Sexual Function in Pelvic Floor Disorders: A Pilot Study on the Feasibility of Routine Assessment

TL;DR

A pilot study explores the use of a sexual health questionnaire in pelvic floor clinics to better assess and address sexual dysfunction in patients with pelvic floor disorders.

Contribution

The study demonstrates the feasibility of using the FSFI questionnaire in routine pelvic floor disorder consultations to evaluate sexual function.

Findings

A brief sexual health questionnaire can be integrated into pelvic floor clinics to assess sexual function.

Sexual dysfunction varied across pelvic floor disorder phenotypes, with lubrication and satisfaction showing greater variability.

Moderate-to-high anticipatory sexual anxiety was present in 80% of the participants.

Abstract

Background/Objectives: Pelvic floor disorders (PFDs), which include pelvic organ prolapse and urinary incontinence, are common conditions that often affect sexual health, but remain under-assessed within routine care. The following cases are presented to demonstrate the potential of a brief sexual health questionnaire in pelvic floor clinics and to explore how sexual function varies across common PFD phenotypes. Methods: A pilot case series was conducted with a group of five sexually active women diagnosed with PFDs at the Materno-Infantil University Hospital in Gran Canaria, Spain, between January and December 2025. Patients completed the Female Sexual Function Index (FSFI) at the index visit. Results: Mean age was 40.6 years (range 35–46), mean parity was 1.6 births and 60% were active smokers. Mean FSFI total score was 26.9 (range 21.4–32.2) and 60% scored below 26.55. Desire and arousal were relatively preserved (means 5.0 and 4.9), whereas lubrication (3.4) and satisfaction (3.9) showed greater variability. Pain scores were low overall (mean 5.2). Self-rated sexual satisfaction was low in 40%, moderate in 40% and high in 20%. Moderate-to-high anticipatory sexual anxiety was present in 80%. Conclusions: Integrating a concise questionnaire based on the FSFI into the pelvic floor consultation appears to be a reasonable approach, with the potential to address secondary sexual dysfunction in patients with PFD, thereby facilitating personalised counselling and treatment.