Association between pelvic floor muscle strength and sexual function based on PISQ-12-an analysis of data from a multicenter cross-sectional study on 735 nulliparae during pregnancy

Lei Gao; Bing Xie; Hongmei Zhu; Di Zhang; Xiuhong Fu; Hongjuan Li; Min Zhen; Baoling Qin; Weipeng Chen; Xuying Mao; Lingrui Kong; Jianliu Wang; Guizhu Wu; Xiuli Sun

doi:10.3389/fmed.2023.1093830

Association between pelvic floor muscle strength and sexual function based on PISQ-12-an analysis of data from a multicenter cross-sectional study on 735 nulliparae during pregnancy

Front Med (Lausanne). 2023 Apr 25:10:1093830. doi: 10.3389/fmed.2023.1093830. eCollection 2023.

Authors

Lei Gao^#^{1

2}, Bing Xie^#^{1

2}, Hongmei Zhu^{1

2

3}, Di Zhang^{1

2}, Xiuhong Fu^{4

5}, Hongjuan Li⁶, Min Zhen⁷, Baoling Qin⁸, Weipeng Chen⁹, Xuying Mao¹⁰, Lingrui Kong¹¹, Jianliu Wang^{1

2}, Guizhu Wu¹², Xiuli Sun^{1

2}

Affiliations

¹ Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China.
² The Key Laboratory of Female Pelvic Floor Disorders, Peking University People's Hospital, Beijing, China.
³ Department of Sports Medicine and Rehabilitation, Beijing Sports University, Beijing, China.
⁴ Department of Obstetrics and Gynecology, Henan Key Laboratory of Fertility Protection and Aristogenesis, Luohe, China.
⁵ Department of Obstetrics and Gynecology, Luohe Central Hospital of Henan Province, Luohe, China.
⁶ Department of Obstetrics and Gynecology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China.
⁷ Department of Obstetrics and Gynecology, Fangshan District Beijing Maternal and Child Health Hospital, Beijing, China.
⁸ Department of Obstetrics and Gynecology, Beijing Fengtai District Maternal and Child Health Hospital, Beijing, China.
⁹ Department of Obstetrics and Gynecology, Peking University International Hospital, Beijing, China.
¹⁰ Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, China.
¹¹ Department of Obstetrics and Gynecology, Capital Medical University Mentougou Teaching Hospital, Beijing, China.
¹² Department of Obstetrics and Gynecology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China.

^# Contributed equally.

Abstract

Background: Pelvic floor muscle strength is well-known to be associated with female sexual function. However, there were a few studies that reported on the relationship between pelvic floor muscle strength and female sexual function in pregnant women, and the presented results were inconsistent. Nulliparae represent a specific cohort with simplicity to exclude confounding factors that are caused by parity. The present study aimed to explore the association of pelvic floor muscle strength and sexual function based on the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) of nulliparae during pregnancy.

Methods: This is the second analysis of the baseline data from a randomized controlled trial (RCT), which aimed to study the protective efficacy of pelvic floor muscle training on stress urinary incontinence at 6th week postpartum (registration number: ChiCTR2000029618). Nulliparae aged 20-40 years with singleton pregnancy before 16 weeks of gestation were enrolled in this study, and data, including participants' demographic information, the Modified Oxford Scale (MOS), and PISQ-12, were collected. Eligible nulliparae were divided into two groups: Group MOS > 3 and Group MOS ≤ 3. Demographic information of the two groups was compared. Sexual function based on the PISQ-12 scores of the two groups was compared. A comparison of the PISQ-12 scores between the two groups was calculated by the Mann-Whitney U-test using SPSS version 23.0.

Results: A total of 735 eligible nulliparae were enrolled in this study. Along with MOS grading up, PISQ-12 scores tended to get lower. Of the 735 nulliparae, there were 378 and 357 participants included in Group MOS > 3 and Group MOS ≤ 3, respectively. The PISQ-12 scores of Group MOS > 3 were significantly lower than those of Group MOS ≤ 3 (11 vs. 12, p < 0.001). The scores of the frequency of feeling sexual desire, orgasm achievement, sexual excitement, sexual activity satisfaction, sexual intercourse pain, fear of urinary incontinence, and negative emotion reactions with the sexual intercourse of Group MOS > 3 were lower than those of Group MOS ≤ 3 (p < 0.05).

Conclusion: Pelvic floor muscle strength was positively associated with sexual function based on the questionnaire of young nulliparae during their first trimester. Up to half of the nulliparae during the first trimester were suffering from weak pelvic floor muscle strength and nearly a quarter of the nulliparae were facing this weakness combined with sexual dysfunction.

Trial registration: This study has been registered at http://www.chictr.org.cn (registration number: ChiCTR2000029618).

Keywords: muscle strength (MeSH); pelvic floor (MESH unique ID = D017773); pregnant women; sexual dysfunction; women.

Grants and funding

This research was supported by the National Natural Science Foundation of China (grant number: 82101697), the National Key Technology R&D Program of China (grant number: 2018YFC2002204), the Beijing Natural Science Foundation (grant number: 7214263), the Chinese Association of Plastics and Aesthetics (grant number: 2020-Z-33), Peking University People's Hospital Research and Development Fund (grant number: RDH2020-08), and the National Natural Science Foundation of China (grant number: 81571420).