Effects of Sex Education and Kegel Exercises on the Sexual Function of Postmenopausal Women: A Randomized Clinical Trial

Background: The sex lives of women are strongly affected by menopause. Non-pharmacologic approaches to improving the sexual function of postmenopausal women might prove effective. Aim: To compare two methods of intervention (formal sex education and Kegel exercises) with routine postmenopausal care services in a randomized clinical trial. Methods: A randomized clinical trial was conducted of 145 postmenopausal women residing in Chalus and Noshahr, Iran. Their sexual function statuses were assessed using the Female Sexual Function Index (FSFI) questionnaire. After obtaining written informed consents, they were randomly assigned to one of three groups: (i) formal sex education, (ii) Kegel exercises, or (iii) routine postmenopausal care. After 12 weeks, all participants completed the FSFI again. Analysis of covariance was used to compare the participants' sexual function before and after the interventions, and multiple linear regression analysis was used to determine the predictive factors for variation in FSFI scores in the postintervention stage. Outcomes: Sexual function was assessed using the FSFI. Results: There were no statistically significant differences in demographic and socioeconomic characteristics and FSFI total scores among the three study groups at the outset of the study. After 12 weeks, the scores of arousal in the formal sex education and Kegel groups were significantly higher compared with the control group (3.38 and 3.15 vs 2.77, respectively). The scores of orgasm and satisfaction in the Kegel group were significantly higher compared with the control group (4.43 and 4.88 vs 3.95 and 4.39, respectively). Clinical Implications: Formal sex education and Kegel exercises were used as two non-pharmacologic approaches to improve the sexual function of women after menopause. Strengths and Limitations: The main strength of this study was its design: a well-organized randomized trial using precise eligibility criteria with a small sample loss. The second strength was the methods of intervention used, namely non-pharmacologic approaches that are simple, easily accessible, and fairly inexpensive. The main limitation of the study was our inability to objectively assess the participants' commitment to exercise and the sexual function of their partners. Conclusion: Sex education programs and Kegel exercises could cause improvements in some domains of sexual function-specifically arousal, orgasm, and satisfaction-in postmenopausal women. Copyright (C) 2017, International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.