[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-212858-en":3,"doc-seo-212858-105":30,"detail-sidebar-cat-0-en-105":96},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":20,"is_deleted":4,"is_public":20,"is_downloadable":20,"audit_status":20,"page_count":21,"language":22,"language_code":23,"site_id":24,"html_lang":23,"table_of_contents":25,"faqs":26,"seo_title":27,"seo_description":14,"update_tm":28,"read_time":29},212858,7971474920318,"Mabel","https://ap-avatar.wpscdn.com/avatar/74000ee537e6b0ca360?x-image-process=image/resize,m_fixed,w_180,h_180&k=1788430171632181674",7,"Healthcare","The Pelvic Floor - Sexual and Medical Co-morbidities","Explores the pelvic floor as a dynamic anatomical structure that influences both medical and sexual conditions, with emphasis on frequently overlooked comorbidity. Connects overlap between urinary incontinence and lower urinary tract symptoms with female sexual dysfunctions, including arousal disorders, dyspareunia, and orgasmic difficulties. Presents evidence from risk-factor analyses and clinical perspectives, highlighting lifespan factors and the need for active investigation by clinicians. Discusses OAB-related barriers to disclosure, differential diagnosis around orgasmic leakage, and the roles of vaginal pH and pelvic floor tonus, including treatment rationale and outcomes.","The pelvic floor – sexual and medical co-morbidities  \nAlessandra Graziottin MD  \nDirector, Center of Gynecology and Medical Sexology  \nH.San Raffaele Resnati, Milan, Italy  \nCo-Director, Post-graduate Course of Sexual Medicine University of Florence, Italy  \nThe pelvic floor is the anatomic, static and dynamic structure that inferiorly closes the pelvis and sustains the pelvic and abdominal organs. Its role is increasingly recognized in the etiology of different medical (urologic, gynecologic, proctologic, physiatric) and sexual conditions, contributing toa significant comorbidity [1] .  \nThe role of the pelvic floor overlaps with other biological factors. Embriologic affinity, anatomic contiguity, hormonal sensitivity, vulnerability to reproductive, coitus-related and iatrogenic and/or traumatic events [2], further contribute to the frequent and yet neglected co-morbidity between Urinary Incontinence (UI), Lower Urinary Tract Symptoms (LUTS) and Female Sexual Dysfunctions (FSD), specifically genital arousal disorders [3], dyspareunia and orgasmic difficulties [4] . New reading of clinical data indicate that a significant (and yet neglected) co-morbidity is also present with proctological and bowel diseases [5] .  \nLatent classes analysis of sexual dysfunctions by risk factors in women indicate that urinary tract symptoms have a RR = 4.02 (2.75-5.89) of being associated with arousal disorders (and its most frequently reported associated symptom: vaginal dryness) and a RR=7.61 (4.06-14.26) of being associated with sexual pain disorders [6] .  \nThe presentation will discuss this co-morbidity in the lifespan perspective, with special focus on predisposing, precipitating and maintaining factors –biological, psychosexual and context-related-the clinician should pay attention to, for a comprehensive diagnosis and a well tailored etiologically oriented treatment [7] .  \nThe Overactive Bladder (OAB) is a frequent but underreported condition, affecting from 11.4% to 17% of women over 40 year. Fear of rejection, shame, embarrassment, loss of self-esteem, all contribute to the difficulty the woman has in reporting to her own physician and asking for help.  \nActive investigation on the part of the clinician (physician and nurses) is key to avoid the “collusion of silence” that involves in a common denial both bladder and sexual problems. OAB is a taboo for many patients, as it conveys the fear and the threat of social rejection. Incontinence violates the social request of control, on mental impulses and on basic functions, like micturition, that is expected to be postponed to time and places socially appropriated.  \nEmotional and sexual intimacy may be crippled by OAB: sexual identity, sexual function and sexual relationship may all change for worse. Up to two thirds of affected women report to be less confident in courting and less willing to start a new history; one third prefers not to reach orgasm for fear of leaking when pleasure peaks. More than half the women affected by OAB report their feeling less feminine and less sexually attractive: the smell of urine instead of the “scent of woman” is difficult to be accepted by both men and women.“Feeling wet” not because one is aroused, but because of urinary leakage, may block every possibility of intimacy. Sexual co-morbidity is frequent. Dissatisfaction and avoidance of intimacy may be the conclusion of a repeatedly disappointing experience.  \nThe criteria for the differential diagnosis between female ejaculation at orgasm and OAB associated leaking at orgasm will be presented, as they are increasingly relevant in the clinician’s practice [4]  \nStress incontinence and its gynecological and sexual co-morbidities will be briefly discussed.  \nPost-coital cystitis is more frequent in hypoestrogenic conditions (hypothalamic amenorrhea, post-partum amenorrhea, menopause) when the vaginal pH increases; when the pelvic floor is hyperactive; when genital arousal is poor or absent; when irritabl","cbCaiqWR45zNAGX2","https://ap.wps.com/l/cbCaiqWR45zNAGX2","pdf",95916,1,2,"English","en",105,"# Pelvic floor role in medical and sexual comorbidity\n## Overlapping conditions: UI/LUTS and FSD\n## OAB and barriers to reporting\n## Clinician approach and differential diagnosis\n## Stress incontinence and post-coital cystitis\n## Assessment focus: vaginal pH and pelvic floor tonus\n## Treatment outcomes and woman-centered care","[{\"question\":\"How does the pelvic floor contribute to medical and sexual comorbidities?\",\"answer\":\"It is an anatomic, static and dynamic structure that supports pelvic and abdominal organs and increasingly plays a role in the causes of both medical and sexual conditions.\"},{\"question\":\"Why is overactive bladder (OAB) often underreported?\",\"answer\":\"Fear of rejection, shame, embarrassment, and loss of self-esteem make many women reluctant to report symptoms or ask for help to their physician.\"},{\"question\":\"What key assessments are emphasized for co-treatment of sexual symptoms and LUTS?\",\"answer\":\"The document highlights assessing vaginal pH and pelvic floor tonus, using these findings to guide etiologically oriented management, including local and relaxation strategies.\"}]","The Pelvic Floor - Sexual and Medical Co-morbidities | PDF",1788749603,5,{"code":4,"msg":31,"data":32},"ok",{"site_id":24,"language":23,"slug":33,"title":13,"keywords":34,"description":14,"schema_data":35,"social_meta":91,"head_meta":93,"extra_data":95,"updated_unix":28},"the-pelvic-floor-sexual-and-medical-co-morbidities","",{"@graph":36,"@context":90},[37,53,73],{"@type":38,"itemListElement":39},"BreadcrumbList",[40,44,47,50],{"item":41,"name":42,"@type":43,"position":20},"https://docshare.wps.com","Home","ListItem",{"item":45,"name":46,"@type":43,"position":21},"https://docshare.wps.com/document/","Document",{"item":48,"name":12,"@type":43,"position":49},"https://docshare.wps.com/document/healthcare/",3,{"item":51,"name":13,"@type":43,"position":52},"https://docshare.wps.com/document/the-pelvic-floor-sexual-and-medical-co-morbidities/212858/",4,{"url":51,"name":13,"@type":54,"image":55,"author":60,"headline":13,"publisher":62,"fileFormat":65,"inLanguage":23,"description":14,"dateModified":66,"datePublished":67,"encodingFormat":65,"isAccessibleForFree":68,"interactionStatistic":69},"DigitalDocument",{"url":56,"@type":57,"width":58,"height":59},"https://docshare.wps.com/thumbnails/the-pelvic-floor-sexual-and-medical-co-morbidities/212858.png","ImageObject",300,407,{"name":9,"@type":61},"Person",{"url":41,"name":63,"@type":64},"DocShare","Organization","application/pdf","2026-09-11","2026-09-07",true,{"@type":70,"interactionType":71,"userInteractionCount":20},"InteractionCounter",{"@type":72},"ViewAction",{"@type":74,"mainEntity":75},"FAQPage",[76,82,86],{"name":77,"@type":78,"acceptedAnswer":79},"How does the pelvic floor contribute to medical and sexual comorbidities?","Question",{"text":80,"@type":81},"It is an anatomic, static and dynamic structure that supports pelvic and abdominal organs and increasingly plays a role in the causes of both medical and sexual conditions.","Answer",{"name":83,"@type":78,"acceptedAnswer":84},"Why is overactive bladder (OAB) often underreported?",{"text":85,"@type":81},"Fear of rejection, shame, embarrassment, and loss of self-esteem make many women reluctant to report symptoms or ask for help to their physician.",{"name":87,"@type":78,"acceptedAnswer":88},"What key assessments are emphasized for co-treatment of sexual symptoms and LUTS?",{"text":89,"@type":81},"The document highlights assessing vaginal pH and pelvic floor tonus, using these findings to guide etiologically oriented management, including local and relaxation strategies.","https://schema.org",{"og:url":51,"og:type":92,"og:title":13,"og:site_name":63,"og:description":14},"article",{"robots":94,"canonical":51},"index,follow",{"doc_id":7,"site_id":24},{"code":4,"msg":5,"data":97},[98,102,106,110,114,119,122,127,132,135,139],{"id":20,"doc_module":4,"doc_module_name":46,"category_name":99,"show_sort_weight":100,"slug":101},"Story & Novel",90,"story-novel",{"id":21,"doc_module":4,"doc_module_name":46,"category_name":103,"show_sort_weight":104,"slug":105},"Literature",80,"literature",{"id":52,"doc_module":4,"doc_module_name":46,"category_name":107,"show_sort_weight":108,"slug":109},"Exam",70,"exam",{"id":29,"doc_module":4,"doc_module_name":46,"category_name":111,"show_sort_weight":112,"slug":113},"Comic",60,"comic",{"id":115,"doc_module":4,"doc_module_name":46,"category_name":116,"show_sort_weight":117,"slug":118},6,"Technology",50,"technology",{"id":11,"doc_module":4,"doc_module_name":46,"category_name":12,"show_sort_weight":120,"slug":121},40,"healthcare",{"id":123,"doc_module":4,"doc_module_name":46,"category_name":124,"show_sort_weight":125,"slug":126},8,"Research & Report",30,"research-report",{"id":128,"doc_module":4,"doc_module_name":46,"category_name":129,"show_sort_weight":130,"slug":131},9,"Religion & Spirituality",20,"religion-spirituality",{"id":130,"doc_module":4,"doc_module_name":46,"category_name":133,"show_sort_weight":130,"slug":134},"World Cup","world-cup",{"id":136,"doc_module":4,"doc_module_name":46,"category_name":137,"show_sort_weight":136,"slug":138},10,"Lifestyle","lifestyle",{"id":140,"doc_module":4,"doc_module_name":46,"category_name":141,"show_sort_weight":29,"slug":142},19,"General","general"]