The effect of pelvic floor muscle exercises on female sexual function during pregnancy and the first three months postpartum

Abstract

It is estimated that around 63% to 93% of women experience sexual dysfunction during pregnancy and over 90% of postpartum women report sexual problems in the first three months after birth. Even though pelvic floor muscle exercises (PFME) are recommended for healthy sexual function, the current evidence about the effect of antenatal PFME on female sexual function (FSF) and childbirth is unclear. There is also conflicting evidence for the effect of antenatal PFME on prevention of urinary and faecal incontinence symptoms during pregnancy and the postpartum period. The randomised controlled trial (RCT) reported in this thesis primarily aimed to investigate the effect of antenatal PFME on FSF during pregnancy and at three months after birth, and secondarily the effect on childbirth outcomes and urinary and faecal incontinence symptoms during pregnancy and the first three months after birth. A meta-analysis of published papers was also performed to examine the effect of PFME on childbirth outcomes. Eligible women who were less than 22 weeks gestation were recruited from the antenatal clinics of a tertiary hospital setting in Western Sydney, Australia. No statistically significant effect of PFME was found on FSF, childbirth outcomes, urinary and faecal incontinence symptoms. The results of this RCT need to be interpreted cautiously considering a 50% adherence rate with PFME and 40% of women not resuming sexual intercourse by three months postpartum. Some trends were seen in childbirth outcomes and faecal incontinence. A higher compliance rate and a larger sample size may have shown statistically significant findings. The meta-analysis, however, showed PFME did reduce severe perineal trauma and duration of labour significantly and is now cited as evidence in the Australian Third- and Fourth-Degree Perineal Tears Clinical Care Standard (2021). More research is recommended into the effect of PFME on FSF, childbirth outcomes and urinary and faecal incontinence during pregnancy and postpartum. The optimal frequency and ideal PFME protocol also need further examination.

Date of Award	2022
Original language	English