title: Relationship between female pelvic floor dysfunction and sexual dysfunction: an observational study.
abstract: BACKGROUND
  The ability to express one's sexuality and engage in sexual activity requires multisystemic coordination involving many psychological functions as well as the integrity of the nervous, hormonal, vascular, immune, and neuromuscular body structures and functions.
  
  
  OBJECTIVE
  The purpose of this study was to investigate the associations among pelvic floor function, sexual function, and demographic and clinical characteristics in a population of women initiating physical therapy evaluation and treatment for pelvic floor-related dysfunctions (urinary incontinence, pelvic organ prolapse, vulvodynia, vaginismus, and constipation).
  
  
  METHODS
  We consented and collected completed demographic data and data related to symptoms and clinical condition on 85 consecutive patients in an outpatient physical therapy clinic. Clinical and anthropometric characteristics were analyzed descriptively. Analysis of variance and linear regression analyses were used to analyze Female Sexual Function Index (FSFI) scale ratings, whereas zero-inflated beta-binomial regression was applied to the pain subscale.
  
  
  METHODS
  Main outcome measure was FSFI score, whereas the secondary outcome measure was the FSFI subscale score related to pain.
  
  
  RESULTS
  Women in our sample were 38 years old on average, 33% of whom had given birth and 82% of whom had high tone pelvic floor. Being in the middle-tercile age group and exhibiting low pelvic floor tone (Beta = 6.8; 95% confidence interval [CI] = [1.4; 12.0]) were significantly associated with lower levels of sexual dysfunction. Women with low tone pelvic floor also reported lower pain (odds ratio = 4.0; 95% CI = [1.6; 9.6]), whereas younger aged and physically unsatisfied subjects were more likely not to have sexual activity in the month prior to scale measurement.
  
  
  CONCLUSIONS
  In female patients with pelvic floor muscle dysfunction undergoing physical therapy and rehabilitation, sexual dysfunction appears to be significantly correlated with age and high pelvic floor muscle tone.
authors: Occupational Medicine Unit, Department of Biomedical and Neurological Sciences, University of Bologna, Bologna, Italy.
authors: Arianna
authors: A
authors: Bortolami
authors: Occupational Medicine Unit, Department of Biomedical and Neurological Sciences, University of Bologna, Bologna, Italy.
authors: Carla
authors: C
authors: Vanti
authors: Department of Statistical Sciences "Paolo Fortunati", University of Bologna, Bologna, Italy.
authors: Federico
authors: F
authors: Banchelli
authors: Department of Rehabilitation Science, College of Health and Human Services, George Mason University, Fairfax, VA, USA.
authors: Andrew A
authors: AA
authors: Guccione
authors: Occupational Medicine Unit, Department of Biomedical and Neurological Sciences, University of Bologna, Bologna, Italy.
authors: Paolo
authors: P
authors: Pillastrini
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007989:Libido; D008875:Middle Aged; D016017:Odds Ratio; D017773:Pelvic Floor / Q000503:physiopathology*; D010808:Physical Examination; D012649:Self Concept; D020018:Sexual Dysfunctions, Psychological / Q000503:physiopathology* / Q000523:psychology / Q000534:rehabilitation; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000503:physiopathology* / Q000523:psychology / Q000534:rehabilitation
keywords: Physical Therapy; Quality of Life; Sexual Dysfunction