Effects of pelvic floor muscle training on sexual function of postmenopausal women. A systematic review and meta-analysis

盆底肌训练对绝经后女性性功能的影响:系统评价和荟萃分析

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Abstract

BACKGROUND: During postmenopause, women frequently experience genitourinary symptoms that may result in sexual dysfunctions. Common treatments include hormone replacement therapy or vaginal lubricants. Pelvic floor muscle training (PFMT) has been observed to have beneficial effects on sexual function in other groups of women. AIM: To evaluate the effect of PFMT on sexual function in postmenopausal women. METHODS: A systematic search was conducted in June 2025, in PubMed, Scopus, Web of Science, Medline, CINAHL databases, and the Google Scholar search engine. Inclusion criteria were randomized clinical trial articles published in English, in which at least one intervention addressed the study objective. A meta-analysis was conducted with a random-effects model. RESULTS: A total of five studies were selected after applying eligibility criteria. All included articles implemented PFMT interventions, showing improvements in sexual function as assessed by the Female Sexual Function Index. A significant positive effect was shown in the total score of Female Sexual Function Index in experimental group in comparison with control group (P < .001; standard mean difference [SMD] = 1.33; I (2) = 92%). A significant positive effect was also demonstrated in orgasm domain (P < .001; SMD = 1.91; I (2) = 97%), arousal domain (P < .001; SMD = 1.87; I (2) = 96%), and satisfaction domain (P < .001; SMD = 2.16; I (2) = 98%). A significant negative effect was found in desire domain (P < .001; SMD = 0.34; I (2) = 86%) and lubrication domain (P < .001; SMD = 0.26; I (2) = 87%) and finally no significant effects were found in pain domain. STRENGTHS AND LIMITATIONS: Although this is the first meta-analysis to address this topic in postmenopausal women, the results are heterogeneous and the scientific evidence remains limited. CONCLUSION: PFMT appears to have positive effects on sexual function in postmenopausal women, particularly in aspects such as orgasm, arousal, and satisfaction.

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