The Relationship Between Pelvic Floor Function and Sexual Function in Perimenopausal Women

Sexual Medicine - Tập 9 - Trang 100441 - 2021
Zhihong Zhuo1, Chuhan Wang1, Huimin Yu1, Jing Li1
1HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, People's Republic of China

Tóm tắt

Abstract Introduction Perimenopausal women with pelvic floor dysfunction have worse sexual function than women with functional pelvic floor muscle (PFM), especially in terms of libido, orgasm, sexual satisfaction, and total Female Sexual Function Index (FSFI) scores. Aim To explore the relationship between pelvic floor muscle function, hormone levels and sexual function in perimenopausal women. Methods An analytical cross-sectional study was conducted in 252 women aged 40–55 without pelvic floor disease with FSFI, pelvic floor muscle strength and the hormone levels. Main Outcome Measure The principle aim was to determine the relationships between sexual dysfunction, PFM strength, and hormone levels. Results In the functional PFM group, the proportion of menopausal hormone therapy was higher. The proportion of overweight in the dysfunctional PFM group was higher, and had more sexual desire disorder, more orgasm disorder, lower sexual satisfaction, and poor FSFI scores. The correlation between PFM strength, sexual function and female sex hormones suggested that PFM strength and libido, sexual satisfaction and FSFI score are significantly positively correlated, while PFM strength and sexual arousal disorder and vaginal lubricity had a positive correlation. In the multivariate analysis of the risk of sexual dysfunction among perimenopausal women, the higher the PFM strength, the lower the risk of sexual dysfunction. Conclusions Perimenopausal women with pelvic floor dysfunction have worse sexual function than women with functional PFM, especially in obese women, those with central adiposity, and not using hormone replacement therapy. The PFM strength was weakly positively correlated with sexual arousal, orgasm, sexual satisfaction, and FSFI score.

Tài liệu tham khảo

Aslan, 2008, Female suxual dysfunction, Int Urogynecol J Pelvic Floor Dysfunct, 19, 293, 10.1007/s00192-007-0436-3 Shifren, 2008, Sexual problems and distress in United States women: Prevalence and correlates, Obstet Gynecol, 112, 970, 10.1097/AOG.0b013e3181898cdb Meston, 2003, Validation of the female sexual function index (FSFI) in women with female orgasmic disorder and in women with hypoactive sexual desire discorder, J sex Marital Ther, 29, 39, 10.1080/713847100 Basson, 2000, Report of the international consensus development conference on female sexual dysfunction: Definitions and classifications, J Urol, 163, 888, 10.1016/S0022-5347(05)67828-7 Tosun, 2016, Assessment of the effect of pelvic floor exercises on pelvic floor musclestrength using ultrasonography in patients with urinary incontinence: A prospectiverandomized controlled trial, J Phy Ther Sci, 28, 360, 10.1589/jpts.28.360 MacLennan, The prevalence of pelvic floor disorders and their relationship to gender, age, parity and mode of delivery, BJOG, 107, 1460, 10.1111/j.1471-0528.2000.tb11669.x Weber, 2015, Local oestrogen for pelvic floor disorders: A systematic review, PLoS One, 10, 10.1371/journal.pone.0136265 Bø, 2005, Evaluation of female pelvic-floor muscle function and strength, Phys Ther, 85, 269, 10.1093/ptj/85.3.269 Rahn, 2015, Vaginal estrogen use in postmenopausal women with pelvic floor disorders: Systematic review and practice guidelines, Int Urogynecol J, 26, 3, 10.1007/s00192-014-2554-z Mannella, 2013, The female pelvic floor through midlife and aging, Maturitas, 76, 230, 10.1016/j.maturitas.2013.08.008 Nygaard, 2008, Pelvic floor disorders network. Prevalence of symptomatic pelvic floor disorders in US women, JAMA, 300, 1311, 10.1001/jama.300.11.1311 Rostaminia, 2015, How well can levator ani muscle morphology on 3D pelvic floor ultrasound predict the levator ani muscle function?, Int Urogynecol J, 26, 257, 10.1007/s00192-014-2503-x Rosen, 2000, The female sexual function index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function, J Sex Marital Ther, 26, 191, 10.1080/009262300278597 Pacagnella, 2009, Construct validity of a portuguese version of the female sexual function index, Cad Saude Publica, 25, 2333, 10.1590/S0102-311X2009001100004 Sun, 2011, Development and validation of Chinese version of female sexual function index in a Chinese population-a pilot study, J Sex Med, 8, 1101, 10.1111/j.1743-6109.2010.02171.x Chedraui, 2009, Assessment of sexuality among middle-aged women using the female sexual function index, Climacteric, 12, 213, 10.1080/13697130802607727 Iauman, 1999, Sexual dysfunction in the United States: Prevalence and predictors, JAMA, 281, 537, 10.1001/jama.281.6.537 Lou, 2017, Prevalence and factors associated with female sexual dysfunction in Beijing, China, Chin Med J(Engl), 130, 1389 Yang, 2017, Sexual dysfunction among Chinese nurses: Prevalence and predictors, Biomed Environ Sci, 30, 229 Tuncel, 2017, Sexual dysfunction in female patients with type 2 diabetes mellitus: A cross-sectional single-centre study among turkish patient, Hum Fertil(Camb), 20, 192, 10.1080/14647273.2016.1266039 Zhang, 2017, A population-based epidemiologic study of female sexual dysfunction risk in mainland China: Prevalence and predictors, J Sex Med, 14, 1348, 10.1016/j.jsxm.2017.08.012 Barrett, 2000, Women's sexual health after childbirth, BJOG, 107, 186, 10.1111/j.1471-0528.2000.tb11689.x Wiegel, 2005, The female sexual function index (FSFI): Cross-validation and development of clinical cutoff scores, J Sex Marital Ther, 31, 1, 10.1080/00926230590475206 Witting, 2008, Evaluation of the female sexual function index in a population based sample from Finland, Arch Sex Behav, 37, 912, 10.1007/s10508-007-9287-8 Kammerer-Doak, 2008, Female sexual function and dysfunction, Obstet Gynecol Clin North Am, 35, 169, 10.1016/j.ogc.2008.03.006 Martinez, 2014, Women with greater pelvic floor muscle strength have better sexual function, Acta Obstet Gynecol Scand, 93, 497, 10.1111/aogs.12379 Lipschuetz, 2015, Degree of bother from pelvic floor dysfunction in women one year after first delivery, Eur J Obstet Gynecol Reprod Biol, 191, 90, 10.1016/j.ejogrb.2015.05.015 Fritel, 2012, Female urinary incontinence, from pregnancy to menopause: A review of epidemiological and pathophysiological findings, Acta Obstet Gynecol Scand, 91, 901, 10.1111/j.1600-0412.2012.01419.x Lukacz, 2007, Are sexual activity and satisfaction affected by pelvic floor disorders? Analysis of community-based survey, Am J Obstet Gynecol, 197, 88, 10.1016/j.ajog.2007.02.053 Handa, 2008, Female sexual function and pelvic floor disorders, Obstet Gynecol, 111, 1045, 10.1097/AOG.0b013e31816bbe85 Palacios, 2015, Update on management of genitourinary syndrome of menopause: A practical guide, Maturitas, 82, 307, 10.1016/j.maturitas.2015.07.020 2013, Management of symptomatic vulvovaginal atrophy: 2013 position statement of The North American Menopause Society, Menopause, 20, 888, 10.1097/GME.0b013e3182a122c2 Brown, 2006, Subjective and objective outcomes of botulinum toxin type A treatment in vestibulodynia: pilot data, J Reprod Med, 51, 635 Thibault-Gagnon, 2014, Do women notice the impact of childbirth-related levator trauma on pelvic floor and sexual function? Results of an observational ultrasound study, Int Urogynecol J, 25, 1389, 10.1007/s00192-014-2331-z Hetrick, 2006, Pelvic floor electromyography in men with chronic pelvic pain syndrome: A case-control study, Neurourol Urodyn, 25, 46, 10.1002/nau.20162