Pelvic floor maladies can impact women's sex life
Incontinence and other disorders of the pelvic organs can take a toll
on a woman's sex life, a new study suggests.
Researchers found that among 300 women age 40 and older, those with
symptoms of a pelvic floor disorder were more likely to have a
diminished libido, pain during sex, or problems reaching orgasm.
Pelvic floor disorders refer to problems with a woman's pelvic organs
-- the uterus, bladder and rectum -- and the muscles and connective
tissue that support them. Among the most common of these are urinary
incontinence and pelvic organ prolapse, where weakened muscles and
supporting tissue allow one or more pelvic organs to drop down and
protrude into the vagina.
Some symptoms of prolapse include pressure in the vagina, pain in the
lower abdomen or lower back, and chronic constipation.
It has been estimated that one-third of U.S. women have at least one
type of pelvic floor disorder, but studies have come to conflicting
conclusions as to whether the conditions hinder women's sex lives.
The new findings, reported in the journal Obstetrics & Gynecology,
suggest that many women with these disorders do, in fact, have
problems with sexual function.
However, the risk of sexual dysfunction was not elevated among women
who had mild prolapse that was not causing symptoms, lead researcher
Dr. Victoria Handa told Reuters Health.
This is important, she explained, because it indicates that women who
have sexual complaints but no other potential symptoms of pelvic organ
prolapse do not need to be evaluated for the disorder.
"Sexual function is unlikely to be impacted by mild prolapse," said
Handa, an associate professor of gynecology and obstetrics at Johns
Hopkins University in Baltimore.
The findings are based on 301 patients recruited from gynecology
offices affiliated with Johns Hopkins. Eighty women were seeking care
for a pelvic floor disorder, including bladder control problems and
pelvic organ prolapse. The rest of the women had other conditions or
were getting a routine checkup.
All of the women completed questionnaires on their overall health,
pelvic symptoms and sexual function.
Overall, the researchers found, women with pelvic floor disorders were
more likely to have symptoms of a decreased sex drive, pain during sex
and infrequent orgasms -- regardless of age and whether they had gone
through menopause.
The study does not prove that the pelvic floor disorders caused the
women's sexual problems, Handa said. However, the conditions could
impair women's sexual function for a number of reasons, from
diminished body image to problems with muscle and nerve function.
According to Handa, women with pelvic floor disorders should talk with
their doctors about any sexual difficulties they have.
In an earlier study, she and her colleagues found that women's sexual
function often improved after having surgery to correct significant
prolapse. But more research is needed into this area, Handa said.
If certain treatments for pelvic floor disorders are better than
others for improving sexual function, she noted, that will be
important to know.
SOURCE: Obstetrics & Gynecology, May 2008.