Role Of Pelvic Floor Muscle Training In Women’s Health And Quality Of Life A Narrative Review

Szymon  Paruszewski; Aleksandra Dybcio; Mikołaj Jońca; Mikhail Kazachok; Adam Kubisa; Julia Kupczak; Katarzyna Kupczyk; Natasza Kurys; Mateusz Miluski; Dorota Szydłowska

doi:10.12775/JEHS.2026.91.70726

Authors

Szymon Paruszewski Mazovian Bródno Hospital https://orcid.org/0009-0005-1822-244X
Aleksandra Dybcio Independent Public Health Care Complex in Wyszków https://orcid.org/0009-0006-7840-3290
Mikołaj Jońca Pomeranian Medical University https://orcid.org/0009-0006-4435-1138
Mikhail Kazachok Medical University of Warsaw https://orcid.org/0009-0006-2764-3710
Adam Kubisa District Hospital in Sochaczew https://orcid.org/0009-0003-1320-9890
Julia Kupczak District Hospital in Sochaczew https://orcid.org/0009-0002-3423-8685
Katarzyna Kupczyk Warsaw Southern Hospital https://orcid.org/0009-0004-7532-7769
Natasza Kurys Medical University of Lodz https://orcid.org/0009-0005-7090-259X
Mateusz Miluski Pomeranian Medical University https://orcid.org/0009-0003-5744-3291
Dorota Szydłowska County Medical Center in Nowy Dwór Mazowiecki https://orcid.org/0000-0001-6763-6124

DOI:

https://doi.org/10.12775/JEHS.2026.91.70726

Keywords

pelvic floor muscles, pelvic floor muscle dysfunction, pelvic floor muscle training, urinary incontinence, quality of life, women’s health

Abstract

Introduction: Pelvic floor muscle dysfunction disorders are a widespread and frequently undiagnosed health problem among women across all age groups. They can result in urinary and fecal incontinence, pelvic organ prolapse, and chronic pain, significantly reducing women’s quality of life. Conservative treatment, particularly pelvic floor muscle training (PFMT), is currently recognized as a highly effective first-line therapy.

Purpose: This review aims to present the role of pelvic floor muscle training (PFMT) in improving women’s health and quality of life, with a particular focus on the effectiveness of this form of therapy in the prevention and treatment of pelvic floor muscle dysfunction disorders.

A brief description of the state of knowledge: The pelvic floor muscles are crucial for holding urine and stool, keeping the pelvic organs in place, and supporting sexual function. Their dysfunction is linked to many risk factors, such as age, vaginal delivery, obesity, and lifestyle. Pelvic floor muscle training (PFMT) improves muscle tone and strength, leading to reduced symptoms, most commonly urinary incontinence. Pelvic floor muscle training (PFMT) also contributes to improving quality of life in physical, mental, and social dimensions. Biofeedback or electrostimulation are supportive methods, which can further enhance the effectiveness of therapy.

Conclusions: Pelvic floor muscle training (PFMT) is an effective and safe method for the prevention and treatment of pelvic floor dysfunction disorders in women. It contributes to a significant improvement in symptoms and quality of life. An individualized and holistic approach to the patient is recommended, incorporating education and a supervised exercise program to ensure the effectiveness of therapy.

References

[1]. Peinado-Molina RA, Hernández-Martínez A, Martínez-Vázquez S, Rodríguez-Almagro J, Martínez-Galiano JM. Pelvic floor dysfunction: prevalence and associated factors. BMC Public Health. 2023 Oct 14;23(1):2005. doi: 10.1186/s12889-023-16901-3. PMID: 37838661; PMCID: PMC10576367. https://doi.org/10.1186/s12889-023-16901-3

[2]. González-Timoneda A, Valles-Murcia N, Muñoz Esteban P, Torres López MS, Turrión Martínez E, Errandonea Garcia P, Serrano Raya L, Nohales Alfonso F. Prevalence and impact of pelvic floor dysfunctions on quality of life in women 5-10 years after their first vaginal or caesarian delivery. Heliyon. 2025 Jan 21;11(3):e42018. https://doi.org/10.1016/j.heliyon.2025.e42018

[3]. Fedorchenko Y, Usen A. 2025. PELVIC FLOOR DYSFUNCTION AND REHABILITATION IN WOMEN: AGE-SPECIFIC CONSIDERATIONS ACROSS THE LIFESPAN.Anti-Aging Eastern Europe. 4, 3 (Sep. 2025), 156-165. https://doi.org/10.56543/aaeeu.2025.4.3.03.

[4]. Al-Badr A, Saleem Z, Kaddour O, Almosaieed B, Dawood A, Al-Tannir M, AlTurki F, Alharbi R, Alsanea N. Prevalence of pelvic floor dysfunction: a Saudi national survey. BMC Womens Health. 2022 Feb 4;22(1):27. doi: 10.1186/s12905-022-01609-0. Erratum in: BMC Womens Health. 2023 May 19;23(1):274. https://doi.org/10.1186/s12905-023-02432-x

[5]. Wallace SL, Miller LD, Mishra K. Pelvic floor physical therapy in the treatment of pelvic floor dysfunction in women. Curr Opin Obstet Gynecol. 2019 Dec;31(6):485-493. https://doi.org/10.1097/gco.0000000000000584

[6]. Peinado Molina RA, Hernández Martínez A, Martínez Vázquez S, Martínez Galiano JM. Influence of pelvic floor disorders on quality of life in women. Front Public Health. 2023 Oct 24;11:1180907. https://doi.org/10.3389/fpubh.2023.1180907

[7]. Zarawski M, Kołomańska D, Maj M, Panicz D, Opławski M, Mazur-Bialy AI. The Impact of Pelvic Floor Exercises on the Quality of Life of Women with Urinary Incontinence – Analysis of Pregnancy and the Postpartum Period. Journal of Novel Physiotherapy and Physical Rehabilitation. 035-041. 2017. https://doi.org/10.17352/2455-5487.000044

[8]. Nelson RL, Go C, Darwish R, Gao J, Parikh R, Kang C, Mahajan A, Habeeb L, Zalavadiya P, Patnam M. Cesarean delivery to prevent anal incontinence: a systematic review and meta-analysis, Tech. Coloproctol. 23 (9) (2019 Sep) 809–820, https://doi.org/10.1007/s10151-019-02029-3. Epub 2019 Jul 4. Erratum in: Tech Coloproctol. 2020 Oct;24(10):1107. https://doi.org/10.1007/s10151-020-02320-8

[9]. Szatmári É, Balla BJ, Simon-Ugron Á, Hock M. (2020). Efficacy of pelvic floor muscle training in improving symptoms of urinary incontinence and health related quality of life among parous and nulliparous women.Timisoara Physical Education and Rehabilitation Journal,13(25), 36-45.https://doi.org/10.2478/tperj-2020-0014

[10]. Bø K, Hilde G, Stær-Jensen J, Siafarikas F, Tennfjord MK, Engh ME. Postpartum pelvic floor muscle training and pelvic organ prolapse--a randomized trial of primiparous women. Am J Obstet Gynecol. 2015 Jan;212(1):38.e1-7. https://doi.org/10.1016/j.ajog.2014.06.049

[11]. Pizzol D, Demurtas J, Celotto S, Maggi S, Smith L, Angiolelli G, Trott M, Yang L, Veronese N. Urinary incontinence and quality of life: a systematic review and meta-analysis. Aging Clin Exp Res. 2021 Jan;33(1):25-35. https://doi.org/10.1007/s40520-020-01712-y

[12]. Grimes WR, Stratton M. Pelvic Floor Dysfunction. 2023 Jun 26. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan–. https://www.ncbi.nlm.nih.gov/books/NBK559246/

[13]. Eickmeyer SM. Anatomy and Physiology of the Pelvic Floor. Phys Med Rehabil Clin N Am. 2017 Aug;28(3):455-460. https://doi.org/10.1016/j.pmr.2017.03.003

[14]. Rieger M, Duran P, Cook M, Schenk S, Shah M, Jacobs M, Christman K, Kado DM, Alperin M. Quantifying the Effects of Aging on Morphological and Cellular Properties of Human Female Pelvic Floor Muscles. Ann Biomed Eng. 2021 Aug;49(8):1836-1847. https://doi.org/10.1007/s10439-021-02748-5

[15]. Larsson L, Degens H, Li M, Salviati L, Lee YI, Thompson W, Kirkland JL, Sandri M. Sarcopenia: Aging-Related Loss of Muscle Mass and Function. Physiol Rev. 2019 Jan 1;99(1):427-511. https://doi.org/10.1152/physrev.00061.2017

[16]. Ściążko-Gancarczyk S, Gancarczyk M, Węgrzyn J. Stress urinary incontinence in physically active women – current evidence, risk factors and clinical relevance.Journal of Education, Health and Sport. Online. 6 December 2025. Vol.85, p.66678. [Accessed10March2026]. https://doi.org/10.12775/JEHS.2025.85.66678

[17]. Martinho NM, Silva VR, Marques J, Carvalho LC, Iunes DH, Botelho S. The effects of training by virtual reality or gym ball on pelvic floor muscle strength in postmenopausal women: a randomized controlled trial. Braz J Phys Ther. 2016 Mar 22;20(3):248-57. https://doi.org/10.1590/bjpt-rbf.2014.0148

[18]. Takaoka S, Kobayashi Y, Taniguchi T. Effect of pelvic floor muscle training program in reducing postpartum levator hiatus area in Japanese women: A prospective cohort study using three-dimensional ultrasonography. Jpn J Nurs Sci. 2020 Oct;17(4):e12346. https://doi.org/10.1111/jjns.12346

[19]. Ouchi M, Kitta T, Suzuki S, Shinohara N, Kato K. Evaluating pelvic floor muscle contractility using two-dimensional transperineal ultrasonography in patients with pelvic organ prolapse. Neurourol Urodyn. 2019 Jun;38(5):1363-1369. https://doi.org/10.1002/nau.23987

[20]. Zhao H, Liu XN, Liu LN. Effect of structured pelvic floor muscle training on pelvic floor muscle contraction and treatment of pelvic organ prolapse in postpartum women: ultrasound and clinical evaluations. Arch Gynecol Obstet. 2024 May;309(5):2177-2182. https://doi.org/10.1007/s00404-023-07226-y

[21]. Yin P, Wang H. Evaluation of Nursing Effect of Pelvic Floor Rehabilitation Training on Pelvic Organ Prolapse in Postpartum Pregnant Women under Ultrasound Imaging with Artificial Intelligence Algorithm. Comput Math Methods Med. 2022 Apr 25;2022:1786994. https://doi.org/10.1155/2022/1786994

[22]. Dornowski M, Sawicki P, Wilczyńska D, Vereshchaka I, Piernicka M, Błudnicka M, Worska A, Szumilewicz A. Six-Week Pelvic Floor Muscle Activity (sEMG) Training in Pregnant Women as Prevention of Stress Urinary Incontinence. Med Sci Monit. 2018 Aug 14;24:5653-5659. https://doi.org/10.12659/MSM.911707

[23]. Woodley SJ, Lawrenson P, Boyle R, Cody JD, Mørkved S, Kernohan A, Hay-Smith EJC. Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2020 May 6;5(5):CD007471. https://doi.org/10.1002/14651858.CD007471.pub4

[24]. Richmond CF, Martin DK, Yip SO, Dick MA, Erekson EA. Effect of Supervised Pelvic Floor Biofeedback and Electrical Stimulation in Women With Mixed and Stress Urinary Incontinence. Female Pelvic Med Reconstr Surg. 2016 Sep-Oct;22(5):324-7. https://doi.org/10.1097/SPV.0000000000000279

[25]. Gagnon LH, Boucher J, Robert M. Impact of pelvic floor muscle training in the postpartum period.Int Urogynecol J27, 255–260 (2016). https://doi.org/10.1007/s00192-015-2822-6

[26]. Fitz FF, Gimenez MM, de Azevedo Ferreira L, Matias MMP, Bortolini MAT, Castro RA. Pelvic floor muscle training for female stress urinary incontinence: a randomised control trial comparing home and outpatient training. Int Urogynecol J. 2020 May;31(5):989-998.https://doi.org/10.1007/s00192-019-04081-x

[27]. NICE Guidance - Urinary incontinence and pelvic organ prolapse in women: management: © NICE (2019). Urinary incontinence and pelvic organ prolapse in women: management. BJU Int. 2019 May;123(5):777-803. https://doi.org/10.1111/bju.14763

[28]. Mishra DG, Vaishnav SB, Phatak AG. Comparison of Effectiveness of Home-Based Verses Supervised Pelvic Floor Muscle Exercise in Women with Urinary Incontinence. J Midlife Health. 2022;13(1):74–9. https://doi.org/10.4103/jmh.jmh_83_21

[29]. Nagib ABL, Silva VR, Martinho NM, Marques A, Riccetto C, Botelho S. Can Supervised Pelvic Floor Muscle Training Through Gametherapy Relieve Urinary Incontinence Symptoms in Climacteric Women? A Feasibility Study. Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia. 2021;43(7):535–44. https://doi.org/10.1055/s-0041-1733979

[30]. Curillo-Aguirre CA, Gea-Izquierdo E. Effectiveness of Pelvic Floor Muscle Training on Quality of Life in Women with Urinary Incontinence: A Systematic Review and Meta-Analysis. Medicina. 2023; 59(6):1004. https://doi.org/10.3390/medicina59061004

[31]. Molina-Torres G, Moreno-Muñoz M, Rebullido TR, Castellote-Caballero Y, Bergamin M, Gobbo S, Hita-Contreras F, Cruz-Diaz D. The effects of an 8-week hypopressive exercise training program on urinary incontinence and pelvic floor muscle activation: A randomized controlled trial. Neurourol Urodyn. 2023 Feb;42(2):500-509. https://doi.org/10.1002/nau.25110

[32]. Hagen S, Elders A, Stratton S, Sergenson N, Bugge C, Dean S, Hay-Smith J, Kilonzo M, Dimitrova M, Abdel-Fattah M, Agur W, Booth J, Glazener C, Guerrero K, McDonald A, Norrie J, Williams LR, McClurg D. Effectiveness of pelvic floor muscle training with and without electromyographic biofeedback for urinary incontinence in women: multicentre randomised controlled trial. BMJ. 2020 Oct 14;371:m3719. https://doi.org/10.1136/bmj.m3719

[33]. Marcellou EG, Stasi S, Giannopapas V, Bø K, Bakalidou D, Konstadoulakis M, Papathanasiou G. Effect of pelvic floor muscle training on urinary incontinence symptoms in postmenopausal women: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2025 Jan;304:134-140. https://doi.org/10.1016/j.ejogrb.2024.11.040

[34]. Fritel X, de Tayrac R, Bader G, Savary D, Gueye A, Deffieux X, Fernandez H, Richet C, Guilhot J, Fauconnier A. Preventing Urinary Incontinence With Supervised Prenatal Pelvic Floor Exercises: A Randomized Controlled Trial. Obstet Gynecol. 2015 Aug;126(2):370-377. https://doi.org/10.1097/AOG.0000000000000972

[35]. Fenocchi L, Collins M, Elders A, Hagen S. Assessment of the Relative Performance of the EQ-5D-3L, ICIQ-UI SF and POP-SS Using Data from the OPAL Trial. Int J Environ Res Public Health. 2022 Jan 26;19(3):1351. https://doi.org/10.3390/ijerph19031351

[36]. Bezerra LO, de Oliveira MCE, da Silva Filho EM, Vicente da Silva HK, Menezes de Oliveira GF, da Silveira Gonçalves AK, Pegado R, Micussi MTABC. Impact of Pelvic Floor Muscle Training Isolated and Associated with Game Therapy on Mixed Urinary Incontinence: A Randomized Controlled Trial. Games Health J. 2021 Feb;10(1):43-49. https://doi.org/10.1089/g4h.2019.0207

[37]. Dumoulin C, Cacciari LP, Hay‐Smith EJC. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database of Systematic Reviews 2018, Issue 10. Art. No.: CD005654. https://doi.org/10.1002/14651858.CD005654.pub4

[38]. Verbeek M,Hayward L. Pelvic Floor Dysfunction And Its Effect On Quality Of Sexual Life. Sex Med Rev 2019;7(4):559-564. https://doi.org/10.1016/j.sxmr.2019.05.007

[39]. Al Belushi ZI, Al Kiyumi MH, Al-Mazrui AA, Jaju S, Alrawahi AH, Al Mahrezi AM. Effects of home-based pelvic floor muscle training on decreasing symptoms of stress urinary incontinence and improving the quality of life of urban adult Omani women: A randomized controlled single-blind study. Neurourol Urodyn. 2020 Jun;39(5):1557-1566. https://doi.org/10.1002/nau.24404

[40]. Stenzelius K, Molander U, Odeberg J, Hammarström M, Franzen K, Midlöv P, Samuelsson E, Andersson G. The effect of conservative treatment of urinary incontinence among older and frail older people: a systematic review. Age Ageing. 2015 Sep;44(5):736-44. https://doi.org/10.1093/ageing/afv070

[41]. Shafaq S, Khan AA, Kazi M. Effects of Iyengar Yoga on pelvic floor muscle strength and endurance among young females with stress urinary incontinence. Pakistan Armed Forces Medical Journal,72(5), 1518. https://doi.org/10.51253/pafmj.v72i5.7691

[42]. Lausen A, Marsland L, Head S, Jackson J, Lausen B. Modified Pilates as an adjunct to standard physiotherapy care for urinary incontinence: a mixed methods pilot for a randomised controlled trial. BMC Womens Health. 2018 Jan 12;18(1):16.https://doi.org/10.1186/s12905-017-0503-y

[43]. EAU Guidelines on Non-neurogenic Female LUTS - DISEASE MANAGEMENT https://uroweb.org/guidelines/non-neurogenic-female-luts/chapter/disease-management

[44]. Cardozo L, Rovner E, Wagg A, Wein A, Abrams P. (Eds) Incontinence 7th Edition (2023). ICI-ICS. International Continence Society, Bristol UK, ISBN: 978-0-9569607-4-0. https://www.ics.org/ici

[45]. Bø K, Anglès-Acedo S, Batra A, Brækken IH, Chan YL, Jorge CH, Kruger J, Yadav M, Dumoulin C. International urogynecology consultation chapter 3 committee 2; conservative treatment of patient with pelvic organ prolapse: Pelvic floor muscle training. Int Urogynecol J. 2022 Oct;33(10):2633-2667. https://www.ncbi.nlm.nih.gov/pubmed/35980443

Role Of Pelvic Floor Muscle Training In Women’s Health And Quality Of Life A Narrative Review

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