Can pelvic floor muscle training improve sexual function in women with pelvic organ prolapse?

Pelvic floor muscle training (PFMT) has level 1 evidence of decreasing the size and symptoms related to pelvic organ prolapse (POP). There is scant knowledge, however, regarding whether PFMT has an effect on sexual function. This trial’s objective was to evaluate the effect of PFMT on sexual function in women with POP. Participants completed a validated POP-specific questionnaire to describe frequency and bother of prolapse, bladder, bowel, and sexual symptoms and answered a semi-structured interview. No significant change in number of women being sexually active was reported. There were no significant differences between groups related to 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 greater levels of 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 16 ± 10 cmH2 0) and endurance (mean 150 ± 140 cmH2 0s) (P < 0.01).

PFMT can improve sexual function in some women. Women reporting improvement in sexual function showed the largest increase in PFM strength and endurance.