HOLLYWOOD, FLA. — Women with a pelvic floor disorder do not experience significantly diminished rates of sexual activity compared with unaffected women, based on a study of 505 women older than 40 years.
Only the desire component of the Female Sexual Function Index (FSFI) was significantly lower among women with a pelvic floor disorder, suggesting no notable impact on arousal, lubrication, orgasm, satisfaction, or pain, Dr. Tola B. Omotosho said at the annual meeting of the American Urogynecologic Society.
“Sexual health is an essential component of a woman's overall well-being,” Dr. Omotosho said. “But there remains limited and conflicting information about the impact of pelvic floor disorders on sexual health and well-being.”
So Dr. Omotosho and her Fellows' Pelvic Research Network colleagues recruited 505 women older than 40 years from September 2007 to April 2009. The cohort included 308 urogynecology patients with a pelvic floor disorder and 197 general gynecology patients without such a disorder. Participants came from 11 clinical sites in the United States.
Women in the pelvic floor disorder group were older, with a mean age of 56, vs. 52 years in the unaffected group. Although mean parity also was significantly higher in affected women (2.6 vs. 2.1), only age remained significantly different after multivariate analysis adjustment. There were no significant differences in race, body mass index, depression, comorbidity, or relationship status between groups.
The primary outcome measure was the total mean score on the FSFI, where a higher score indicates better sexual function. The mean total score in the pelvic floor disorder group was 23.2, and was not significantly lower than the mean 24.4 score in the unaffected women.
“Women with pelvic floor disorders were as sexually active as women without pelvic floor disorders when [the results were] adjusted for age,” said Dr. Omotosho, an ob.gyn
Sexual activity in the past 6 months with a male partner was reported by 62% of affected and 75% of unaffected women. This difference was not statistically significant after age was controlled for, Dr. Omotosho said. The lack of a sexual partner was the most commonly cited reason for sexual inactivity. Only heterosexual women were studied because the FSFI is not validated in a lesbian population.
Of the women with a pelvic floor disorder, 75% had urinary incontinence, defined as a score of 1 or greater on the Incontinence Severity Index. In addition, 53% met criteria for anal incontinence, defined as a score of 1 or greater for liquid or solid stool on the Wexner Fecal Incontinence Scale. Also, 30% had at least stage II pelvic organ prolapse based on a Pelvic Organ Prolapse Quantification examination.
The inclusion of only women older than 40 years is a potential limitation of the study, Dr. Omotosho said. A multicenter design and the use of validated instruments were strengths.