Stamos Dimitrios, Sapouna Vaia, Astraka Katerina Maria, Thanopoulou Sofia, Giannakis Ioannis, Pantou Agni, Baltogiannis Dimitrios, Paschopoulos Minas, Sofikitis Nikolaos, Zachariou Athanasios
Department of Urology, University of Ioannina, Ioannina, GRC.
Clinical Exercise Physiology and Rehabilitation Laboratory, Department of Physiotherapy, University of Thessaly, Lamia, GRC.
Cureus. 2025 Jun 11;17(6):e85751. doi: 10.7759/cureus.85751. eCollection 2025 Jun.
Female sexual dysfunction (FSD) is a multifactorial condition affecting desire, arousal, orgasm, and satisfaction, with wide-ranging implications for women's physical and emotional well-being. Although prevalent, especially among postmenopausal and postpartum populations, FSD remains under-recognized and undertreated. Pelvic floor muscle training (PFMT) has emerged as a promising, non-invasive therapeutic approach for managing FSD, particularly when associated with pelvic floor disorders such as urinary incontinence, pelvic organ prolapse, and overactive bladder. This narrative review synthesizes anatomical, physiological, clinical, and therapeutic insights into the relationship between pelvic floor function and female sexual health. The pelvic floor's structural complexity-comprising muscular, connective, and neurovascular elements-plays a crucial role in sexual response. Dysfunction of this system can contribute to sexual pain, reduced arousal, and orgasmic disorders. PFMT, involving voluntary muscle contractions, biofeedback, or electrical stimulation, has demonstrated benefits across diverse female populations. Variables such as frequency, intensity, supervision, and duration of PFMT significantly influence its effectiveness. Evidence suggests that PFMT improves sexual function in general populations and is particularly beneficial for postpartum, postmenopausal women, and those with neurological or gynecological issues. Improvements are seen in sexual desire, arousal, lubrication, orgasm, and pain reduction. The mechanisms underlying these effects include enhanced muscle strength, increased genital blood flow, and psychological improvements such as body awareness and reduced anxiety. Despite strong supportive evidence, implementation challenges persist, including adherence difficulties, a lack of standardized protocols, and insufficient professional training. Barriers to adherence include misconceptions, discomfort, lack of motivation, and poor understanding of proper technique. Facilitators include clear guidance, customized approaches, technological tools, and professional supervision. Mobile health applications and patient empowerment strategies show promise in enhancing engagement and outcomes. Future research should focus on long-term efficacy, standard intervention protocols, and the integration of PFMT with other therapies, such as pharmacological treatments. Overall, PFMT represents a low-risk, cost-effective intervention capable of significantly improving quality of life and sexual function in women across the lifespan.
女性性功能障碍（FSD）是一种多因素疾病，会影响性欲、性唤起、性高潮和性满意度，对女性的身心健康有着广泛影响。尽管FSD很普遍，尤其是在绝经后和产后人群中，但它仍然未得到充分认识和治疗。盆底肌肉训练（PFMT）已成为一种有前景的、非侵入性的治疗FSD的方法，特别是当它与盆底疾病如尿失禁、盆腔器官脱垂和膀胱过度活动症相关时。本叙述性综述综合了有关盆底功能与女性性健康之间关系的解剖学、生理学、临床和治疗方面的见解。盆底结构复杂，由肌肉、结缔组织和神经血管成分组成，在性反应中起关键作用。该系统功能障碍可导致性交疼痛、性唤起降低和性高潮障碍。PFMT包括自主肌肉收缩、生物反馈或电刺激，已在不同女性人群中显示出益处。PFMT的频率、强度、监督和持续时间等变量会显著影响其效果。有证据表明，PFMT能改善普通人群的性功能，对产后、绝经后女性以及患有神经或妇科问题的女性尤其有益。在性欲、性唤起、润滑、性高潮和疼痛减轻方面都有改善。这些效果的潜在机制包括增强肌肉力量、增加生殖器血流量以及心理改善，如身体意识增强和焦虑减轻。尽管有强有力的支持证据，但实施方面仍存在挑战，包括依从性困难、缺乏标准化方案以及专业培训不足。依从性障碍包括误解、不适、缺乏动力以及对正确技术理解不足。促进因素包括明确的指导、定制化方法、技术工具和专业监督。移动健康应用和患者赋权策略在提高参与度和治疗效果方面显示出前景。未来研究应关注长期疗效、标准干预方案以及PFMT与其他疗法（如药物治疗）的整合。总体而言，PFMT是一种低风险、具有成本效益的干预措施，能够显著改善女性一生中的生活质量和性功能。
