International Urogynecology Journal · Nov 29, 2025

Comparison of Pelvic Floor Muscle Function Between Sexually Active and Sexually Inactive Women with Pelvic Floor Dysfunction: Retrospective Cross-Sectional Study

By Ferreira LA, Fitz FF, Cruz MA et al.

INTRODUCTION AND HYPOTHESIS: Sexual performance is influenced by pelvic floor muscle (PFM) function. The hypothesis is that sexually active women with pelvic floor dysfunction (PFD) would have better PFM function compared with sexually inactive women. This study was aimed at comparing PFM function between sexually active and inactive women with PFD. METHODS: This retrospective, cross-sectional study included women over 18 years of age diagnosed with PFD, divided into two groups based on sexual activity, as determined by a structured questionnaire. PFM function was assessed via bidigital palpation using the Power, Endurance, Repetitions, Fast contractions, and Every Contraction Timed scheme. Mann-Whitney, likelihood ratio tests, post hoc power and multivariate regression analyses were conducted, with a significance level of p < 0.05. RESULTS: A total of 229 charts were analyzed (117 sexually active, 112 sexually inactive women). Sexually active women demonstrated significantly better PFM function in terms of strength (p < 0.001), endurance (p < 0.001), and fast contractions (p < 0.001). Post hoc analysis revealed an overall study power of 0.93. Sexually active women had a fivefold greater chance of presenting better muscle function (OR 5.04; IC 95% 2.6-9.6, p < 0.001), longer endurance (+3.5; IC 95% 2.1-4.9; p<0.001) and a higher number of fast contractions (+1.2; IC 95% 0.56-1.84; p < 0.001). Increasing age reduces the PFM strength (p = 0.029), muscular endurance (p = 0.008), and fast contractions (p = 0.054). Menopause status reduces muscular endurance in 1.8 s (p = 0.005) and increase fast contractions in 0.8 (p = 0.021). Marital status and urinary incontinence were not associated with PFM function. CONCLUSIONS: Sexually active women with PFD exhibit superior pelvic floor muscle function compared with sexually inactive women.

doi.org/10.1007/s00192-025-06352-2PubMed 41317300Populations