Female Sexual Function and Pelvic Floor Disorders

Overview

Journal Obstet Gynecol

Specialty Gynecology & Obstetrics

Date 2008 May 2

PMID 18448734

Citations 66

Authors

Victoria L Handa

Geoffrey Cundiff

Howard H Chang

Kathy J Helzlsouer

Affiliations

Soon will be listed here.

Abstract

Objective: To investigate the hypothesis that pelvic floor disorders are associated with female sexual problems, independently of other related factors.

Methods: The study population included 301 adult women seeking outpatient gynecologic and urogynecologic care. Pelvic floor disorders were assessed with the Pelvic Floor Disorders Inventory-20 (PFDI-20) and the pelvic organ prolapse quantification examination. Sexual function was assessed with the Personal Experiences Questionnaire. Using ordinal regression analysis, we identified characteristics and conditions associated with decreased libido, infrequent orgasm, decreased arousal, and dyspareunia.

Results: Sexual function was poorer among 78 women (26%) without a current sexual partner than among 223 with a partner (P<.01). Among the 223 with a current partner, women with a high Pelvic Floor Disorders Inventory score were significantly more likely to report decreased arousal (P<.01), infrequent orgasm (P<.01), and increased dyspareunia (P<.01). A similar pattern was observed for the urinary, colorectal-anal, and prolapse scales of the Pelvic Floor Disorders Inventory, although some associations were marginally significant. Stage III-IV prolapse was significantly associated with infrequent orgasm (P=.02), but other sexual complaints were not more common with increasing prolapse stage.

Conclusion: Pelvic floor symptoms are significantly associated with reduced sexual arousal, infrequent orgasm, and dyspareunia. We conclude that sexual function is worse in women with symptomatic prolapse but not in women with asymptomatic prolapse.

Level Of Evidence: II.

Citing Articles

Unraveling the Complexity of Vaginismus in Marital Relationship: A Case Series.

Sahoo M, Biswas H Cureus. 2024; 16(11):e73414.

PMID: 39669858 PMC: 11634548. DOI: 10.7759/cureus.73414.

Hagenbeck C, Kossendrup J, Soff J, Thangarajah F, Scholten N Acta Obstet Gynecol Scand. 2024; 104(1):203-214.

PMID: 39460381 PMC: 11683533. DOI: 10.1111/aogs.14990.

Pelvic floor dysfunction in postpartum women: A cross-sectional study.

Gao Q, Wang M, Zhang J, Qing Y, Yang Z, Wang X PLoS One. 2024; 19(10):e0308563.

PMID: 39361594 PMC: 11449369. DOI: 10.1371/journal.pone.0308563.

Evaluation of the Relationship between the Severity of Pelvic Organ Prolapse and Female Sexual Function.

Darvish S, Fakari F, Ashka N, Mazaheri A Adv Biomed Res. 2024; 13:41.

PMID: 39224400 PMC: 11368226. DOI: 10.4103/abr.abr_371_22.

Minimally Invasive Sacrocolpopexy: Impact on Sexual Function.

Ashmore S, Geller E, Bretschneider C Int Urogynecol J. 2024; 35(12):2335-2340.

PMID: 39101957 DOI: 10.1007/s00192-024-05834-z.

References

Gracia C, Freeman E, Sammel M, Lin H, Mogul M . Hormones and sexuality during transition to menopause. Obstet Gynecol. 2007; 109(4):831-40. DOI: 10.1097/01.AOG.0000258781.15142.0d. View

Barber M, Walters M, Bump R . Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7). Am J Obstet Gynecol. 2005; 193(1):103-13. DOI: 10.1016/j.ajog.2004.12.025. View

Dennerstein L, Randolph J, Taffe J, Dudley E, Burger H . Hormones, mood, sexuality, and the menopausal transition. Fertil Steril. 2002; 77 Suppl 4:S42-8. DOI: 10.1016/s0015-0282(02)03001-7. View

Bump R, Mattiasson A, Bo K, Brubaker L, DeLancey J, Klarskov P . The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol. 1996; 175(1):10-7. DOI: 10.1016/s0002-9378(96)70243-0. View

Basson R, Leiblum S, Brotto L, DeRogatis L, Fourcroy J, Fugl-Meyer K . Revised definitions of women's sexual dysfunction. J Sex Med. 2006; 1(1):40-8. DOI: 10.1111/j.1743-6109.2004.10107.x. View

Handa V, Harvey L, Cundiff G, Siddique S, Kjerulff K . Sexual function among women with urinary incontinence and pelvic organ prolapse. Am J Obstet Gynecol. 2004; 191(3):751-6. DOI: 10.1016/j.ajog.2003.11.017. View

Dennerstein L, Lehert P, Dudley E . Short scale to measure female sexuality: adapted from McCoy Female Sexuality Questionnaire. J Sex Marital Ther. 2001; 27(4):339-51. DOI: 10.1080/009262301317081098. View

Ananth C, Kleinbaum D . Regression models for ordinal responses: a review of methods and applications. Int J Epidemiol. 1998; 26(6):1323-33. DOI: 10.1093/ije/26.6.1323. View

Dennerstein L, Anderson-Hunt M, Dudley E . Evaluation of a short scale to assess female sexual functioning. J Sex Marital Ther. 2002; 28(5):389-97. DOI: 10.1080/00926230290001510. View

10.

Ozel B, White T, Urwitz-Lane R, Minaglia S . The impact of pelvic organ prolapse on sexual function in women with urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 2005; 17(1):14-7. DOI: 10.1007/s00192-005-1327-0. View

11.

Weber A, Walters M, Schover L, Mitchinson A . Sexual function in women with uterovaginal prolapse and urinary incontinence. Obstet Gynecol. 1995; 85(4):483-7. DOI: 10.1016/0029-7844(94)00434-F. View

12.

Ware Jr J, Kosinski M, Keller S . A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996; 34(3):220-33. DOI: 10.1097/00005650-199603000-00003. View

13.

Barber M, Visco A, Wyman J, Fantl J, Bump R . Sexual function in women with urinary incontinence and pelvic organ prolapse. Obstet Gynecol. 2002; 99(2):281-9. DOI: 10.1016/s0029-7844(01)01727-6. View

14.

Handa V, Zyczynski H, Brubaker L, Nygaard I, Janz N, Richter H . Sexual function before and after sacrocolpopexy for pelvic organ prolapse. Am J Obstet Gynecol. 2007; 197(6):629.e1-6. PMC: 2367128. DOI: 10.1016/j.ajog.2007.08.016. View

15.

Gallicchio L, Schilling C, Tomic D, Miller S, Zacur H, Flaws J . Correlates of sexual functioning among mid-life women. Climacteric. 2007; 10(2):132-42. DOI: 10.1080/13697130601167956. View

16.

Rogers R, Kammerer-Doak D, Darrow A, Murray K, Qualls C, Olsen A . Does sexual function change after surgery for stress urinary incontinence and/or pelvic organ prolapse? A multicenter prospective study. Am J Obstet Gynecol. 2006; 195(5):e1-4. DOI: 10.1016/j.ajog.2006.09.021. View

17.

Komesu Y, Rogers R, Kammerer-Doak D, Barber M, Olsen A . Posterior repair and sexual function. Am J Obstet Gynecol. 2007; 197(1):101.e1-6. PMC: 3097466. DOI: 10.1016/j.ajog.2007.03.054. View

18.

Maher C, Baessler K, Glazener C, Adams E, Hagen S . Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev. 2007; (3):CD004014. DOI: 10.1002/14651858.CD004014.pub3. View

19.

Lukacz E, Whitcomb E, Lawrence J, Nager C, Contreras R, Luber K . Are sexual activity and satisfaction affected by pelvic floor disorders? Analysis of a community-based survey. Am J Obstet Gynecol. 2007; 197(1):88.e1-6. DOI: 10.1016/j.ajog.2007.02.053. View