Effect of Pelvic Floor Muscle Training on Female Sexual Function During Pregnancy and Postpartum: A Randomized Controlled Trial

Abstract

Background: Current evidence on the effect of pelvic floor muscle (PFM) training for promoting sexual function is limited. Recent reviews indicate need for high quality trials in this area. Objectives: To examine the effect of PFM training on sexual function (primary outcome), sexual quality of life, and PFM strength (secondary outcomes) in pregnant and postpartum women. Methods: This was an assessor-blind two parallel arm superiority trial. A total of 84 nulliparous women with a singleton pregnancy at 17 - 20 weeks, aged 18 - 35 years, were recruited using purposive sampling among clients of five public health centers or two governmental maternity clinics in Sari-Iran. The recruitment was done from May to November 2014 and follow up ended on July 2015. Participants were equally allocated into either PFM training or routine care groups using block randomization. Women allocated to the PFM group received 4 sessions of supervised training, with practical, oral, and written instructions on how to continue performing regular PFM exercises at home. Female sexual function index, sexual quality of life questionnaire-female, and Oxford scoring were used to assess the outcomes at 28 - 30 weeks gestation and 80 - 90 days following birth. Results: There was one loss to follow-up from each group. A total of 6 women had not exercised regularly. Compared with the control group, the mean total sexual function score was significantly greater in the PFM training group during both pregnancy (29.3 vs 21.1; adjusted difference 9.4, 95%CI 7.7 to 11.0, P < 0.001) and postpartum (28.7 vs 16.0; adjusted difference 13.0, 95%CI 12.1 to 13.9, P < 0.001). Also, almost all domains of sexual function, sexual quality of life, and PFM strength during both periods improved significantly in women who received the PFM training compared with the controls. Conclusions: Based on the results, PFM training during pregnancy and postpartum could improve sexual function in nulliparous women. Therefore, it should be recommended to all of the women.