Pelvic floor maladies can impact women's sex life (Reuters)

NEW YORK (Reuters Health) - Incontinence and otherdisorders of the pelvic organs can take a toll on a woman's sexlife, a new study suggests.

Researchers found that among 300 women age 40 and older,those with symptoms of a pelvic floor disorder were more likelyto have a diminished libido, pain during sex, or problemsreaching orgasm.

Pelvic floor disorders refer to problems with a woman'spelvic organs -- the uterus, bladder and rectum -- and themuscles and connective tissue that support them. Among the mostcommon of these are urinary incontinence and pelvic organprolapse, where weakened muscles and supporting tissue allowone or more pelvic organs to drop down and protrude into thevagina.

Some symptoms of prolapse include pressure in the vagina,pain in the lower abdomen or lower back, and chronicconstipation.

It has been estimated that one-third of U.S. women have atleast one type of pelvic floor disorder, but studies have cometo conflicting conclusions as to whether the conditions hinderwomen's sex lives.

The new findings, reported in the journal Obstetrics &Gynecology, suggest that many women with these disorders do, infact, have problems with sexual function.

However, the risk of sexual dysfunction was not elevatedamong women who had mild prolapse that was not causingsymptoms, lead researcher Dr. Victoria Handa told ReutersHealth.

This is important, she explained, because it indicates thatwomen who have sexual complaints but no other potentialsymptoms of pelvic organ prolapse do not need to be evaluatedfor the disorder.

"Sexual function is unlikely to be impacted by mildprolapse," said Handa, an associate professor of gynecology andobstetrics at Johns Hopkins University in Baltimore.

The findings are based on 301 patients recruited fromgynecology offices affiliated with Johns Hopkins. Eighty womenwere seeking care for a pelvic floor disorder, includingbladder control problems and pelvic organ prolapse. The rest ofthe women had other conditions or were getting a routinecheckup.

All of the women completed questionnaires on their overallhealth, pelvic symptoms and sexual function.

Overall, the researchers found, women with pelvic floordisorders were more likely to have symptoms of a decreased sexdrive, pain during sex and infrequent orgasms -- regardless ofage and whether they had gone through menopause.

The study does not prove that the pelvic floor disorderscaused the women's sexual problems, Handa said. However, theconditions could impair women's sexual function for a number ofreasons, from diminished body image to problems with muscle andnerve function.

According to Handa, women with pelvic floor disordersshould talk with their doctors about any sexual difficultiesthey have.

In an earlier study, she and her colleagues found thatwomen's sexual function often improved after having surgery tocorrect significant prolapse. But more research is needed intothis area, Handa said.

If certain treatments for pelvic floor disorders are betterthan others for improving sexual function, she noted, that willbe important to know.

SOURCE: Obstetrics & Gynecology, May 2008.