Sexual distress in relation to pelvic floor dysfunction-related distress

Background: Sexual distress is seen as an essential component of female sexual dysfunction. Sexual
distress originates from problems with sexual desire, sexual arousal, lubrication, orgasm, or painful
intercourse, for which women could and do seek help, for example, in a pelvic physical therapy
(PPT) practice. In PPT practice, sexual dysfunction is often presented as a main reason to seek help,
besides commonly treated complaints, such as urinary and fecal incontinence, micturition and
defecation problems, pelvic organ prolapses, and pelvic pain. However, it is not clear if sexual
dysfunction and distress is the main reason to seek help. In this study, women’s help-seeking
behavior in PPT practice was investigated, focusing on sexual distress in relation to pelvic floor
complaints.
Method: Pelvic floor dysfunction-related distress was assessed with the Pelvic Floor Distress
Inventory, pelvic pain-related distress with a question from the Four-Dimensional Symptom
Questionnaire, and painful intercourse with a question from the Female Sexual Functioning Index.
Sexual distress was assessed with the Female Sexual Distress Scale. Women with PPT experience
were compared to women without PPT experience.
Results: Women with PPT experience scored higher on the Female Sexual Distress Scale in
comparison to women without PPT experience. However, when corrected for the distress scores,
this effect disappeared. Pelvic floor dysfunction-related distress completely mediated the relationship
between help-seeking and sexual distress. Reversed mediation analysis did not show such an effect.
That is, no effect of sexual distress was found on the relationship between help-seeking and pelvic
floor dysfunction-related distress.
Conclusion: In the current study, pelvic floor dysfunction-related distress was the main reason for
seeking help in a PPT practice, not sexual distress.