Pelvic floor maladies can impact women's sex life

By Amy Norton
NEW YORK (Reuters Health) -
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.