Sexual changes during climacterium under a kinesiological-functional approach – review

Abstract

INTRODUCTION: The physical and psychological changes that the woman faces during the climacteric can damage sexuality due to the hormonal changes of the period. OBJECTIVES: Therefore, the objective of this review is to investigate the possible physiotherapeutic resources used under a functional kinesiological prism to minimize the effects of this period. METHODS: An electronic search of the following databases was performed: PubMed, Lilacs and Google Scholar. The research was performed from the year 2010 to the year 2018, using the following combinations of words: female sexual dysfunction AND menopause AND physiotherapy, with the terms in Portuguese and English. RESULTS: During climacteric vaginal atrophy occurs, and this condition can lead to pain during sexual intercourse which, in turn, may lead to contractures in the pelvic floor muscles (PFM), once this contracture is established, the pain tends to increase, thus giving rise to a vicious cycle of pain. PFMs during the climacteric also suffer a decrease of their muscular function, being able to generate pelvic dysfunctions, such as urinary incontinence, prolapses of pelvic organs and also to impair the sexual function of the woman. CONCLUSIONS: With this, physiotherapy has a great arsenal of therapeutic resources that can boost pelvic floor muscles and improve the quality of life in this period of hormonal decline. Despite the need for further studies in this regard, the physiotherapeutic techniques that were most effective in the treatment of dyspareunia in menopausal women, described in this review, were the thermotherapy in PFM, manual release of PFM myofascial trigger points and training of this musculature. Therefore, pelvic physiotherapy should be a therapeutic line to be prescribed in climacteric.