title: Relationship between pelvic floor muscle strength and sexual dysfunction in postmenopausal women: a cross-sectional study.
abstract: OBJECTIVE
  The prevalence of sexual dysfunction in postmenopausal women is high. Theoretically pelvic floor muscle (PFM) strength could influence sexual function, but to date there is scant evidence on this topic. The aim of this study was to evaluate the relationship between PFM strength and sexual function in postmenopausal women. The relationship between reported urinary incontinence (UI) and sexual dysfunction was also investigated.
  
  
  METHODS
  This was a cross-sectional study including 113 postmenopausal women. PFM strength was evaluated using vaginal manometry. Sexual function was evaluated using the Female Sexual Function Index (FSFI). A score of ≤26.5 was considered to indicate sexual dysfunction. Urinary incontinence reports were evaluated using the International Consultation on Incontinence Questionnaire-Urinary Incontinence (ICIQ-UI) Short Form. Statistical analysis was performed using Spearman's rank correlation coefficient (ρ), the Mann-Whitney test and 95 % confidence intervals.
  
  
  RESULTS
  The median age of the women was 53 years (range 42 - 65 years) and their median body mass index was 27.9 kg/m2(range 20 - 42 kg/m2). Women without sexual dysfunction showed significantly higher PFM strength (median 41.8, range 11.3 - 94.0 cmH2O) than women with sexual dysfunction (median 30.3, range 3 - 112 cmH2O; p = 0.02). A weak correlation was found between the total FSFI score and the total ICIQ-UI score (ρ = -0.21, p = 0.03).
  
  
  CONCLUSIONS
  Postmenopausal women with sexual dysfunction showed lower PFM strength than women without sexual dysfunction. There was a weak correlation between urinary incontinence severity and sexual function.
authors.affiliation: Department of Biomechanics, Medicine and Rehabilitation, Postgraduate Program in Rehabilitation and Performance, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
authors.forename: Maíra
authors.initials: M
authors.lastname: de Menezes Franco
authors.affiliation: Physiotherapy Course, Federal University of São Carlos, São Carlos, Brazil.
authors.forename: Patricia
authors.initials: P
authors.lastname: Driusso
authors.affiliation: Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
authors.forename: Kari
authors.initials: K
authors.lastname: Bø
authors.affiliation: Department of Biomechanics, Medicine and Rehabilitation, Postgraduate Program in Rehabilitation and Performance, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
authors.forename: Daniela Cristina
authors.initials: DC
authors.lastname: Carvalho de Abreu
authors.affiliation: Department of Obstetrics and Gynecology, Human Reproduction, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
authors.forename: Lucia Alves
authors.initials: LA
authors.lastname: da Silva Lara
authors.affiliation: Department of Obstetrics and Gynecology, Human Reproduction, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
authors.forename: Ana Carolina Japur
authors.initials: ACJ
authors.lastname: de Sá Rosa E Silva
authors.affiliation: Department of Biomechanics, Medicine and Rehabilitation, Postgraduate Program in Rehabilitation and Performance, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil. cristine@fmrp.usp.br.|Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900 Monte Alegre, 14049-900, Ribeirão Preto, SP, Brazil. cristine@fmrp.usp.br.
authors.forename: Cristine Homsi Jorge
authors.initials: CHJ
authors.lastname: Ferreira
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008365:Manometry / Q000379:methods; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D017773:Pelvic Floor / Q000503:physiopathology*; D017698:Postmenopause / Q000502:physiology*; D012735:Sexual Dysfunction, Physiological / Q000503:physiopathology*; D014549:Urinary Incontinence / Q000503:physiopathology; D014621:Vagina / Q000503:physiopathology
keywords: Pelvic floor muscle strength; Quality of life; Sexual dysfunction; Urinary incontinence