Pelvic floor exercises in pregnancy improve sex life, a little

Pregnancy and childbirth place enormous strain on the pelvic floor, the sling of muscle that supports the bladder, bowel and uterus. Weakness in these muscles is linked to problems many new mothers quietly live with, including changes in sexual function. Pelvic floor exercises are already widely recommended around birth, but mostly for continence. Whether they also help women's sexual function, before and after delivery, is a question that had not been pulled together systematically until this review.

The researchers searched PubMed, the Cochrane Library, Web of Science and the Turkish ULAKBİM database using standardised medical keywords. They included only trials in which women were assigned at random to pelvic floor muscle exercises or to a control condition, during pregnancy or after birth. The population of interest was first-time mothers, and the outcomes were sexual function and pelvic floor strength. Results from the eligible trials were then pooled statistically using the Review Manager program.

Pooled scores for sexual function favoured the exercise groups both during pregnancy and after birth. The standardised difference was 6.33 for the pregnancy trials and 1.19 for the postpartum trials, so the postpartum signal was considerably smaller and only just reached statistical significance. Despite those numbers, the authors describe the overall effect on sexual function as little. They also conclude the training is a safe strategy that can improve postpartum sexual function in first-time mothers.

Pelvic floor muscle training has a long evidence base for preventing and treating urinary problems around childbirth, but its effects on sexuality have been far less studied. This review extends the case for the exercises beyond continence into sexual well-being, while being candid that the benefit looks modest. The unusually large pooled figure for the pregnancy trials also hints that the included studies may have measured sexual function in quite different ways. Longer and more consistent trials would be needed to pin down how big the real effect is and how long it lasts.

For women who are pregnant or have recently given birth, this is a reason to see pelvic floor exercises as potentially more than continence insurance. The pooled evidence suggests a modest improvement in sexual function, and the authors judged the approach safe. It is not a dramatic effect, and the review covered only first-time mothers, so the picture for later pregnancies is less clear. The findings apply to structured exercise programmes studied in trials, not to any single app, gadget or routine.