Genital prolapse is one of the main health problems in women that affects various aspects of women's lives including sexual function, quality of life and mental health. However, POP is often overlooked by women and is considered a minor issue. The aim of this study was to investigate the relationship between pelvic stage prolapse and sexual function of Iranian women.

The present study was performed on married women referred to our university hospitals due to pelvic organ prolapse. Patients were selected randomly. The number of patients were accounted with sample size formula (Z=95%, α=0.05).  Postmenopausal women, pregnant women and who are in postpartum period, multi partners and patients who have taken antidepressant and other psychiatric medicine in the last 6 months were excluded from our study. To determine the score of sexual activity, female sexual function index questionnaire (FSFI) was used, which includes 19 questions and 5 Linked options. The severity of pelvic organ prolapse as well as the type of prolapse (anterior, posterior and apical) was determined by clinical examination by a gynecology resident supervised by a female pelvic medicine and reconstructive surgery fellowship based on the pelvic organ prolapse quantification (POPQ) system.

Ninety six patients were enrolled in this study. The frequencies of stages 1, 2, 3 and 4 were 33.3%, 44.8%, 12.5% and 9.4%, respectively. In 61.4% of patients, no sexual dysfunction was reported in the patient or his sexual partner. In 24% of cases, the patient had sexual dysfunction and in 14 patients, the patient and his partner had sexual dysfunction. The sexual function score of patients in stage 2 was 6.6, stage 3 was 20.4 and stage 4 was 35.2 less than the reference group (prolapse stage1 ) and in all these groups the observed differences was statistically significant ( P-value <0.001).

The sexual function score of patients in stage 2 was 6.6, stage 3 was 20.4 and stage 4 was 35.2 less than the reference group (prolapse stage1 ) and in all these groups the observed differences was statistically significant ( P-value <0.001).

In this study increased severity of prolapse leads to decreased sexual activity in women, and this group is at greater risk for decreased sexual activity and satisfaction with their sexual activity. Although this conclusion is similar to the Tok (1) and Handa et al (2) studies but is contrary to Lowenstin et al (3) research.

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Handa VL, Cundiff G, Chang HH, Helzlsouer KJ. Female sexual function and pelvic floor disorders. Obstet Gynecol. 200May; 111(5):1045-52
Lowenstein L, Gamble T, Deniseiko Sanses TV, van Raalte H, Carberry C, Jakus S, Kambiss S, McAchran S, Pham T, Aschkenazi S, Hoskey K, and Kenton K. Sexual function is related to body image perceptionin women with pelvic organ prolapse. J Sex Med 2009; 6:2286–2291.