a Pos-Graduation Program in Medical Sciences (PPGCM) , Hospital de Clínicas de Porto Alegre (HCPA). Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre , RS , Brazil.
b Pos-Graduation Program in Health Sciences: Gynecology and Obstetrics (PPGGO) , Hospital de Clínicas de (HCPA), Universidade Federal do (UFRGS) , Porto Alegre , RS , Brazil.
J Sex Marital Ther. 2019;45(5):378-394. doi: 10.1080/0092623X.2018.1549631. Epub 2019 Mar 20.
Dyspareunia negatively affects women´s quality of life, and is a frequent complaint during the peri- and postmenopausal period. A randomized trial evaluated sexual function, quality of life, pain, and pelvic floor muscle function of climacteric women aged between 40 and 60 years old who were sexually active and had complaints of dyspareunia for at least six months. They were assessed before and after their randomization in one of the following interventions: the first group ( = 21) received five one-hour sessions of thermotherapy for relaxation of pelvic floor muscles, myofascial release, and pelvic training (pelvic floor muscle training-PFMT group). The second group ( = 21) received five one-hour sessions during which heat was applied to the lower back with myofascial release of abdominal diaphragm, piriformis, and iliopsoas muscles, with no involvement of pelvic training (lower back-LB group). Forty-two climacteric women with dyspareunia (mean ± , PFMT group: 51.9 ± 5.3 years, LB group: 50.6 ± 4.7 years, Student's test, = 0.397) were studied. Pain scores (mean ± SEM) in the PFMT group decreased from 7.77 ± 0.38 to 2.25 ± 0.30; and in the LB group from 7.62 ± 0.29 to 5.58 ± 0.49 (generalized estimating equation-GEE model, ≤ 0.001 for group, time, and interaction pairwise comparisons). Conclusion: The proposed pelvic floor muscle training protocol was effective to improve pain, quality of life, sexual function, and pelvic floor muscle function in climacteric women with dyspareunia.
性交困难严重影响女性的生活质量，是围绝经期和绝经后妇女的常见主诉。一项随机试验评估了 40-60 岁、有性交困难至少 6 个月且有性生活的围绝经期女性的性功能、生活质量、疼痛和盆底肌肉功能。这些女性在随机分组前和分组后分别接受以下干预措施之一的评估：第一组（n=21）接受 5 次 1 小时的盆底肌肉热疗，以放松盆底肌肉、肌筋膜松解和骨盆训练（盆底肌肉训练-PFMT 组）。第二组（n=21）接受 5 次 1 小时的治疗，在下背部应用热疗，同时进行腹部横膈膜、梨状肌和髂腰肌的肌筋膜松解，不包括骨盆训练（下背部-LB 组）。共 42 名有性交困难的围绝经期女性（平均 ± ，PFMT 组：51.9±5.3 岁，LB 组：50.6±4.7 岁，Student's 检验， = 0.397）入组研究。PFMT 组疼痛评分（平均 ± SEM）从 7.77±0.38 降至 2.25±0.30；LB 组从 7.62±0.29 降至 5.58±0.49（广义估计方程-GEE 模型，组、时间和交互作用的两两比较均 ≤ 0.001）。结论：提出的盆底肌肉训练方案可有效改善性交困难的围绝经期女性的疼痛、生活质量、性功能和盆底肌肉功能。
