title: Musculoskeletal pain and sexual function in women.
abstract: BACKGROUND
  Sexual pain disorders refer to conditions of genital pain that interfere with intercourse. They often have a musculoskeletal component related to the pelvic floor and are included in the DSM-IV as sexual dysfunctions. Musculoskeletal pain (MP) that is not essentially genitally based often interferes with sex as well yet is not considered a distinct sexual dysfunction. MP is generally addressed by physiatrists, orthopedists, and rheumatologists who are not traditionally trained in sexual medicine, and therefore, the sexual concerns of women with MP often go unaddressed.
  
  
  OBJECTIVE
  The purposes of this review article were to describe how MP is perceived in the literature as affecting sexual function, illustrate how specific MP conditions prevalent in women may affect sexual function, and offer recommendations for clinical practice.
  
  
  METHODS
  PubMed and Medline searches were performed using the keywords "musculoskeletal pain and sex,""lower back pain and sex,""arthritis and sex," and "fibromyalgia and sex". Main Outcome Measure. Review of the peer-reviewed literature.
  
  
  RESULTS
  Most studies cite fatigue, medication, and relationship adjustment as affecting sexuality much as chronic illness does. While musculoskeletal contributors to genital sexual response and pain are considered relevant to sexual function, little is understood about how MP syndromes specifically affect sexual activity.
  
  
  CONCLUSIONS
  Lack of mobility and MP can restrict intercourse and limit sexual activity, and gender differences are noted in response to pain. Sexual and relationship counseling should be offered as a component of rehabilitative treatment. Physical therapists are uniquely qualified to provide treatment to address functional activities of daily living, including sexual intercourse, and offer advice for modifications in positioning.
authors.affiliation: Inner Stability, Ltd, Urogynecological Physiotherapy, Bet Shemesh, Israel. tallir@netvision.net.il
authors.forename: Talli Yehuda
authors.initials: TY
authors.lastname: Rosenbaum
mesh_terms: D001172:Arthritis, Rheumatoid / Q000503:physiopathology; D005260:Female; D005356:Fibromyalgia / Q000503:physiopathology; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology; D009140:Musculoskeletal Diseases / Q000503:physiopathology*; D010146:Pain / Q000503:physiopathology*; D017773:Pelvic Floor / Q000503:physiopathology; D012735:Sexual Dysfunction, Physiological / Q000503:physiopathology*