Pelvic Floor Muscle Training Effect in Sexual Function in Postmenopausal Women: A Randomized Controlled Trial

J Sex Med. 2021 Jul;18(7):1236-1244. doi: 10.1016/j.jsxm.2021.05.005. Epub 2021 Jun 27.


Background: The prevalence of sexual dysfunction is high in postmenopausal women and pelvic floor muscle training (PFMT) could improve sexual function during this period.

Aim: To assess the effect of a PFMT protocol on sexual function in postmenopausal women and to investigate the effect of this protocol on pelvic floor muscle function.

Methods: This is an assessor blinded randomized controlled trial including 77 postmenopausal women. The study was registered in ReBEC Trial: RBR-3s3ff7. The intervention group (n = 40) received an intensive supervised PFMT protocol during 12 weeks and the control group (n = 37) received no intervention.

Outcomes: The primary outcome of the study was assessed by the Female Sexual Function Index (FSFI) questionnaire and the secondary outcome was the evaluation of pelvic floor muscle function performed by digital palpation using the modified Oxford scale at baseline and after 12 weeks.

Results: No difference between groups was found in the FSFI domains and total score at baseline and in the second evaluation after 12 weeks. However, after 12 weeks, a higher percentage of women without sexual dysfunction was found in the intervention group (95% CI = 27.97-72.03) when compared to the control group (95% CI = 7.13-92.87). No difference was found between groups in relation to the pelvic floor muscle function at the baseline (P = .2) and after 12 weeks (P = .06).

Clinical implications: PFMT is a conservative intervention that can lead women to have less sexual dysfunction.

Strengths & limitations: The protocol provided a reduced number of women with sexual dysfunction, the strength of this research is the study design and the limitation is to have used only one tool to assess sexual function although it is a validated questionnaire.

Conclusion: PFMT decreases sexual dysfunction in postmenopausal women. MM Franco, CC Pena, LM de Freitas, et al. Pelvic Floor Muscle Training Effect in Sexual Function in Postmenopausal Women: A Randomized Controlled Trial. J Sex Med 2021;18:1236-1244.

Keywords: Pelvic Floor; Pelvic Floor Muscle; Physical Therapy; Physiotherapy; Postmenopause; Sexuality; Women's Health.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Exercise Therapy
  • Female
  • Humans
  • Pelvic Floor*
  • Postmenopause
  • Sexual Dysfunction, Physiological* / therapy
  • Surveys and Questionnaires
  • Treatment Outcome