Evaluation of Pelvic Floor Muscle Strength in Nulliparous, Parous and Postmenopausal Women and its Association with Various Factors.

OBJECTIVE: To evaluate pelvic floor muscle strength (PFMS) in nulliparous, parous and postmenopausal women using vaginal digital palpation and perineometer.

MATERIAL AND METHODS: It was a cross-sectional study, conducted in department of Obstetrics and Gynecology, VMMC & Safdarjung hospital. A total of 300 women were recruited from Gynaecology and Family welfare outpatient departments and divided into 3 equal groups-nulliparous women, premenopausal parous women and postmenopausal women. PFMS was measured by modified Oxford Scale with vaginal digital palpation and by perineometer. Linear regression analysis was performed to evaluate and compare mean PFMS and identify its associated factors.

RESULTS: Median age was 21 years in nulliparous, 27 years in parous and 58 years in postmenopausal group. The average body mass index was 27.45, 28.01 and 34.63 kg/m2 in nulliparous, parous and postmenopausal group. The mean MOS by digital vaginal palpation was 4.66 in nulliparous, 3.9 in parous and 2.54 in postmenopausal women. The difference was statistically significant. The mean PFMS by perineometer was 40.04 cm H2 O, 37.69 cm H2 O and 34.93 cm H2 O in nulliparous, parous and postmenopausal group, respectively. The difference was statistically significant ( p  < 0.001). Majority (50%) of nulliparous women had PFMs between 41 and 50 cm H2 O and parous (81%) had PFMS between 21 and 30 cm H2 O. There was a statistical significance between the groups.

CONCLUSIONS: The PFMS of nulliparous women was significantly higher than multiparous women, and difference was statically significant ( p  < 0.001). Age had an important influence on pelvic floor muscle before menopause, but after menopause, it is years of menopause which has significant negative impact on PFMS and not age.