Pelvic floor muscle training: mechanisms of action for the improvement of genitourinary syndrome of menopause

Mercier, Joanie; Morin, Mélanie; Tang, An; Reichetzer, Barbara; Lemieux, Marie-Claude; Samir, K.; Zaki, Dina; Gougeon, F.; Dumoulin, Chantale

doi:10.1080/13697137.2020.1724942

Cited by 25 publications

(12 citation statements)

References 28 publications

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“…Women with sensitiveness to palpation usually present with decreased ability to achieve and sustain a PFM contraction and to relax the PFM after activation (McLean & Brooks, 2017). PFMT can contribute to improve PFM function by an increase in the number of capillaries in trained muscle, improving blood flow and reducing muscle tone (Mercier et al., 2020; Naess & Bo, 2018).…”

Section: Discussionmentioning

confidence: 99%

Pelvic floor muscle training for women with lumbopelvic pain: A systematic review and meta‐analysis

Vesentini

Prior

Ferreira

et al. 2020

European Journal of Pain

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Background and Objective: It has been suggested that pelvic floor dysfunction may contribute to the development of lumbopelvic pain as a result of changes in trunk muscle control. However, there is limited evidence that pelvic floor muscle training (PFMT) can improve clinical outcomes in women with lumbopelvic pain. Databases and Data Treatment: Six databases were searched for randomized controlled trials (RCTs) comparing the effectiveness of PFMT to other conservative interventions (usual physiotherapy care or minimal intervention), no treatment or placebo interventions on pain and disability in women with lumbopelvic pain. Results: We included eight RCTs totalling 469 participants. PFMT was more effective than minimal intervention for lumbopelvic pain [mean difference (MD) 15.9/100 (95% confidential interval (CI), 8.2 to 23.6; p = 0.00; I 2 = 3.92%)] and disability [standardized mean difference (SMD) 0.5 (95% CI 0.1-0.9; p = 0.00; I 2 = 0%)] during pregnancy. PFMT was more effective than usual physiotherapy care for pain (MD 11.7/100 [95% CI 7.5-15.9; p = 0.00; I 2 = 94.14%]) and disability (SMD 0.3 (95% CI 0.0-0.6; p = 0.01; I 2 = 82.54%]) in non-pregnant women. Effect sizes were in general of arguable clinical relevance. Conclusions: Overall, the certainty of the evidence was very low to low. There is no conclusive evidence that the addition of PFMT to usual physiotherapy care or minimal intervention is superior to minimal intervention and usual care alone given the small number of studies and high levels of heterogeneity of included studies. Further well-designed trials are needed to establish the effectiveness of PFMT for lumbopelvic pain in women.

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Section: Discussionmentioning

confidence: 99%

Pelvic floor muscle training for women with lumbopelvic pain: A systematic review and meta‐analysis

Vesentini

Prior

Ferreira

et al. 2020

European Journal of Pain

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show abstract

“…The mechanism of how PFMT helps to address GSM symptoms has been shown to be impactful in the following ways: improves vulvoginal blood flow, enhances tissue elasticity, and restores pelvic floor muscle coordination and function [80].…”

Section: Pelvic Floor Physical Therapymentioning

confidence: 99%

“…With PFM activation, the internal pudendal artery is able to provide more blood flow to the vagina, vulva, clitoris, PFM, and the perineum [80]. The improvement in blood flow to these structures facilitates an increase in the production of vaginal secretions and improves thickness of the vaginal mucosa.…”

Section: Pelvic Floor Physical Therapymentioning

confidence: 99%

“…Poor tissue elasticity along with vaginal dryness can cause tissue friction and vulvovaginal pain. A 12-week study on the impact of PFMT on GSM symptoms by Mercier et al [80] showed that effective training of these muscles improved tissue elasticity and relaxation capacity. There was also a significant increase in vaginal mucosal thickness and the introital width.…”

Section: Pelvic Floor Physical Therapymentioning

confidence: 99%

“…There was also a significant increase in vaginal mucosal thickness and the introital width. This led the authors to conclude that contraction and relaxation exercises of the PFM may help reduce vulvovaginal tissue friction and dyspareunia during intercourse [80].…”

Section: Pelvic Floor Physical Therapymentioning

confidence: 99%

See 2 more Smart Citations

Genitourinary and Sexual Health

Krapf

Nwabuebo²,

Miller³

2021

Each Woman’s Menopause: An Evidence Based Resource

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Is there evidence for pelvic floor muscle relaxation training in nonneurogenic female bladder outlet obstruction?—A narrative review

Bø

2024

Neurourology and Urodynamics

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IntroductionFunctional bladder outlet obstruction (BOO) in women is postulated to be caused by pelvic floor muscle (PFM) dyssynergia or increased tone. The aim of the present review was to investigate the effect of PFM relaxation training on PFM tone and female BOO symptoms.Materials and MethodsThis was a narrative review using an open search strategy on PubMed with the search terms “Bladder outlet obstruction” AND “female” AND (“pelvic floor muscles” OR “Kegel”). The risk of bias of the randomized controlled trials (RCTs) was scored with the Physiotherapy Evidence Database (PEDro) scale (0–10).ResultsOnly three RCTs were found. All three RCTs compared different types of exercise, and no trial compared relaxation training with no or sham treatment. None of the trials reported the effect between groups on the reduction of PFM tone. There was a tendency toward positive effect of PFM relaxation training to improve BOO symptoms in women. PEDro score varied between 4 and 7. Few studies yielded information on the immediate effect of any type of PFM relaxation technique on PFM tone.ConclusionFew RCTs have been conducted on the effect of PFM relaxation training on PFM tone and functional female BOO symptoms. There is an urgent need for RCTs with high methodological and interventional quality in addition to basic research on mechanisms of different relaxation techniques on PFM activity.

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Pelvic floor muscle training: mechanisms of action for the improvement of genitourinary syndrome of menopause

Cited by 25 publications

References 28 publications

Pelvic floor muscle training for women with lumbopelvic pain: A systematic review and meta‐analysis

Pelvic floor muscle training for women with lumbopelvic pain: A systematic review and meta‐analysis

Genitourinary and Sexual Health

Is there evidence for pelvic floor muscle relaxation training in nonneurogenic female bladder outlet obstruction?—A narrative review

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