Sexual Function and Pessary Management among Women Using a Pessary for Pelvic Floor Disorders

J Sex Med. 2015 Dec;12(12):2339-49. doi: 10.1111/jsm.13060. Epub 2015 Dec 3.

Abstract

Introduction: Pessaries are commonly used to treat pelvic floor disorders, but little is known about the sexual function of pessary users.

Aim: We aimed to describe sexual function among pessary users and pessary management with regard to sexual activity.

Methods: This is a secondary analysis of a randomized trial of new pessary users, where study patients completed validated questionnaires on sexual function and body image at pessary fitting and 3 months later.

Main outcome measures: Women completed the Pelvic Organ Prolapse-Urinary Incontinence Sexual Function Questionnaire, International Urogynecological Association Revised (PISQ-IR), a validated measure that evaluates the impact of pelvic floor disorders on sexual function, a modified female body image scale (mBIS), and questions regarding pessary management surrounding sexual activity.

Results: Of 127 women, 54% (68/127) were sexually active at baseline and 42% (64/114) were sexually active at 3 months. Sexual function scores were not different between baseline and 3 months on all domains except for a drop of 0.15 points (P = 0.04) for sexually active women, and a drop of 0.34 points for non-sexually active women (P = 0.02) in the score related to the sexual partner. Total mBIS score did not change (P = 0.07), but scores improved by 0.2 points (P = 0.03) in the question related to self-consciousness. Pessary satisfaction was associated with improved sexual function scores in multiple domains and improved mBIS scores. The majority (45/64, 70%) of sexually active women removed their pessary for sex, with over half stating their partner preferred removal for sex (24/45, 53%).

Conclusion: Many women remove their pessary during sex for partner considerations, and increased partner concerns are the only change seen in sexual function in the first 3 months of pessary use. Pessary use may improve self-consciousness and pessary satisfaction is associated with improvements in sexual function and body image.

Keywords: Body Image; Hygiene; Partner; Pessaries; Remove; Sexual Activity; Sexual Function.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Body Image / psychology*
  • Body Mass Index
  • Female
  • Humans
  • Middle Aged
  • Outcome Assessment, Health Care
  • Patient Satisfaction
  • Pelvic Floor Disorders / physiopathology
  • Pelvic Floor Disorders / psychology
  • Pelvic Floor Disorders / therapy*
  • Personal Satisfaction
  • Pessaries / statistics & numerical data*
  • Sexual Behavior / psychology
  • Surveys and Questionnaires
  • Treatment Outcome
  • Urinary Incontinence / physiopathology
  • Urinary Incontinence / psychology*
  • Urinary Incontinence / therapy*