Pelvic floor muscle training as a treatment for genitourinary syndrome of menopause

Genitourinary syndrome of menopause (GSM) is a collection of genital and urinary symptoms and signs caused by a decrease in estrogen and other sex steroids. It leads to changes to the vulva, vagina, urethra, and bladder, causing bothersome symptoms such as vaginal dryness, itching sensation, pain with intercourse, and urinary incontinence. It is a highly prevalent condition affecting up to 50% of postmenopausal women.

Adapted from the book ‘’L’incontinence urinaire, La prévenir, la traiter’’ with autorisation’’

The most common treatments for GSM include vaginal hormonal therapy and moisturizer. In a 2017 US survey of women with GSM, 56% of women treated with vaginal hormonal therapy, systemic hormonal therapy, or vaginal moisturizers reported still feeling symptoms and being “somewhat or not satisfied” with their treatment efficacy.[1] Therefore, there is a need to explore effective complementary or alternative GSM treatments.

While I was working at the Women’s Health and Aging Research Laboratory in Montreal, we observed that women taking part in a pelvic floor muscle training program had improvement in their GSM symptoms after the intervention. So, I decided to investigate this effect further in PhD studies.

My main study included 32 postmenopausal women having GSM. They participated in a 12-week pelvic floor muscle training program that included a weekly in-person session and daily home-exercises. During the weekly session, women received information about different topics related to pelvic health and did pelvic floor muscle exercises as well as core exercises. Daily home-exercises included four different pelvic floor muscle exercises.

After the intervention, women from the study reported a statistically significant reduction in their GSM symptoms, a better quality of life and improved sexual function. We also found an improvement in their GSM signs at the physical exam. Women were having more vaginal secretions as well as a thicker and pinker vaginal wall. Moreover, urinary incontinence decreased significantly. Those results are very promising, supporting the effectiveness of a pelvic floor muscle training program to improve GSM symptoms. However, larger studies are needed to confirm those findings.

More details about that study can be found in the article “Pelvic floor muscle training as a treatment for genitourinary syndrome of menopause: A single-arm feasibility study” published in the Maturitas Journal in 2019.

References
1. S.A. Kingsberg, et al., The women’s EMPOWER survey: identifying women’s perceptions on vulvar and vaginal atrophy and its treatment, J. Sex. Med. 14 (3) (2017) 413–424.