(670) Sex: The Best Natural Practice to Preserve the Genitourinary System and Prevent Genitourinary Syndrome of Menopause: Therapeutic, Molecular, and Cellular Mechanisms

Introduction Sex is the gym of the pelvic floor and should be consistently promoted. Objective The objectives are to explain the importance of sexual activity in maintaining the structural and functional integrity of the genitourinary system, and to demonstrate how sex acts as a “natural gym” for the pelvic floor, serving as the most effective way to prevent genitourinary syndrome of menopause (GSM). The study also aims to demystify sexuality in older adulthood and highlight that its practice is as necessary as physical and mental exercise. Methods Over a 17-year period, women aged 45 to 95 were evaluated and divided into three groups based on the frequency of sexual activity. The degree of GSM was assessed across groups, and systemic benefits resulting from arousal and orgasm were analyzed. Results Women with regular sexual activity (> once per week) exhibited a significantly lower degree of GSM than those with moderate or no sexual activity. Findings in the regularly active group included better preservation of vaginal rugae, reduced vulvovaginal atrophy, absent or mild dyspareunia (<\/10), no stress urinary incontinence and only mild general incontinence, and fewer cases of hypoactive sexual desire disorder (HSDD) and orgasmic dysfunction. Furthermore, these women presented minimal presence of vaginal or uterine prolapse or total procidentia, fewer recurrent urinary tract infections, and less vulvovaginal obliteration. Conversely, the most severe cases were observed in women with moderate or no sexual activity. The combination of sexual activity with hormone therapy demonstrated a synergistic effect. Conclusions Sexual activity preserves the genitourinary system and prevents GSM. Orgasm is the most effective pelvic exercise. Arousal and orgasm have been shown to increase steroid hormone receptors in neural, cardiac, and musculoskeletal tissues. Promoting and demystifying sexual activity in older adults is essential to overall well-being, akin to the importance of physical and mental exercise, whether with a partner or alone- Disclosure No