AUTHOR=Baszak-Radomańska Ewa , Wańczyk-Baszak Jadwiga , Paszkowski Tomasz 

TITLE=Women’s sexual health improvement: sexual quality of life and pelvic floor muscle assessment in asymptomatic women

JOURNAL=Frontiers in Medicine

VOLUME=Volume 11 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1289418

DOI=10.3389/fmed.2024.1289418

ISSN=2296-858X

ABSTRACT=Problems related to the quality of sexual life in gynecological practice are usually neglected. This study aimed to highlight the significance of this area of concern and evaluate the usefulness of tools as patient-reported outcomes (PROs) and pelvic floor examination to improve women's sexual well-being and to identify predictors of poor quality of sexual life during well-woman annual visit.A cross-sectional study was designed to examine 300 healthy women to determine whether the Sexual Quality of Life (SQOL) questionnaire (on electronic devices) and pelvic floor muscle assessment (VAMP protocol) during annual bimanual examination in asymptomatic women are helpful in differentiating patients who would benefit from discussing sexual problems with a gynecologist. Dyspareunia was an exclusion criterium.The majority of subjects experienced high sexual well-being (82,0% with SQOL score ≥84), with a mean of 85,7 points. SQOL scores were lower for psychiatric disorders or symptoms (37,0% of subjects), although did not correlate with age, BMI, parity, contraception use, history of vulvovaginal symptoms, neurosurgical/orthopedic problems, rectal, bowel or bladder symptoms. Patients with dyspareunia (16.0% of participants, although they denied it during the face-to-face consultation) had a 3.6 times higher prevalence of low or moderate quality of sexual life. The VAMP protocol score was low in asymptomatic women, 33,0% met positive criteria (VAMP+, NRS ≥3) for pelvic floor dysfunction (overactivity) although at borderline levels. VAMP+ was positively correlated with chronic pain and genitourinary symptoms, but neither with dyspareunia nor incontinence and was unrelated to SQOL score (p = 0.151).Conclusions: Women's sexual health is a global health priority. Finding a way to start discussion with asymptomatic patient is crucial to increase patients' interest in disclosing a sexual health problem to be resolved. PROs or simple questions about sexual well-being direct the discussion mainly in the at-risk group for sexual deterioration: those with mental health problems and women with dyspareunia. Dyspareunia is considered as a predictor of decreased quality of sexual life, a major sexual disorder that should not be overlooked.Gynecological consultation should resolve concerns, identify the problem and refer for professional sexual care, if still needed.