Female Sexual Function and the Pelvic Floor

Sarit O. Aschkenazi;   Roger P. Goldberg


Expert Rev of Obstet Gynecol. 2009;4(2):165-178. 

In This Article

Female Sexual Function & Urinary Incontinence

The relationship between urinary incontinence and FSD is not a simple one. There are limited data on the impact of subtypes of urinary incontinence and female sexual function. Reasons for avoiding sexual intercourse in women with urinary incontinence include wetness at night, leakage during intercourse, embarrassment and depression[69]. A cross-sectional study using the validated FSFI questionnaire, included 21 cases with various types of urinary incontinence including three SUI, nine UUI and nine mixed incontinence, cases, which were compared with 19 control, continent women[70]. All study subjects were premenopausal, without POP and no prior pelvic surgery. The FSFI domains include desire, arousal, lubrication, orgasm, satisfaction and pain. All domain scores were significantly lower in the urinary incontinences cases, except for pain. There was no significant difference among the subtypes; however, the study was not sufficiently powered to reliably detect a clinically significant difference in the subgroups of urinary incontinence.

A retrospective chart review of all women presenting with urinary incontinence for initial evaluation was conducted at a urogynecologic clinic in a LA county hospital in 2003-2004[71]. Sexual function was assessed using the PISQ-12. Complete data were available for 148 women with urodynamically diagnosed urinary incontinence. Subjects included 50 cases with SUI, 50 with detrusor overactivity and 48 with mixed urinary incontinence. There were no differences in age, parity, menopause or pelvic surgery among the subgroups. Mean total and item PISQ12 scores did not differ across all subgroups. One limitation worth mentioning is that the study only included sexually active women, excluding any sexually inactive cases due to urinary incontinence, which would inherently underestimate the global effect of urinary incontinence on sexual function.


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