Sexual Function in Pelvic Floor Disorders: A Pilot Study on the Feasibility of Routine Assessment

Abstract

Background/Objectives: Pelvic floor disorders (PFDs), which include pelvic organ prolapse and urinary incontinence, are common conditions that often affect sexual health, but remain under-assessed within routine care. The following cases are presented to demonstrate the potential of a brief sexual health questionnaire in pelvic floor clinics and to explore how sexual function varies across common PFD phenotypes. Methods: A pilot case series was conducted with a group of five sexually active women diagnosed with PFDs at the Materno-Infantil University Hospital in Gran Canaria, Spain, between January and December 2025. Patients completed the Female Sexual Function Index (FSFI) at the index visit. Results: Mean age was 40.6 years (range 35-46), mean parity was 1.6 births and 60% were active smokers. Mean FSFI total score was 26.9 (range 21.4-32.2) and 60% scored below 26.55. Desire and arousal were relatively preserved (means 5.0 and 4.9), whereas lubrication (3.4) and satisfaction (3.9) showed greater variability. Pain scores were low overall (mean 5.2). Self-rated sexual satisfaction was low in 40%, moderate in 40% and high in 20%. Moderate-to-high anticipatory sexual anxiety was present in 80%. Conclusions: Integrating a concise questionnaire based on the FSFI into the pelvic floor consultation appears to be a reasonable approach, with the potential to address secondary sexual dysfunction in patients with PFD, thereby facilitating personalised counselling and treatment.