexual Function and Pelvic Floor Disorders

Abstract

Objectives-Sexual function is an important dimension of adult life and yet very little is known about the relationships between female sexuality and chronic health conditions, including pelvic floor disorders. Our goal was to investigate the hypothesis that pelvic floor disorders are associated with female sexual problems, independent of other related factors.Methods-The study population included 301 adult women seeking outpatient gynecologic and urogynecologic care. Pelvic floor disorders were assessed with the Pelvic Floor Disorders Inventory-20 (PFDI) and the Pelvic Organ Prolapse Quantification examination. Sexual function was assessed with the Personal Experiences Questionnaire. Using ordinal regression analysis, we identified characteristics and conditions associated with decreased libido, infrequent orgasm, decreased arousal, and dyspareunia.Results-Sexual function was poorer among 78 women (26%) without a current sexual partner than among 223 with a partner (p<0.01). Among the 223 with a current partner, women with a high PFDI score were significantly more likely to report decreased arousal (p<0.01), infrequent orgasm (p<0.01) and increased dyspareunia (p<0.01). A similar pattern was observed for the urinary, colorectal-anal, and prolapse scales of the PFDI, although some associations were marginally significant. Stage III-IV prolapse was significantly associated with infrequent orgasm (p=0.02), but other sexual complaints were not more common with increasing prolapse stage.Conclusion-Pelvic floor symptoms are significantly associated with reduced sexual arousal, infrequent orgasm, and dyspareunia. Clinicians who care for women with pelvic floor disorders should be aware of this association and should specifically address sexual concerns with women seeking treatment of incontinence and prolapse.

Sexual function in older women with pelvic floor symptoms: a cross-sectional study in general practice

“…7 However, the evidence on the relationship between pelvic floor symptoms and sexual function remains conflicting. [10][11][12][13] Research in general practice is scarce, and it is difficult to extrapolate evidence from research performed in urogynaecology clinics 3,[7][8][9] to general practice, since women presenting at these clinics may be a selection of women with more severe symptoms.…”

“…6 More than one-third of sexually active women with an advanced prolapse indicate that their sexuality is affected by prolapse symptoms, 7 and experiencing more pelvic floor symptoms is associated with poorer sexual function. 8,9 Embarrassment or discomfort, resulting from prolapse or urinary incontinence, can result in sexual inactivity. 7 However, the evidence on the relationship between pelvic floor symptoms and sexual function remains conflicting.…”

A Clinical Perspective On Sexuality With Pregnancy and Postpartum

“…Women with 2° perineal tears had an 80% increased incidence of dyspareunia at 3 months postpartum and women with 3° and 4° tears had a 270% increased incidence of dyspareunia. Pelvic organ prolapse, urinary incontinence, and anal incontinence correlate significantly with sexual dysfunction [25,26] and the importance of pelvic floor exercises during pregnancy and postpartum cannot be stressed enough as a way to decrease urinary and anal incontinence at 12 months [27].…”

Estradiol plays a role in regulating the expression of lysyl oxidase family genes in mouse urogenital tissues and human Ishikawa cells

“…Pelvic organ prolapse (POP) affects many women, leading to a decreased quality of life (Handa et al, 2008). There are multiple causes of POP, with aging, obesity, vaginal childbirth, and menopause as risk factors and with most patients being older and postmenopausal (Olsen et al, 1997;Hunskaar et al, 2005).…”