Effects of pelvic floor muscle training combined with patient education in genitourinary syndrome of menopause: a randomized controlled trial

OBJECTIVE: Evidence supporting the effects of pelvic floor muscle training (PFMT) in the management of genitourinary syndrome of menopause (GSM) is limited; nevertheless, patient education constitutes a fundamental therapeutic component that is frequently neglected. Therefore, the aim of this study was to investigate the effects of PFMT combined with patient education specific to GSM in postmenopausal women. METHODS: Fifty-eight postmenopausal women diagnosed with GSM were randomized to the PFMT plus structured patient education group (study group, n=28) or the patient education-only group (control group, n=30). PFMT was implemented as a supervised and progressive program for 8 weeks. Primary outcome measures were vulvovaginal and urogenital symptom levels. Secondary outcome measures included the urinary incontinence (UI) impact, ability to stop urine flow, pelvic floor strength, and menopause-specific QoL. Statistical analyses were performed using analysis of covariance (ANCOVA) under both the intention-to-treat (ITT) and per-protocol (PP) approaches. The significance level was set at 5%. RESULTS: The study group showed greater reductions in vulvovaginal and urogenital symptoms, UI impact (P<0.001), and sexual QoL scores (P<0.001). Pelvic floor muscle strength (P=0.001) and the proportion of participants able to stop urine flow (P=0.010) were also significantly higher in the study group. No significant between-group differences were observed in vasomotor, psychosocial, or physical QoL subdomains (P>0.05). CONCLUSIONS: Supervised PFMT combined with GSM-specific patient education appears to be an effective approach for GSM in postmenopausal women. Further studies with larger sample sizes investigating conservative interventions for GSM management are warranted, and long-term outcomes should be evaluated.