PELVIC FLOOR DYSFUNCTION AND REHABILITATION IN WOMEN: AGE-SPECIFIC CONSIDERATIONS ACROSS THE LIFESPAN

The pelvic floor represents a complex anatomical and functional unit essential for pelvic stability, continence, organ support, and sexual health. Pelvic floor dysfunction (PFD), encompassing urinary and fecal incontinence, pelvic organ prolapse, pelvic pain, and sexual dysfunction, is highly prevalent among women worldwide but remains frequently underdiagnosed. This review synthesizes current evidence on the epidemiology, risk factors, and therapeutic strategies for PFD, with emphasis on age-specific presentations and rehabilitation approaches. Younger women are predominantly affected by pregnancy- and childbirth-related trauma, with mode of delivery exerting significant influence on long-term outcomes. In older women, age-related physiological changes, including estrogen decline, collagen remodeling, and muscle atrophy, predispose to incontinence, prolapse, and diminished sexual function. Across all age groups, PFD exerts substantial psychosocial and quality-of-life impacts, particularly through sexual dysfunction and mental health sequelae. Pelvic floor muscle training (PFMT) remains the cornerstone of conservative management, with robust evidence supporting its effectiveness in improving continence, pelvic stability, pain, and sexual function. Adjunctive modalities—including manual therapies, biofeedback, electrical stimulation, vibrating vaginal cones, and emerging telehealth-based programs—demonstrate additional therapeutic benefits, though evidence quality varies. Preventive and rehabilitative strategies tailored to age, parity, and comorbidities are essential, alongside structured educational initiatives to improve awareness, reduce stigma, and enhance treatment-seeking behavior. Future research should prioritize large-scale randomized trials, long-term follow-up, and integration of interdisciplinary care models to optimize outcomes in women with PFD.