(663) Assessment of Sexual Function in Women with Pelvic Floor Dysfunction

Abstract Introduction Pelvic floor dysfunction (PFD) is a highly prevalent yet often underrecognized condition affecting up to half of women worldwide. It results from the weakening of pelvic support tissues, leading to urinary incontinence (UI) and pelvic organ prolapse (POP). Beyond its physical implications, PFD exerts a profound impact on emotional well-being and intimate relationships, contributing to anxiety, dyspareunia, and diminished quality of life. Despite its high prevalence, sexual health in women with PFD remains insufficiently explored, particularly in those awaiting surgical correction. Understanding how clinical and demographic factors influence sexual function is essential to guide a more holistic and patient-centered approach to care. Objective To evaluate sexual function in women with PFD scheduled for surgical treatment, and to analyze associations between sociodemographic and clinical factors, menopausal status, and sexual outcomes. Methods A cross-sectional observational study was conducted among 18 sexually active women listed for PFD repair at a Portuguese Hospital. Sociodemographic and clinical data were collected using anonymous questionnaires. Sexual function was assessed with the Female Sexual Function Index (FSFI) and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12), while urinary incontinence severity was evaluated using the International Consultation on Incontinence Questionnaire–Short Form (ICIQ-SF). Data were analyzed with non- parametric statistical tests (Mann–Whitney, Kruskal–Wallis, and Spearman’s correlation), with p-values 0.05 considered significant. Ethical approval was obtained from the institutional ethics and data protection committees. Results Participants had a median age of 48.5 years and a median BMI of 28.5 kg/m2. POP was present in 50% and UI in 83% of women. Overall, 50% demonstrated sexual dysfunction (FSFI ≤ 26.55), with desire and arousal being the most affected domains. Menopause (p = 0.007) and older age (p = 0.016) were significantly associated with lower PISQ-12 scores, reflecting poorer sexual function. Among women with UI, one-third reported that fear of urine leakage limited sexual activity, while 89% of those with POP avoided intercourse due to vaginal bulging. Emotional factors were also evident, with one-third of participants describing negative feelings such as shame, fear, or guilt during intimacy. No significant associations were found between sexual function and parity, contraceptive use, or comorbidities, likely reflecting the limited sample size. Nonetheless, the data reveal clear patterns of decline in sexual well-being associated with menopausal transition and PFD symptoms. Conclusions Women with pelvic floor dysfunction experience substantial impairments in sexual health driven by both physiological and psychosocial mechanisms. Menopause and advancing age exacerbate these effects, reducing desire, arousal, and overall satisfaction. The findings highlight the importance of integrating sexual health assessment into the routine management of PFD and underscore the need for multidisciplinary interventions addressing not only anatomical correction but also emotional and relational dimensions. Larger, longitudinal studies-particularly with pre- and postoperative follow-up-are warranted to clarify the impact of surgical treatment on sexual outcomes and to guide evidence-based, holistic care for affected women. Disclosure No