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