The effect of pelvic floor exercises on the quality of life in postmenopausal women: a meta-analysis of randomized controlled trials.

OBJECTIVE

This meta-analysis aims to evaluate the effects of pelvic floor muscle exercises (PFME) on quality of life in postmenopausal women based on current literature,distinguishing between supervised and self-directed interventions.

METHODS

Relevant randomized controlled trials published after 2020 were systematically searched in the ASSIA, CENTRAL, CINAHL, LILACS, PubMed, Embase, and WOS databases. A total of 21 studies were included.Both supervised (18) and self-directed (3) PFME studies were included. Intervention details such as exercise type, duration, frequency, and delivery method were clearly described. Meta-analyses were conducted using RevMan and JASP software, and heterogeneity and publication bias were assessed using standard statistical methods.

RESULTS

Pelvic floor muscle exercises demonstrated a moderate positive effect on quality of life (95 % CI: 0.373-0.647, p < 0.001). High heterogeneity was detected among studies (Q = 1202.529, p < 0.001, τ = 0.281, τ2 = 0.079). Subgroup assessment showed that some dimensions included only single studies utilizing self-directed PFME, making separate meta-analyses for these subgroups statistically unfeasible. Therefore, the pooled effects reflect overall PFME outcomes while transparently acknowledging these subgroup distinctions. PFME showed a strong effect on vaginal/genital discomfort symptoms (g = 1.187, p = 0.009), moderate effects on sexual function (g = 0.549, p = 0.001), quality of life (g = 0.438, p = 0.008), urinary incontinence (g = 0.335, p < 0.001), and pelvic floor muscle function (g = 0.527, p < 0.001), and a small positive effect on sleep quality (g = 0.334, p = 0.066). No significant difference was found in psychological status (g = 0.393, p = 0.199). Intervention duration was identified as a significant moderator, with 12-week programs being the most effective (g = 0.658, p < 0.001). No evidence of publication bias was observed (p = 0.360).

CONCLUSION

Pelvic floor exercises are an effective intervention for improving quality of life in postmenopausal women.