Skip to main content

Can stronger pelvic muscle floor improve sexual function?


Introduction and hypothesis

This study aims to evaluate the association between pelvic floor muscle (PFM) strength and sexual functioning.


Retrospective chart review of consecutive all women who were referred with a primary complaint of sexual dysfunction. Women underwent standardized clinical evaluation including pelvic muscle strength which was ranked from 0 (weak) to 2 (strong). The duration of pelvic muscle contraction was also recorded in seconds. Sexual function was evaluated by using a validated questionnaire, the Female Sexual Function Index (FSFI).


One hundred seventy-six women with a mean age of 37 ± 11 years were included. Women with strong or moderate PFM scored significantly higher on the FSFI orgasmic and arousal domains than women with weak PFM (5.4 ± 0.8 vs. 2.8 ± 0.8, and 3.9 ± 0.5 vs. 1.7 ± 0.24, respectively; P < 0.001). The duration of PFM contraction was correlated with FSFI orgasmic domain and sexual arousal (r = 0.26, P < 0.001; r = 0.32, P < 0.0001, respectively).


Our findings suggest that both the orgasm and arousal function are related to better PFM function.

This is a preview of subscription content, access via your institution.



pelvic floor muscle


pelvic floor muscle training


maximum voluntary contraction


Female Sexual Function Index


sexual dysfunction


  1. Graber B, Kline-Graber G (1979) Female orgasm: role of pubococcygeus muscle. J Clin Psychiatry 40(8):348–351

    CAS  PubMed  Google Scholar 

  2. Kinsey A, Pomeroy W, Martin C, Paul G (1998) Sexual behavior in the human female. W. B. Saunders, Philadelphia

    Google Scholar 

  3. Bo K, Talseth T, Vinsnes A (2000) Randomized controlled trial on the effect of pelvic floor muscle training on quality of life and sexual problems in genuine stress incontinent women. Acta Obstet Gynecol Scand 79(7):598–603

    Article  CAS  PubMed  Google Scholar 

  4. Beji NK, Yalcin O, Erkan HA (2003) The effect of pelvic floor training on sexual function of treated patients. International urogynecology journal and pelvic floor dysfunction 14(4):234–238, discussion 238

    Article  PubMed  Google Scholar 

  5. Zahariou AG, Karamouti MV, Papaioannou PD (2008) Pelvic floor muscle training improves sexual function of women with stress urinary incontinence. International urogynecology journal and pelvic floor dysfunction 19(3):401–406

    Article  PubMed  Google Scholar 

  6. Messe MR, Geer JH (1985) Voluntary vaginal musculature contractions as an enhancer of sexual arousal. Arch Sex Behav 14(1):13–28

    Article  CAS  PubMed  Google Scholar 

  7. Achtari C, Dwyer PL (2005) Sexual function and pelvic floor disorders. Best practice & research 19(6):993–1008

    Google Scholar 

  8. Foldes P, Buisson O (2009) The clitoral complex: a dynamic sonographic study. The journal of sexual medicine 5:1223–1231

    Article  Google Scholar 

  9. Kegel AH (1952) Sexual functions of the pubococcygeus muscle. West J Surg Obstet Gynecol 60(10):521–524

    CAS  PubMed  Google Scholar 

  10. Shafik A (2000) (2000) The role of the levator ani muscle in evacuation, sexual performance and pelvic floor disorders. International urogynecology journal and pelvic floor dysfunction 11(6):361–376

    Article  CAS  PubMed  Google Scholar 

  11. Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R et al (2000) The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital ther 26(2):191–208

    Article  CAS  PubMed  Google Scholar 

  12. Helstrom L, Nilsson B (2005) Impact of vaginal surgery on sexuality and quality of life in women with urinary incontinence or genital descensus. Acta Obstet Gynecol Scand 84(1):79–84

    PubMed  Google Scholar 

  13. Ghezzi F, Serati M, Cromi A, Uccella S, Triacca P, Bolis P (2006) Impact of tension-free vaginal tape on sexual function: results of a prospective study. International urogynecology journal and pelvic floor dysfunction 17(1):54–59

    Article  PubMed  Google Scholar 

  14. Laycock JSB, Norton P, Stanton S (1994) Pelvic floor re-education: principles and practice. Springer, London

    Google Scholar 

  15. Bo K, Sherburn M (2005) Evaluation of female pelvic-floor muscle function and strength. Phys Ther 85(3):269–282

    PubMed  Google Scholar 

Download references

Conflicts of interest


Author information

Authors and Affiliations


Corresponding author

Correspondence to Lior Lowenstein.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Lowenstein, L., Gruenwald, I., Gartman, I. et al. Can stronger pelvic muscle floor improve sexual function?. Int Urogynecol J 21, 553–556 (2010).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


  • Duration of muscle contraction
  • Muscle strength
  • Pelvic floor muscles
  • Sexual function