Pelvic floor strengthening exercise program for women with sexual dysfunction
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Abstract
Introduction: Female sexual dysfunction is one of the gynecological consultations with the highest demand, being dyspareunia one of the disorders that afflict the female population in 26%. Pelvic floor muscle training exercises are a treatment to mitigate the adverse effects on sexual function. Some of the sexual health programs in physiotherapy are multimodal, integrating exercises with sexual education. Objective: To analyze physiotherapeutic programs aimed at pelvic floor muscle strengthening through literature reviews to mitigate female sexual dysfunction. Methodology: It is of bibliographic type with documentary design, inductive method, with data collected since 2017 from the following databases: PubMed, ProQuest, ScienceDirect, EBSCO, Semantic Scholar, SPRINGER LINK and Em Saúde. We were able to identify, filter and pre-analyze randomized clinical trials with the help of Boolean operators (AND, OR and NOT), along with inclusion, exclusion criteria and the Physiotherapy Evidence Database scale. Results: It started with a population of 112 articles, after analyzing a sample of 27 articles was obtained, covering pelvic floor strengthening programs in female sexual dysfunction, starting by raising awareness of pelvic muscle contraction, along with instruments, sex education, partner support and self-directed work, being effective in dyspareunia and sexual dysfunction disorders. Conclusions: It was demonstrated the effectiveness of multimodal programs in training the hypotonic pelvic floor musculature, increasing sexual desire, lubrication, orgasm, sexual satisfaction, and pain reduction in women with sexual dysfunction. General Area of Study: Physical therapy. Specific area of study: Pelvic floor. Type of study: Bibliography Review.
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Calvopiña Caizahuano, V. E., Rodríguez Bermeo, E. A., Barreno Gadvay, A. D., & Vallejo Chinche, S. D. P. (2025). Pelvic floor strengthening exercise program for women with sexual dysfunction. Anatomía Digital, 8(1.1), 22-46. https://doi.org/10.33262/anatomiadigital.v8i1.1.3317
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Articulos de revisión bibliográfica
References
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2. Arias S. Disfunción sexual femenina por deterioro de la musculatura del suelo pélvico tras el proceso de embarazo y parto. Programa de entrenamiento muscular del suelo pélvico. NPunto [Internet]. 2020 [citado 16 de Diciembre de 2024]; 3(33): 79-106. Disponible en: https://dialnet.unirioja.es/servlet/articulo?codigo=8227492
3. Clayton AH, Valladares Juarez EM. Female Sexual Dysfunction. Medical Clinics of North America [Internet]. 2019 [citado 16 de Diciembre de 2024]; 103(4):681-698. Disponible en: https://doi.org/10.1016/j.mcna.2019.02.008
4. Hill DA, Taylor CA. Dyspareunia in Women. American family physician [Internet]. 2021 [citado 16 de Diciembre de 2024]; 103(10):597-604. Disponible en: https://www.aafp.org/pubs/afp/issues/2021/0515/p597.html
5. McCool-Myers M, Theurich M, Zuelke A, Knuettel H, Apfelbacher C. Predictors of female sexual dysfunction: a systematic review and qualitative analysis through gender inequality paradigms. BMC women's health [Internet]. 2018 [citado 16 de Diciembre de 2024]; 18(108):1-15. Disponible en: https://doi.org/10.1186/s12905-018-0602-4
6. Nazarpour S, Simbar M, Majd HA, Tehrani FR. Beneficial effects of pelvic floor muscle exercises on sexual function among postmenopausal women: a randomised clinical trial. Sex Health [Internet]. 2018 [citado 16 de Diciembre de 2024]; 15(5):396-402. Disponible en: https://www.publish.csiro.au/sh/SH17203
7. Gonzaga S, Oliveira RG de, Paiva BRM, Domanoski NB, Dutra LL, Oliveira LC de. Pelvic floor muscle training vs. Pilates exercises on the sexual function of post-menopause women with urinary incontinence: PFMT vs. Pilates on the sexual function. Manual Therapy, Posturology & Rehabilitation Journal [Internet]. 2023 [citado 16 de Diciembre de 2024]; 21. Disponible en: https://doi.org/10.17784/mtprehabjournal.2023.21.1300
8. Morin M, Dumoulin C, Bergeron S, Mayrand M-H, Khalifé S, Waddell G, et al. Multimodal physical therapy versus topical lidocaine for provoked vestibulodynia: a multicenter, randomized trial. American journal of obstetrics and gynecology [Internet]. 2021 [citado 16 de Diciembre de 2024]; 224(2), 189.e1-189.e12. Disponible en: https://www.ajog.org/article/S0002-9378(20)30866-8/abstract
9. Erdős C, Kelemen O, Pócs D, Horváth E, Dudás N, Papp A, et al. Female sexual dysfunction in association with sexual history, sexual abuse and satisfaction: A cross-sectional study in Hungary. Journal of Clinical Medicine [Internet]. 2023 [citado 16 de Diciembre de 2024]; 12(3):1112. Disponible en: https://www.mdpi.com/2077-0383/12/3/1112
10. Tserotas K, Blümel JE. Menopause research in Latin America. Climacteric [Internet]. 2019 [citado 16 de Diciembre de 2024]; 22(1): 17-21. Disponible en: https://doi.org/10.1080/13697137.2018.1540565
11. Carranza-Lira S, Casillas Núńez FD. Sexual dysfunction prevalence in a group of pre-and postmenopausal Mexican women. Menopause Review/Przegląd Menopauzalny [Internet].2018 [citado 16 de Diciembre de 2024]; 17(1): 39-42. Disponible en: https://doi.org/10.5114/pm.2018.74901
12. Villa Rosero CY de LM, Mazin SC, Nogueira AA, Vargas-Costales JA, Rosa-e-Silva JC, Candido-dos-Reis FJ, et al. Prevalence of chronic pelvic pain and primary dysmenorrhea in women of reproductive age in Ecuador. BMC Women's Health [Internet]. 2022 [citado 16 de Diciembre de 2024]; 22(1):363. Disponible en: https://doi.org/10.1186/s12905-022-01948-y
13. Jorge JMN, Bustamante-Lopez LA. Pelvic floor anatomy. Annals of Laparoscopic and Endoscopic Surgery [Internet].2022 [citado 16 de Diciembre de 2024]; 7:20. Disponible en: https://doi.org/10.21037/ales-2022-06
14. Stein A, Sauder S, Reale J. The role of physical therapy in sexual health in men and women: evaluation and treatment. Sexual Medicine Reviews [Internet]. 2019 [citado 16 de Diciembre de 2024]; 7(1): 46-56. Disponible en: https://doi.org/10.1016/j.sxmr.2018.09.003
15. Molina-Torres G, Moreno-Muñoz M, Rebullido TR, Castellote-Caballero Y, Bergamin M, Gobbo S, et al. The effects of an-8‐week hypopressive exercise training program on urinary incontinence and pelvic floor muscle activation: A randomized controlled trial. Neurourology and Urodynamics [Internet]. 2023 [citado 16 de Diciembre de 2024]; 42(2), 500-509. Disponible en: https://pubmed.ncbi.nlm.nih.gov/36482844/
16. Resende APM, Bernardes BT, Stüpp L, Oliveira E, Castro RA, Girão MJBC, et al. Pelvic floor muscle training is better than hypopressive exercises in pelvic organ prolapse treatment: An assessor-blinded randomized controlled trial. Neurourology and Urodynamics [Internet].2018 [citado 16 de Diciembre de 2024]; 38(1), 171–179. Disponible en: https://doi.org/10.1002/nau.23819
17. Aboseif C, Liu P. Pelvic organ prolapse. StatPearls Publishing [Internet]. 2024 [citado 16 de Diciembre de 2024]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/33085376/
18. Luginbuehl H, Radlinger L, Lehmann C, Kuhn A, Koenig I. Intervention effects maintenance: 6-month randomized controlled trial follow-up of standard and reflexive pelvic floor muscle training. AJOG Global Reports [Internet]. 2022 [citado 16 de Diciembre de 2024]; 2(4): 100089. Disponible en: https://doi.org/10.1016/j.xagr.2022.100089
19. Bergström BS. Stress urinary incontinence is caused predominantly by urethral support failure. International Urogynecology Journal [Internet]. 2022 [citado 16 de Diciembre de 2024]; 33: 523–530. Disponible en: https://doi.org/10.1007/s00192-021-05024-1
20. Escandiusi Avramidis R, Barbosa AMP, Thomaz de Aquino Nava G, Hikaru Nagami D, Prudencio CB, Rodrigues Pedroni C. Effect of different electrostimulation currents on female urinary incontinence: A protocol of a randomized controlled trial. Plos one [Internet]. 2022 [citado 16 de Diciembre de 2024]; 17(12): e0276722. Disponible en: https://doi.org/10.1371/journal.pone.0276722
21. Sun Y, Liu Y, Chen H, Yan Y, Liu Z. Electroacupuncture for stress-predominant mixed urinary incontinence: a protocol for a three-armed randomised controlled trial. BMJ open [Internet]. 2021 [citado 16 de Diciembre de 2024]; 11(1): e038452. Disponible en: https://doi.org/10.1136/bmjopen-2020-038452
22. Spruijt M, Kerkhof M, Rombouts M, Brohet R, Klerkx W. Efficacy of botulinum toxin A injection in pelvic floor muscles in chronic pelvic pain patients: a study protocol for a multicentre randomised controlled trial. BMJ Open [Internet]. 2023 [citado 16 de Diciembre de 2024]; 13(7). Disponible en: https://doi.org/10.1136/bmjopen-2022-070705
23. Aydın S, Arıoğlu Aydın Ç, Batmaz G, Dansuk R. Effect of vaginal electrical stimulation on female sexual functions: a randomized study. The journal of sexual medicine [Internet]. 2015 [citado 16 de Diciembre de 2024]; 12(2): 463-469. Disponible en: https://doi.org/10.1111/jsm.12788
24. Eftekhar T, Sohrabi M, Haghollahi F, Shariat M, Miri E. Comparison effect of physiotherapy with surgery on sexual function in patients with pelvic floor disorder: a randomized clinical trial. Iranian Journal of Reproductive Medicine [Internet]. 2014 [citado 16 de Diciembre de 2024]; 12(1): 7-14. Disponible en: https://pubmed.ncbi.nlm.nih.gov/24799856/
25. Tabal AAA, Saleh SAELA, Ibrahim D, Shahin AELHE. Effect of contraceptive methods on female sexual function. The Egypt Journal of Hospital Medicine [Internet]. 2021 [citado 16 de Diciembre de 2024]; 83(1): 1582–1588. Disponible en: http://dx.doi.org/10.21608/ejhm.2021.171406
26. Parish SJ, Cottler-Casanova S, Clayton AH, McCabe MP, Coleman E, Reed GM. The evolution of the female sexual disorder/dysfunction definitions, nomenclature, and classifications: A review of DSM, ICSM, ISSWSH, and ICD. Sexual Medicine Reviews [Internet]. 2021 [citado 16 de Diciembre de 2024]; 9(1): 36–56. Disponible en: http://dx.doi.org/10.1016/j.sxmr.2020.05.001
27. Lundin C, Malmborg A, Slezak J, Danielsson KG, Bixo M, Bengtsdotter H, et al. Sexual function and combined oral contraceptives: a randomised, placebo-controlled trial. Endocrine Connections [Internet]. 2018 [citado 16 de Diciembre de 2024]; 7(11): 1208–1216. Disponible en: http://dx.doi.org/10.1530/ec-18-0384
28. Ghaderi F, Bastani P, Hajebrahimi S, Jafarabadi MA, Berghmans B. Pelvic floor rehabilitation in the treatment of women with dyspareunia: a randomized controlled clinical trial. International Urogynecology Journal [Internet]. 2019 [citado 16 de Diciembre de 2024]; 30:1849– 1855. Disponible en: http://dx.doi.org/10.1007/s00192-019-04019-3
29. Stuparu C. Female orgasm disorder. Anorgasmia. International Journal of Advanced Studies in Sexology [Internet]. 2020 [citado 16 de Diciembre de 2024]; 2(2): 89-93. Disponible en: https://www.sexology.ro/wp-content/uploads/2020/06/314232140_73890216_1587199722497.pdf
30. Yaraghi M, Ghazizadeh S, Mohammadi F, Ashtiani EM, Bakhtiyari M, Mareshi SM, et al. Comparing the effectiveness of functional electrical stimulation via sexual cognitive/behavioral therapy of pelvic floor muscles versus local injection of botulinum toxin on the sexual functioning of patients with primary vaginismus: a randomized clinical trial. International Urogynecology Journal [Internet]. 2019 [citado 16 de Diciembre de 2024]; 30:1821– 1828. Disponible en: http://dx.doi.org/10.1007/s00192-018-3836-7
31. Carey ET, Geller EJ, Rapkin A, Farb D, Cutting H, Akaninwor J, et al. Rationale and design of a multicenter randomized clinical trial of vestibulodynia: understanding pathophysiology and determining appropriate treatments (vestibulodynia: UPDATe). Annals of Medicine [Internet]. 2022 [citado 16 de Diciembre de 2024]; 54(1): 2884–2896. Disponible en: http://dx.doi.org/10.1080/07853890.2022.2132531
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