title: Experience of pelvic floor muscle exercises among women in Taiwan: a qualitative study of improvement in urinary incontinence and sexuality.
abstract: OBJECTIVE
  To gain an in-depth understanding of women's experiences of performing pelvic floor muscle exercises for urinary incontinence and the impact on their sexuality.
  
  
  BACKGROUND
  Urinary incontinence is not a life-threatening disorder; however, it has been shown to have detrimental effects on quality of life in terms of psychological, social and sexual dysfunction. Pelvic floor muscle exercises is the first recommended strategy for managing mild to moderate urinary incontinence as it is noninvasive and cost effective. Pelvic floor muscle exercises reduce incontinence and strengthen the pelvic floor muscles, which positively affects sexual function in women. Currently, the data are scarce for qualitative literature regarding the subjective experiences of Taiwanese women undergoing pelvic floor muscle exercises and the impact on their urinary incontinence and sexuality.
  
  
  METHODS
  Qualitative exploratory study.
  
  
  METHODS
  Semi-structured in depth interviews were undertaken with twelve women who had completed a pelvic floor muscle exercises program in Taiwan. Data were analysed using thematic analysis.
  
  
  RESULTS
  Themes were related to Taiwanese women's initial feelings that urinary incontinence was inevitable and the effects on their sexuality. Three core themes were identified: perceptions of inevitability, developing awareness and gaining control and sexual taboo. Through developing awareness and control of their pelvic floor muscles women expressed improvement in urinary incontinence. Sexual enjoyment, body image, self confidence and sexuality were also enhanced.
  
  
  CONCLUSIONS
  Pelvic floor muscle exercises had a positive effect on urinary incontinence and sexuality. The findings demonstrated that sex is a taboo topic for many Taiwanese women. With the sensitive management of pelvic floor muscle exercises programs this issue can be addressed.
  
  
  CONCLUSIONS
  This study raises awareness of healthcare professionals by identifying how Taiwanese women perceive pelvic floor muscles. The positive impact of pelvic floor muscle exercises upon both urinary incontinence and sexuality within the Taiwanese context are addressed. Nurses may also, with greater confidence initiate discussion of women's sexual concerns as part of managing urinary incontinence.
authors: Department of Nursing, Tzu Chi College of Technology, Hualien City, Taiwan.|School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors: Hsia-Tzu
authors: http://orcid.org/0000-0001-8899-9346
authors: HT
authors: Kao
authors: Faculty of Health and Social Care, University of Hull, UK.
authors: Mark
authors: M
authors: Hayter
authors: The School of Nursing & Midwifery, The University of Sheffield, Sheffield, UK.
authors: Sharron
authors: S
authors: Hinchliff
authors: Department of Nursing, Tzu Chi University, Hualien City, Taiwan.
authors: Chuan-Hsiu
authors: CH
authors: Tsai
authors: School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors: Min-Tao
authors: MT
authors: Hsu
mesh_terms: D000328:Adult; D000368:Aged; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D017773:Pelvic Floor; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology; D012649:Self Concept; D019529:Sexuality / Q000523:psychology*; D013624:Taiwan; D014549:Urinary Incontinence / Q000503:physiopathology / Q000523:psychology* / Q000534:rehabilitation*
keywords: pelvic floor muscle exercise; sexual taboo; sexuality; urinary incontinence