Pelvic floor muscle training as a treatment for genitourinary syndrome of menopause: A single-arm feasibility study

Maturitas. 2019 Jul:125:57-62. doi: 10.1016/j.maturitas.2019.03.002. Epub 2019 Mar 29.


Objectives: Treatments for genitourinary syndrome of menopause (GSM) may not be suitable for all women, may not be completely effective, and may cause adverse effects. Therefore, there is a need to explore new treatment approaches. The objectives were to evaluate the feasibility of using a pelvic floor muscle training (PFMT) program in postmenopausal women with GSM, and to investigate its effect on symptoms, signs, activities of daily living (ADL), quality of life (QoL) and sexual function.

Study design: Postmenopausal women with GSM participated in a single-arm feasibility study embedded in a randomized controlled trial (RCT) on PFMT for urinary incontinence. This substudy was composed of two pre-intervention evaluations, a 12-week PFMT program and a post-intervention evaluation.

Main outcome measures: Feasibility was defined as study completion and participation in physiotherapy sessions and in-home exercises. The effects of the PFMT program were assessed by measuring GSM symptoms ('Most Bothersome Symptom' approach, ICIQ-UI SF), GSM signs (Vaginal Health assessment scale), GSM's impact on ADL (Atrophy Symptom questionnaire), QoL and sexual function (ICIQ-VS, ICIQ-FLUTSsex) and leakage episodes.

Results: Thirty-two women participated. The study completion rate was high (91%), as was participation in treatment sessions (96%) and in-home exercises (95%). Post-intervention, there were significant reductions in GSM symptoms and signs (p < 0.01) as well as in its impacts on ADL, QoL and sexual function (p < 0.05).

Conclusions: A study including a PFMT program is feasible, and the outcomes indicate PFMT to be an effective treatment approach for postmenopausal women with GSM and urinary incontinence. This intervention should be assessed through a RCT.

Keywords: Genitourinary syndrome of menopause; Menopause; Pelvic floor; Physiotherapy; Quality of life; Vaginal atrophy.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Activities of Daily Living
  • Aged
  • Atrophy / pathology
  • Atrophy / physiopathology*
  • Electric Stimulation Therapy
  • Exercise Therapy / methods*
  • Feasibility Studies
  • Female
  • Genital Diseases, Female / psychology
  • Genital Diseases, Female / rehabilitation
  • Humans
  • Menopause*
  • Middle Aged
  • Pelvic Floor / physiopathology*
  • Quality of Life
  • Sexuality
  • Surveys and Questionnaires
  • Treatment Outcome
  • Urinary Incontinence / psychology
  • Urinary Incontinence / rehabilitation*
  • Vagina / pathology
  • Vagina / physiopathology*