Pelvic floor exercises can help make sex more enjoyable, study finds

Pelvic floor exercises, which strengthen the muscles around the bladder, bowel, and vagina, can help with sexual health and lessen sex-related distress in women with multiple sclerosis (MS), a small study found.

Women reported increased sexual desire, arousal, and better overall satisfaction after engaging in a 12-week training program, adding to growing evidence that toning the pelvic floor may make for a healthier sexual life with MS.

The study, “Supervised Pelvic Floor Muscle Training Improves Sexual Function and Diminishes Sexual Distress in Women with Relapsing–Remitting Multiple Sclerosis: A Randomised Controlled Study,” was published in the Journal of Personalized Medicine.

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In MS, damage to nerve cells can cause a disconnect between the brain and the muscles located around the sexual organs. As a result, many people living with the disease experience a range of problems with arousal and orgasm.

Other symptoms of MS — from emotional problems to fatigue and movement difficulties — also can contribute to a diminished libido and other challenges to intimacy and sexual relationships.

Pelvic floor muscle training involves a series of exercises designed to strengthen the muscles of the pelvic floor through rapid and sustained contractions (tightening). These muscles hold the bladder, bowel, and sexual organs in place. In women with MS, toning the pelvic floor also may ease symptoms of an overactive bladder.

Researchers in Greece conducted a randomized and controlled study to investigate whether pelvic floor muscle training can help in alleviating sexual dysfunction.

Their study included 82 sexually active women, with a mean age of 38.4, who had been living with relapsing-remitting MS for an average of seven years and had Extended Disability Status Scale (EDSS) scores below 4, indicating they were ambulatory. All were being treated with interferon-based medications.

These women were randomly assigned either to a 12-week (three-month) training program or to simply continue with their standard treatment as a control group. At the study’s start and end, all were asked to complete questionnaires about sexual function and distress. In total, 69 women finished the study, with discontinuations attributed to causes that included fatigue and changes in treatment regimens.

The training program involved three, 30-minute biofeedback sessions (a technique used to gain control over some of the body’s functions, such as muscle responses) and home workouts starting with five rapid and 10 sustained contractions, later reaching five rapid and 20 sustained contractions done twice daily.

At the study’s start, there were no significant differences in sexual function and distress between the two groups.

Women reported improvements with pelvic floor muscle training

After the 12-week period, however, women who engaged in the pelvic floor exercises scored significantly higher on the Female Sexual Function Index, indicating better sexual function (27.02 vs. 22.88 points). This self-reported questionnaire covers six domains: desire, arousal, lubrication, orgasm, satisfaction, and pain.

They also scored significantly lower in the Female Sexual Distress Scale-Revised, indicating less sex-related distress (7.23 vs. 9.35 points) across those same domains.

Overall, patients given the training showed higher scores in five of the six domains — desire, arousal, lubrication, orgasm, and satisfaction — except for pain.

“The lack of significant change in the pain domain suggests that while PFMT [pelvic floor muscle training] can enhance sexual function, it may not directly impact sexual pain,” the researchers wrote.

None of the 33 women who engaged in the training reported unintended effects, indicating that the program may be safe and well tolerated. Twelve in this group, but none in the control group, said their sexual problems had resolved.

“While PFMT and related physical therapies show promise in addressing sexual dysfunction in MS patients, further research is needed to understand the full spectrum of factors affecting sexual health in this population,” the researchers wrote.

In addition to patient-tailored training programs, “a holistic approach to care and a deeper understanding of the individual’s experience are crucial for improving quality of life for women with MS,” they concluded.