School of Rehabilitation Science, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
School of Kinesiology, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
Sex Med Rev. 2017 Jul;5(3):282-294. doi: 10.1016/j.sxmr.2017.02.001. Epub 2017 Mar 18.
Emergent evidence suggests that pelvic floor muscle (PFM) dysfunction contributes to dyspareunia, the experience of pain on vaginal penetration. Electromyography (EMG) is a valuable tool for the assessment of neuromuscular control and could be very useful in enhancing our understanding of PFM involvement in sexual function and in conditions such as dyspareunia. However, PFM EMG must be interpreted within the context of the many factors that can influence findings.
To outline the main factors to consider when evaluating PFM EMG for female sexual function and dyspareunia and to synthesize the literature in which EMG has been acquired and interpreted appropriately in this context.
Standards for the acquisition and interpretation of EMG were retrieved and consulted. An exhaustive search of four electronic databases (Embase, CINAHL, PubMed, and PsycLit) and hand searching references from relevant articles were performed to locate articles relevant to PFM involvement in sexual function and in dyspareunia in which EMG was used as a primary outcome. Study outcomes were evaluated within the context of the appropriate application and interpretation of EMG and their contribution to knowledge.
A synthesis of the evidence was used to present the current state of knowledge on PFM involvement in sexual function and in dyspareunia.
Few standards documents and no practice guidelines for the acquisition and interpretation of PFM EMG are available. Some cohort studies with small samples of women have described the role of the PFMs in female sexual function. The literature on PFM involvement in dyspareunia also is limited, with outcomes suggesting that higher than normal tonic activation and higher than normal reflex responses might be present in the superficial PFM layer and might be characteristic features of dyspareunia. The data are less clear on the involvement of the deep layer of the PFMs in dyspareunia.
Guidelines for the application and interpretation of PFM EMG in the context of sexual function and dyspareunia are needed. When interpreted within the context of their strengths and limitations, EMG data have contributed valuable information to our understanding of PFM involvement in dyspareunia. The literature to date suggests that the superficial PFMs might have higher than normal tone and exaggerated responses to tactile or penetrative provocation in at least some women with dyspareunia. McLean L, Brooks K. What Does Electromyography Tell Us About Dyspareunia? Sex Med Rev 2017;5:282-294.
新出现的证据表明，盆底肌肉（PFM）功能障碍与性交疼痛（阴道插入时的疼痛）有关。肌电图（EMG）是评估神经肌肉控制的一种有价值的工具，对于增强我们对 PFM 参与性功能和性交疼痛等情况的理解可能非常有用。然而，PFM EMG 必须在可能影响结果的许多因素的背景下进行解释。
概述评估女性性功能和性交疼痛的 PFM EMG 时需要考虑的主要因素，并综合在这种情况下适当获取和解释 EMG 的文献。
检索并咨询了 EMG 的获取和解释标准。对四个电子数据库（Embase、CINAHL、PubMed 和 PsycLit）进行了全面搜索，并从相关文章的参考文献中进行了手工搜索，以找到与 PFM 参与性功能和性交疼痛有关的文章，其中 EMG 作为主要结果。在适当应用和解释 EMG 及其对知识的贡献的背景下评估研究结果。
综合证据以呈现当前关于 PFM 参与性功能和性交疼痛的知识状态。
目前可获得的关于 PFM EMG 获取和解释的标准文件和实践指南很少。一些队列研究对小样本女性描述了 PFM 在女性性功能中的作用。关于 PFM 参与性交疼痛的文献也很有限，研究结果表明，在浅层 PFM 层中可能存在高于正常的紧张性激活和高于正常的反射反应，这可能是性交疼痛的特征。关于深层 PFM 层在性交疼痛中的参与，数据不太清楚。
需要有关于性功能和性交疼痛背景下 PFM EMG 的应用和解释的指南。当在其优缺点的背景下进行解释时，EMG 数据为我们理解 PFM 参与性交疼痛提供了有价值的信息。迄今为止的文献表明，在至少一些患有性交疼痛的女性中，浅层 PFM 可能具有高于正常的张力和对触觉或穿透性刺激的反应过度。McLean L, Brooks K. What Does Electromyography Tell Us About Dyspareunia? Sex Med Rev 2017;5:282-294.
