Impact of vulvovaginal atrophy on pelvic floor muscle strength in healthy continent women

OBJECTIVES: To assess the correlation between hormonal status and pelvic floor muscle strength. METHODS: A total of 140 continent women were prospectively evaluated, and divided into four groups according to age: group 1 (n = 34) aged 30-40 years; group 2 (n = 38) aged 41-50 years; group 3 (n = 35) aged 51-60; and group 4 (n = 33) aged >60 years. The following parameters were evaluated: demographic data using clinical questionnaire; hypermobility of the bladder neck using swab test; vaginal trophism by gynecological examination; hormonal status of the vagina by cytology; and pelvic floor muscle strength using a perineometer and electromyography. RESULTS: There were no statistical differences between pelvic floor muscle strength, demographic characteristics, vaginal trophism and hypermobility of the bladder neck between groups (P > 0.05). There was a larger number of women with vaginal atrophy among those aged >60 years. Vaginal trophism assessed by pelvic examination was highly consistent with the findings of colpocytology (kappa test = 0.888). Electromyography showed that women with hypermobility had lower muscle resistance (endurance) when compared with those without hypermobility. CONCLUSIONS: Although vaginal atrophy is more intense in women aged >60 years, no difference can be found in the pelvic floor muscle strength during the physiological aging process in continent women. As a consequence, trophism is not the only factor related to pelvic floor muscle strength, and it should not preclude the selection of patients who are referred to prophylaxis.