Description of complaints and functionality of pelvic floor muscles in climacteric women
a retrospective study
DOI:
https://doi.org/10.24220/2318-0897v33a2025e8830Keywords:
Pelvic floor, Climacteric, Aging, HypoestrogenismAbstract
Objective
Describe the symptomatology of pelvic floor dysfunctions and correlate with the functionality of this musculature.
Methods
This is a retrospective and descriptive study, based on the analysis of medical records of women between 40 and 60 years of age, who were sexually active. Regarding the research, specific information was collected on gynecological and obstetric history, as well as the function of the pelvic floor musculature.
Results
Twelve medical records were selected, in which there was a predominance of women who do not undergo hormone replacement, are multi-pregnant and multiparous, with a higher rate of vaginal deliveries. In addition to the greater presence of stress urinary incontinence, as well as the predominance of sexual dysfunctions with an emphasis on dyspareunia. No woman achieved an efficient degree of pelvic floor strength, most evidently in endurance. The majority did not present a cough reflex and performed co-contraction of accessory muscles.
Conclusion
Hypoestrogenism in the climacteric triggers the various dysfunctions of the pelvic floor and cannot exclude the deleterious effects of aging.
Downloads
References
Selbac MT, Fernandes CGC, Marrone LCP, Vieira AG, Silveira EF, Morgan-Martins MI. Mudanças comportamentais e fisiológicas determinadas pelo ciclo biológico feminino: climatério à menopausa. Aletheia [Internet]. 2018 [citado 2022 set 5];51(1-2):177-190. Disponível em: http://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S1413-03942018000100016&lng=pt.
Camilo SN, De Conto CL, Carneiro Nunes EF, Latorre GFS. Alterações sexuais no climatério do ponto de vista cinesiológico-funcional - revisão. Rev Pesq Fisio. 2019;9(4):532-38. doi: https://doi.org/10.17267/2238-2704rpf.v9i4.1757.
Bachmann GA, Leiblum SR. The impact of hormones on menopausal sexuality: a literature review. Menopause. 2004;11(1):120-30. doi: https://doi.org/10.1097/01.GME.0000075502.60230.28.
Crema IL, Tilio R, Campos MTA. Repercussões da Menopausa para a Sexualidade de Idosas: Revisão Integrativa da Literatura. Psicol. Ciênc. Prof. 2017;37(3):753-69. doi: https://doi.org/10.1590/1982-3703003422016.
Martins M, Bandeira VAC, Gewehr DM, Berlezi EM. Prevalence and factors associated with sexual dysfunction in climacteric women. Mundo Saúde. 2018;42(3):642-55. doi: https://doi.org/10.15343/0104-7809.20184203642655.
Alencar-Cruz JM, Lira-Lisboa L. O impacto da incontinência urinária sobre a qualidade de vida e sua relação com a sintomatologia depressiva e ansiedade em mulheres. Rev. Salud Pública. 2019;21(4):390-97. doi: https://doi.org/10.15446/rsap.V21n4.50016.
Chen CH, Lin YC, Chiu LH, Chu YH, Ruan FF, Liu WM, et al. Female sexual dysfunction: definition, classification, and debates. Taiwan J Obstet Gynecol. 2013;52(1):3-7. doi: https://doi.org/10.1016/j.tjog.2013.01.002.
Yang PL, Heitkemper MM, Kamp KJ. Irritable bowel syndrome in midlife women: a narrative review. Women’s Midlife Health. 2021;7(4). doi: https://doi.org/10.1186/s40695-021-00064-5.
Palomba S, Di Cello A, Riccio E, Manguso F, La Sala GB. Ovarian function and gastrointestinal motor activity. Minerva Endocrinol. 2011 [citado 2022 set 7];36(4):295-310. Disponível em: http://pubmed.ncbi.nlm.nih.gov/22322653/.
Dantas AAG, Barbosa IR, Castri SS, Ferreira CWS, Camara SMA, Dantas DS. Prevalence and factors associated with constipation in premenopausal women: a community-based study. Arq Gastroenterol. 2020;57(2). doi: https://doi.org/10.1590/S0004-2803.202000000-36.
Oliveira CA, Silveira EF, Machado YAF, Martins MIM. Effectiveness of pelvic physiotherapy in treating urinary incontinence in climate women. RSD. 2020;9(11):e2979119880. doi: https://doi.org/10.33448/rsdv9i11.9880.
Hakimi S, Aminian E, Mohammadi M, Alizadeh SM, Bastani P, Houshmandi S. Prevalence and Risk Factors of Urinary/Anal Incontinence and Pelvic Organ Prolapse in Healthy Middle-Aged Iranian Women. J Menopausal Med. 2020;26(1):24-8. doi: https://doi.org/10.6118/jmm.19201.
Hillard TC. Pelvic floor function around the menopause and how to improve it. Climacteric. 2019;22(3):213-14. doi: https://doi.org/10.1080/13697137.2019.1583827.
Johnston SL. Pelvic floor dysfunction in midlife women. Climacteric. 2019;22(3):270-76. doi: https://doi.org/10.1080/13697137.2019.1568402.
Vieira GF, Saltiel F, Miranda-Gazzola APG, Kirkwood RN, Figueiredo EM. Pelvic floor muscle function in women with and without urinary incontinence: are strength and endurance the only relevant functions? a cross-sectional study. Physiotherapy. 2019;109:85-93. doi: https://doi.org/10.1016/j.physio.2019.12.006.
Yang JM, Yang SH, Huang WC, Tzeng CR. Impact of two reflex pelvic floor muscle contraction patterns on female stress urinary incontinence. Ultraschall Med. 2013;34(4):335-39. doi: https://doi.org/10.1055/s-0032-1313206.
Graziottin A, Basson R. Sexual dysfunction in women with premature menopause. Menopause. 2004;11(6):766-77. doi: http://dx.doi.org/10.1097/01.GME.0000139926.02689.A1.
Weintraub AY, Glinter H, Marcus-Braun N. Narrative review of the epidemiology, diagnosis and pathophysiology of pelvic organ prolapse. Int Braz J Urol. 2020;46(1):5-14. doi: http://dx.doi.org/10.1590/S1677-5538.IBJU.2018.0581.
Amselem C, Puigdollers A, Azpiroz F, Sala C, Videla S, Fernández-Fraga X, et al. Constipation: a potential cause of pelvic floor damage?. Neurogastroenterology & Motility. 2010;22(2):150-e48. doi: https://doi.org/10.1111/j.1365-2982.2009.01409.x.
Mannella P, Palla G, Bellini M, Simoncini T. The female pelvic floor through midlife and aging. Maturitas. 2013;76(3):230-34. doi: https://doi.org/10.1016/j.maturitas.2013.08.008.
MacArthur C, Wilson D, Herbison P, Lancashire RJ, Hagen S, Toozs-Hobson P, et al. Urinary incontinence persisting after childbirth: extent, delivery history, and effects in a 12–year longitudinal cohort study. BJOG: 2015;123(6):1022-29. doi: https://doi.org/10.1111/1471-0528.13395.
Leroy LS, Lúcio A, Lopes MHBM. Risk factors for postpartum urinary incontinence. Rev Esc Enferm. 2016;50(2):200-7. doi: https://doi.org/10.1590/S0080-623420160000200004.
Huy Quoc NV, Phuc An LS, Phuong LS, Tam LM. Pelvic Floor and Sexual Dysfunction After Vaginal Birth With Episiotomy in Vietnamese Women. Sex Med. 2019;7(4):514-21. doi: https://doi.org/10.1016/j.esxm.2019.09.002.
Van Geelen H, Ostergard D, Sand P. A review of the impact of pregnancy and childbirth on pelvic floor function as assessed by objective measurement techniques. Int Urogynecol J. 2018;29(3):327-38. doi: https://doi.org/10.1007/s00192-017-3540-z.
Zizzi PT, Trevisan KF, Leister N, Cruz CS, Riesco ML. Women’s pelvic floor muscle strength and urinary and anal incontinence after childbirth: a crosssectional study. Rev Esc Enferm. 2017;51:e03214. doi: https://doi.org/10.1590/S1980-220X2016209903214.





