Effect of postpartum pelvic floor muscle training on vaginal symptoms and sexual dysfunction - Secondary analysis of a randomised trial

Abstract

Objective Evaluate effect of pelvic floor muscle training (PFMT) on vaginal symptoms and sexual matters, dyspareunia and coital incontinence in primiparous women stratified by major or no defects of the levator ani muscle. Design Randomised controlled trial (RCT). Setting Akershus University Hospital, Norway. Sample About 175 primiparous women with a singleton vaginal delivery. Methods Two-armed assessor blinded parallel group RCT from 6 weeks to 6 months postpartum comparing effect of PFMT versus control. Main outcome measures International Consultation on Incontinence Modular Questionnaire - vaginal symptoms questionnaire (ICIQ-VS) and ICIQ sexual matters module (ICIQ-FLUTSsex). Results Overall, analysis (n = 175) showed no difference between training and control groups in women having vaginal symptoms or symptoms related to sexual dysfunction 6 months postpartum. The majority of women (88%) had intercourse and there was no difference between groups. Unadjusted subgroup analysis of women with a major defect of the levator ani muscle (n = 55) showed that women in the training group had 45% less risk of having the symptom 'vagina feels loose or lax' compared with the control group (relative risk 0.55, 95% confidence interval 0.31, 0.95; P = 0.03). Conclusions Unadjusted analysis showed that in women with major defect of the levator ani muscle, significantly fewer in the training group had the symptom 'vagina feels loose or lax' compared with the control group. No difference was found between groups for symptoms related to sexual dysfunction. More studies are needed to explore effect of PFMT on vaginal symptoms and sexual dysfunction. Tweetable abstract Unadjusted analysis shows that PFMT might prevent symptoms of 'vagina feels loose or lax'. Tweetable abstract Unadjusted analysis shows that PFMT might prevent symptoms of 'vagina feels loose or lax'.