(646) 355-8777

Herman & Wallace Blog

Pelvic Floor Muscle Training for Sexual Dysfunction in Women with Multiple Sclerosis

Sexual dysfunction is a common negative consequence of Multiple Sclerosis, and may be influenced by neurologic and physical changes, or by psychological changes associated with the disease progression. Because pelvic floor muscle health can contribute to sexual health, the relationship between the two has been the subject of research studies for patients with and without neurologic disease. Researchers in Brazil assessed the effects of treating sexual dysfunction with pelvic floor muscle training with or without electrical stimulation in women diagnosed with multiple sclerosis (MS.) Thirty women were allocated randomly into 3 treatment groups; 20 women completed the study. All participants were evaluated before and after treatment for pelvic floor muscle (PFM) function, PFM tone, flexibility of the vaginal opening, ability to relax the PFM’s, and with the Female Sexual Function Index (FSFI). Rehabilitation interventions included pelvic floor muscle training (PFMT) using surface electromyographic (EMG) biofeedback, neuromuscular electrostimulation (NMES), sham NMES, or transcutaneous tibial nerve stimulation (TTNS). The treatments offered to each group are shown below.

  sEMG biofeedback Sham NMES Intravaginal NMES TTNS
Group 1 (n=6) X X    
Group 2 (n=7) X   X  
Group 3 (n=7) X     X

 

The following factors made up the inclusion criteria for the study: age at least 18 years, diagnosis of relapsing-remitting MS, and a 4 month history of stable symptoms. All of the participants were sexually active and were found to be able to contract pelvic floor muscles correctly. Group 1 patients were treated with “sham” electrical stimulation using surface electrodes placed over the sacrum at a pulse width of 50 ms and a frequency of 2 Hz. Patients in Group 2 used an internal (vaginal) electrode at 200 ms at 10 Hz. Group 3 were given transcutaneous tibial nerve stimulation at 200 ms and 10 Hz. All groups followed these treatments with pelvic floor muscle exercises using a vaginal sensor and biofeedback.

The authors concluded that pelvic floor muscle training alone or in combination with intravaginal neuromuscular electrostimulation or transcutaneous tibial nerve stimulation is effective in treating sexual dysfunction in women who have MS. Improvements were noted in these groups in sexual arousal, vaginal lubrication, satisfaction, and in the Female Sexual Function Index. While the numbers in the respective intervention groups is not large enough to determine the best option for patients who have multiple sclerosis, the research reminds us that neurostimulation in conjunction with pelvic muscle training may be very valuable.

Home Exercises for Diastasis of the Rectus Abdomin...
What does Vitamin D have to do with the Pelvic Flo...

Upcoming Continuing Education Courses

Bowel Pathology and Function - Remote Course

Feb 28, 2021 - Mar 1, 2021
Location: Replacement Remote Course

Pelvic Floor Level 1 - Self-Hosted (SOLD OUT)

Mar 1, 2021 - Mar 2, 2021
Location: Self-Hosted Course

Pelvic Floor Level 1 - Brooklyn, NY Satellite Location (SOLD OUT)

Mar 1, 2021 - Mar 2, 2021
Location: Prime Fitness Physical Therapy

Nutrition Perspectives for the Pelvic Rehab Therapist - Remote Course

Mar 5, 2021 - Mar 6, 2021
Location: Replacement Remote Course

Mobilization of Visceral Fascia 2: The Reproductive System - Valencia, CA Satellite Location

Mar 5, 2021 - Mar 7, 2021
Location: Henry Mayo Newhall Memorial Hospital

Mobilization of Visceral Fascia 2: The Reproductive System - Medford, OR Satellite Location

Mar 5, 2021 - Mar 7, 2021
Location: Asante Rogue Valley Medical Center

Mobilization of Visceral Fascia 2: The Reproductive System - St. Louis, MO Satellite Location

Mar 5, 2021 - Mar 7, 2021
Location: Mercy Hospital St. Louis

Mobilization of Visceral Fascia 2: The Reproductive System - Jackson, WY Satellite Location

Mar 5, 2021 - Mar 7, 2021
Location: Four Pines Physical Therapy

Male Pelvic Floor - Satellite Lab Course

Mar 6, 2021 - Mar 7, 2021
Location: Replacement Remote Course

Male Pelvic Floor - St Paul, MN Satellite Location (SOLD OUT)

Mar 6, 2021 - Mar 7, 2021
Location: Regions Hospital

Male Pelvic Floor - Kenosha, WI Satellite Location

Mar 6, 2021 - Mar 7, 2021
Location: Aurora Health Care

Pelvic Floor Level 2B - Self-Hosted (SOLD OUT)

Mar 6, 2021 - Mar 7, 2021
Location: Self-Hosted Course

Male Pelvic Floor - Atlanta, GA Satellite Location

Mar 6, 2021 - Mar 7, 2021
Location: JMM Health Solutions LLC

Male Pelvic Floor - Akron, OH Satellite Location (SOLD OUT)

Mar 6, 2021 - Mar 7, 2021
Location: Summa Health Center

Pelvic Floor Level 2B - Oklahoma City OK Satellite Course

Mar 6, 2021 - Mar 7, 2021
Location: Oklahoma Physical Therapy

Male Pelvic Floor - Asheville, NC Satellite Location

Mar 6, 2021 - Mar 7, 2021
Location: Cornerstone Physical Therapy

Pelvic Floor Level 2B - Little Rock, AR Satellite Course (SOLD OUT)

Mar 6, 2021 - Mar 7, 2021
Location: Core Pelvic Physical Therapy

Pelvic Floor Level 2B - Truckee, CA Satellite Course

Mar 6, 2021 - Mar 7, 2021
Location: Tahoe Forest Center for Health and Sports Performance / Alliance Therapy Partners

Pelvic Floor Level 1 - Self-Hosted (SOLD OUT)

Mar 6, 2021 - Mar 7, 2021
Location: Self-Hosted Course

Pelvic Floor Level 2B - Torrance CA Satellite Course

Mar 6, 2021 - Mar 7, 2021
Location: Women's Advantage Inc

Pelvic Floor Level 2B - Grand Rapids, MI Satellite Course

Mar 6, 2021 - Mar 7, 2021
Location: Mary Free Bed Rehabilitation Hospital

Pelvic Floor Level 1 - Jonesboro, AR Satellite Location (SOLD OUT)

Mar 6, 2021 - Mar 7, 2021
Location: Arkansas State University

Pelvic Floor Level 2B - Williamsburg, VA Satellite Course

Mar 6, 2021 - Mar 7, 2021
Location: Peak Therapy and Sports Rehabilitation

Pelvic Floor Level 2B - Livonia, MI Satellite Course (SOLD OUT)

Mar 6, 2021 - Mar 7, 2021
Location: Mendelson Kornblum Physical Therapy

Biofeedback for Pelvic Muscle Dysfunction - Tampa, FL Satellite Lab Course

Mar 6, 2021 - Mar 7, 2021
Location: Optimal Performance and Physical Therapies

Biofeedback for Pelvic Muscle Dysfunction - Denver, CO Satellite Lab Course

Mar 6, 2021 - Mar 7, 2021
Location: Kelsey Mathias OTR/L

Acupressure for Optimal Pelvic Health - Remote Course

Mar 6, 2021 - Mar 7, 2021
Location: Replacement Remote Course

Pelvic Floor Level 1 - Athens, GA Satellite Location (SOLD OUT)

Mar 6, 2021 - Mar 7, 2021
Location: Thrive Integrated Medicine