Pelvic floor dysfunctions in women with fibromyalgia: A cross-sectional study

Eur J Obstet Gynecol Reprod Biol. 2023 Mar:282:1-6. doi: 10.1016/j.ejogrb.2022.12.030. Epub 2022 Dec 30.


Background: Fibromyalgia (FM) is a rheumatic syndrome that causes musculoskeletal disorders and is associated with several problems that affect quality of life. As the musculoskeletal system is affected, it can have an impact on the pelvic floor muscles, leading to pelvic floor dysfunction (PFD).

Objective: Investigate the occurrence of PFD, such as urinary incontinence (UI) and anal incontinence (AI), sexual problems, and pelvic organ prolapse (POP), in women with FM compared to a control group composed of women without FM; and investigate the association between FM and PFD.

Study design: This was an online cross-sectional survey. Demographic and anthropometric data, the description of PFD (UI, nocturia, AI, genital-pelvic pain/penetration disorder, and POP), and previous obstetric history were collected through a web-based questionnaire. The groups were compared using the independent t-test for quantitative variables and the chi-square test for categorical variables. The association between FM and PFD was tested using logistic regression analysis.

Results: A total of 175 women answered the questionnaire (97 with FM and 78 healthy controls). The women with FM reported significantly more UI, mixed urinary incontinence, AI, POP, and vaginismus than the healthy controls (p ≤ 0.05). FM was associated with mixed urinary incontinence (OR: 2.6; 95 % CI: 1.1-6.4; p = 0.04), anal incontinence (OR: 2.9; 95 % CI: 1.3-6.1; p = 0.01), and flatus incontinence (OR: 2.6; 95 % CI: 1.2-5.4; p = 0.01).

Conclusion: The prevalence of PFD was significantly higher in women with FM compared to healthy women. Indeed, the women with FM were 2.6-fold to 2.9-fold more likely to report mixed urinary incontinence, anal and flatus incontinence than those in the control group. The present findings show possible impairment of the pelvic floor musculature in women with FM.

Keywords: Dyspareunia; Fecal incontinence; Pelvic floor disorders; Rheumatic diseases; Urinary incontinence.

MeSH terms

  • Cross-Sectional Studies
  • Fecal Incontinence* / epidemiology
  • Fecal Incontinence* / etiology
  • Female
  • Fibromyalgia* / complications
  • Fibromyalgia* / epidemiology
  • Flatulence / complications
  • Humans
  • Pelvic Floor
  • Pelvic Floor Disorders* / complications
  • Pelvic Floor Disorders* / epidemiology
  • Pelvic Organ Prolapse* / complications
  • Pelvic Organ Prolapse* / epidemiology
  • Pregnancy
  • Quality of Life
  • Surveys and Questionnaires
  • Urinary Incontinence* / epidemiology
  • Urinary Incontinence* / etiology
  • Urinary Incontinence, Stress* / etiology
  • Urinary Incontinence, Urge / complications