This cross-sectional study examined the association between pelvic floor muscle (PFM) function, hormone levels, and sexual function in perimenopausal women—a population particularly vulnerable to female sexual dysfunction (FSD). FSD can significantly affect emotional well-being, quality of life, and relationship stability, yet it often remains undiagnosed and untreated, especially in cultures where female sexuality is stigmatized.
What the Research Shows
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252 women aged 40–55 without diagnosed pelvic floor disease were assessed.
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Sexual function was evaluated using the Female Sexual Function Index (FSFI), covering libido, arousal, lubrication, orgasm, satisfaction, and pain.
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PFM strength was measured alongside hormone levels.
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Stronger PFM strength was positively correlated with:
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Higher libido
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Better orgasm and sexual satisfaction
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Higher overall FSFI scores
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Weaker PFM strength was linked to higher rates of sexual desire disorder and orgasmic dysfunction.
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Higher PFM strength was independently associated with a lower risk of sexual dysfunction, even after controlling for hormone levels, BMI, and hormone therapy use.
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Obesity and central adiposity were more common in the dysfunctional PFM group and associated with lower FSFI scores.
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Women in the functional PFM group were more likely to use menopausal hormone therapy (MHT), which appeared to support better sexual function outcomes.
What This Means for Clinical Care
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Pelvic floor muscle function should be evaluated in the assessment and management of sexual dysfunction in perimenopausal women.
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Stronger PFM function is associated with better sexual health outcomes, independent of hormonal status.
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Obesity and absence of hormone therapy may worsen dysfunction and should be addressed as part of care planning.
A Multidisciplinary Approach
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Integrating pelvic floor rehabilitation with hormonal assessment may improve sexual health in midlife women.
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Collaborative care between pelvic floor PTs, gynecologists, and endocrinologists can support early detection and intervention for FSD.
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Education and awareness are essential during the perimenopausal transition to reduce stigma and promote timely treatment.
- Zhihong Zhuo, Chuhan Wang, Huimin Yu, Jing Li, The Relationship Between Pelvic Floor Function and Sexual Function in Perimenopausal Women, Sexual Medicine, Volume 9, Issue 6, December 2021, Page 100441, https://doi.org/10.1016/j.esxm.2021.100441
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