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Sexual performance and pelvic floor muscle strength in patients with fibromyalgia: a controlled cross-sectional study

  • Observational Research
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Abstract

Background

Fibromyalgia (FM) is characterized by chronic and widespread pain, sleep disturbances, fatigue, psychological distress and morning stiffness. These patients also present symptoms such as depression, sexual dysfunctions and reproductive problems. Sexuality involves several aspects, including pelvic floor functionality, and one question is whether the sexual performance of women with fibromyalgia is associated with pelvic floor function or other characteristics of the disease.

Objective

The aim of this study was to gauge the association between perineal function and sexual performance in women with and without fibromyalgia.

Methods

We performed a cross-sectional study with 109 sexually active women from 19 to 65 years of age, either suffering from fibromyalgia (FM group, n = 51) or free from fibromyalgia (non-FM group, n = 58). Perineal function was measured with the use of perineometry and digital vaginal palpation (PERFECT Scheme), while sexual performance was assessed by the Sexual Quotient Female questionnaire (QS-F).

Results

Patients with fibromyalgia presented poor sexual performance compared to those without fibromyalgia (QS-F score 58 (32–66) vs. 66 (56–70); p = 0.002) as well as lower pelvic floor muscle strength measured by perineometry (32.5 (18.2–40.5) vs. 37.9 (23.4- 57.3); p = 0.03). Patients without fibromyalgia presented a positive correlation between perineometry and QS-F (r = 0.22; p = 0.038), while those with fibromyalgia presented no correlation between those two variables (r = 0.22; p = 0.12). The regression model showed an association between sexual performance and the presence of fibromyalgia, pelvic floor muscle strength (perineometry) and age, according to the following equation: sexual performance = 48.52 + (9.5 * non-FM group) + (0.23 * perineometry)–(0.4 * age), with adjusted R2 = 0.19.

Conclusion

Women with FM present poor sexual performance and lower pelvic floor muscle strength compared to those without FM. However, the correlation between these variables among women without FM was not observed in women with FM. Sexual performance showed a positive association with absence of fibromyalgia and higher pelvic floor muscle strength, and a negative association with age.

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Acknowledgements

We thank (Coordination for the Improvement of Higher Education Personnel—Government Research Agency).

Funding

This study received funds from CAPES (Coordination for the Improvement of Higher Education Personnel—Government Research Agency) with scholarship to the first author.

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Authors and Affiliations

  1. Department of Physiotherapy, Speech Therapy and Occupational Therapy, School of Medicine, Faculty of Medicine, University of São Paulo, Cipotanea Street, 51, São Paulo, SP, Brazil

    Hellen Cristina Souza de Carvalho Fusco, Rafael Treitero Consolo, Adriana Claudia Lunardi & Elizabeth Alves Gonçalves Ferreira

  2. Department of Rheumatology, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil

    Marco Antônio Pontes Filho

Authors
  1. Hellen Cristina Souza de Carvalho Fusco
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  2. Marco Antônio Pontes Filho
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  3. Rafael Treitero Consolo
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  4. Adriana Claudia Lunardi
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  5. Elizabeth Alves Gonçalves Ferreira
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Contributions

HCSCF: conceptualization; methodology; data collection; formal analysis and investigation; writing—original draft preparation; writing—review and editing; funding acquisition; resources. MAP-F: conceptualization; methodology; data collection; formal analysis and investigation; writing—review and editing; resources. RTC: conceptualization; methodology; formal analysis and investigation; writing—review and editing; resources. ACL: methodology; formal analysis and investigation; writing—original draft preparation; writing—review and editing. EAGF: conceptualization; methodology; formal analysis and investigation; writing—original draft preparation; writing—review and editing; funding acquisition; resources; supervision. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Hellen Cristina Souza de Carvalho Fusco.

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Conflict of interest

The authors have no disclosure of potential conflicts of interest. All subjects agreed to participate and signed the Informed consent form.

Ethical approval

The Ethics Committee for Analysis of Research Projects approved this study (protocol number 40789914.1.0000.0065). All subjects agreed to participate and signed the informed consent form.

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de Carvalho Fusco, H.C.S., Filho, M.A.P., Consolo, R.T. et al. Sexual performance and pelvic floor muscle strength in patients with fibromyalgia: a controlled cross-sectional study. Rheumatol Int 41, 415–421 (2021). https://doi.org/10.1007/s00296-020-04595-4

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