(099) A Systematic Review Investigating the Involvement of the Pelvic Floor Muscles in Sexual Function and Sexual Response
Authors: Faucher S , Dery-Rouleau G , Bardin M , Morin M 
Published: May 2023

Abstract

Introduction
The pelvic floor muscles (PFM) have been suggested to play a key role in sexual function and sexual response in women. However, current syntheses of the evidence have been limited to interventional studies investigating the effect of modalities targeting the PFM on sexual function in women with pelvic pain and pelvic floor disorders. The literature has therefore never been critically appraised while excluding these potential confounders, which prevents to fully capture and understand the involvement of the PFM in sexual function and sexual response.

Objective
To examine and synthesize the available evidence on: i) the effects of PFM training on sexual function in women without pelvic pain or pelvic disorders, ii) the association between PFM function and sexual function/response and iii) the differences in the PFM function between women with and without sexual dysfunctions.

Methods
Electronic databases including Medline, Cochrane, CENTRAL, CINAHL, Psycinfo, Sportdiscuss, AMED, Scopus and EMBASE were searched using a peer-reviewed search strategy. We also performed a hand search of the references of all relevant articles and a grey literature search. Main outcomes included sexual function (self-reported questionnaire), sexual response (physiological test) and PFM function (strength and tone assessed with various assessment tools). We included interventional studies (randomized controlled trials and non-randomized studies) investigating the effects of PFM training on sexual outcomes as well as observational studies examining the association between PFM function (strength and tone) and sexual outcomes or the differences in PFM function in women with and without sexual dysfunctions. Quality of selected studies was assessed using the Mixed Methods Appraisal Tool by a team of two reviewers and disagreements were resolved by consensus or involvement of a third-party.

Results
The literature search resulted in 33 eligible studies including 14 interventional studies and 19 observational studies. Most studies (31/33) were of moderate quality or higher. Overall, 10 of the 14 interventional studies reported that PFM training had a significant effect on sexual function. Of the 11 observational studies investigating the association between PFM function and sexual function, 8 showed significant correlations (ranging from weak to strong) with sexual satisfaction, lubrication, arousal, orgasm or overall sexual function. Of the observational studies, 7 supported the involvement of the PFM as part of the sexual response (i.e. in the arousal and orgasm phases). Regarding the 3 studies evaluating the differences in the PFM function of women with and without sexual dysfunctions, the results were conflicting.

Conclusions
Findings of this review support the involvement of the PFM in sexual function and in sexual response in women without pain and pelvic dysfunctions. This review supports the need to further investigate modalities targeting the PFM as part of the management for sexual dysfunctions.

Disclosure
No