Can Pelvic Floor Muscle Training Improve Sexual Function in Women with Pelvic Organ Prolapse? A Randomized Controlled Trial
Abstract
Introduction: Pelvic 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. Aim: The aim of the trial was to evaluate the effect of PFMT on sexual function in women with POP. Methods: In 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 Measures: 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. Results: No 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 16 ± 10 cmH20) and endurance (mean 150 ± 140 cmH20s) (P < 0.01). Conclusion: PFMT can improve sexual function in some women. Women reporting improvement in sexual function demonstrated the greatest increase in PFM strength and endurance.
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Braekken et al. (2015) found no significant change in the number of sexually active women and no significant differences between groups regarding change in satisfaction with frequency of intercourse.
“Braekken et al. (2015) [74] using a validated questionnaire from Mouritsen et al. (2003) [73] found no significant change in the number of sexually active women and no significant differences between groups regarding change in satisfaction with frequency of intercourse.”
From International urogynecology consultation chapter 3 committee 2; conservative treatment of patient with pelvic organ prolapse: Pelvic floor muscle training (2022) · cites this paper as [74]
Two studies found some effect of PFMT on sexual function in women with POP.
“Two studies found some effect of PFMT on sexual function [74, 75].”
From International urogynecology consultation chapter 3 committee 2; conservative treatment of patient with pelvic organ prolapse: Pelvic floor muscle training (2022) · cites this paper as [74]
Interview data showed that 19 (39%) of women in the PFMT group reported improved sexual function compared to only two participants (5%) in the control group (P < 0.01).
“However, interview data showed that 19 (39%) of women in the PFMT group reported improved sexual function compared to only two participants (5%) in the control group (P < 0.01).”
From International urogynecology consultation chapter 3 committee 2; conservative treatment of patient with pelvic organ prolapse: Pelvic floor muscle training (2022) · cites this paper as [74]
The two RCTs offering supervised PFMT for a longer time showed improvement in bladder and anorectal symptoms in women with POP.
“The two RCTs offering supervised PFMT for a longer time showed improvement in bladder and anorectal symptoms in women with POP [25, 39, 74].”
From International urogynecology consultation chapter 3 committee 2; conservative treatment of patient with pelvic organ prolapse: Pelvic floor muscle training (2022) · cites this paper as [74]
Only two RCTs showed some positive effects of PFMT on sexual function of women with POP.
“We found that only two RCTs which showed some positive effects of PFMT on sexual function of women with POP [71, 74].”
From International urogynecology consultation chapter 3 committee 2; conservative treatment of patient with pelvic organ prolapse: Pelvic floor muscle training (2022) · cites this paper as [74]
Eight studies found that PFMT improved bladder symptoms and five studies found improvement of anorectal symptoms in women with POP.
“Eight studies found that PFMT improved bladder symptoms [38, 39, 43, 44, 47, 60, 61, 74] and five studies found improvement of anorectal symptoms [39, 43, 44, 47, 61, 74].”
From International urogynecology consultation chapter 3 committee 2; conservative treatment of patient with pelvic organ prolapse: Pelvic floor muscle training (2022) · cites this paper as [74]
Participants who described improved sexual function obtained the greatest increases in PFM strength (mean 16 ± 10 cmH2O) and endurance (mean 150 ± 140 cmH2O s) (P < 0.01).
“Additionally, the study found that participants who described improved sexual function obtained the greatest increases in pelvic floor muscle (PFM) strength (mean 16 ± 10 cmH2O) and endurance (mean 150 ± 140 cmH2O s) (P < 0.01).”
From International urogynecology consultation chapter 3 committee 2; conservative treatment of patient with pelvic organ prolapse: Pelvic floor muscle training (2022) · cites this paper as [74]
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- Authors
- Brækken, I. H., Majida, M., Ellström Engh, M., & Bø, K.
- Affiliations
- University of Bergen (NO)
- Akershus University Hospital (NO)
- Department of Obstetrics and Gynaecology , Lørenskog , Norway
- Norwegian School of Sport Sciences (NO)
- Corresponding author
- Brækken, Ingeborg H.
- Venue
- The Journal of Sexual Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2015-02-01
- Volume
- 12
- Issue
- 2
- Pages
- 470-480
- ISSN
- 1743-6095 (ISSN-L)
- 1743-6109
- OpenAlex
- W1871265368
- Cited by
- 75
- References
- 52
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 7 · 2023: 5 · 2022: 8 · 2021: 10 · 2020: 7 · 2019: 3 · 2018: 7 · 2017: 7 · 2016: 3 · 2015: 7
- FWCI
- 4.70
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- The Journal of Sexual Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- EkstraStiftelsen Helse og Rehabilitering (Stiftelsen Dam)
- Akershus Universitetssykehus
- Topics
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Health Sciences › Medicine › Urology › Urinary Bladder and Prostate Research
- Keywords
- pelvic floor muscle training, pelvic organ prolapse, sexual function, women's sexual health, pelvic floor muscle strength, pelvic floor muscle endurance, lifestyle advice, dyspareunia, orgasm, sexual desire
- MeSH terms
- Exercise Therapy, Female, Humans, Middle Aged, Surveys and Questionnaires, Sexual Dysfunction, Physiological, Outcome Assessment, Health Care, Pelvic Floor, Muscle Strength, Pelvic Organ Prolapse
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