Efficacy of Biofeedback Therapy on Chronic Constipation and Sexual Dysfunction in Postmenopausal Women: A Randomized Controlled Trial

Objectives: This study aimed to assess the effectiveness of biofeedback therapy on chronic constipation and sexual dysfunction in postmenopausal women. Methods: This multicenter, prospective, single-blind, randomized controlled trial was conducted in two hospitals in China. A total of 228 postmenopausal women diagnosed with functional constipation and self-reported sexual dysfunction were randomly assigned to either a control group, which received dietary and lifestyle counseling, or an intervention group, which received the same counseling plus biofeedback therapy twice weekly for 6 months. Primary outcomes were changes in the Constipation Symptom Score (CSS), Female Sexual Function Index (FSFI), and sex hormone levels (testosterone, estrogen, and progesterone). Secondary outcomes included changes in the Hospital Anxiety and Depression Scale (HADS) and pelvic floor function, measured by anal and rectal pressures. Results: The intervention group demonstrated significant improvements in constipation symptoms, as evidenced by reductions in CSS scores at both 3 and 6 months (both p < 0.001) compared to the control group. FSFI scores indicated significant improvement in sexual function, particularly in vaginal lubrication, at 3 months (p = 0.022) and 6 months (p < 0.001). Testosterone levels significantly increased in the intervention group at 6 months (p = 0.016), while estrogen and progesterone levels remained stable across both groups. The intervention group also showed significant reductions in anxiety and depression (HADS) and improved pelvic floor function, as indicated by decreased anal pressure and increased rectal pressure. Conclusions: Biofeedback therapy represents a promising non-pharmacological intervention for postmenopausal women suffering from chronic constipation and sexual dysfunction. The therapy improves pelvic floor function and raises testosterone levels, contributing to enhanced bowel and sexual health, particularly vaginal lubrication.