Pelvic floor and sexual function
Everyone has a pelvic floor: this is the set of muscles, bones, and connective tissue found in the genital area, and more precisely that supports the pelvic organs.
It is involved in many functions: urinary, anorectal, biomechanics, etc .; in this blog we will deal with better explaining the sexual function, in a scientific way but without (I hope!) to bore.
'Sex is a natural function'
To better understand the link between sexual function and the pelvic floor we need to take a step back, and understand how they are arranged and what role the muscles mainly involved during sexual intercourse play: the levator ani and the double pair of bulbocavernosus and ischiocavernosis.
The levator ani makes up the deepest layer of the pelvic floor, it is made up of several branches and in women it is crossed by the urethra and vaginal canal (while in men only by the urethra).
The bulbo-cavernous and ischio-cavernous muscles form the most superficial layer of the pelvic floor; in women they are functionally connected to the clitoris, in men they are located at the base of the penis.
Now that we have a general idea of their position, let's try to understand what role they play during the sexual act:
In the female pelvis, the muscles crossed by the vaginal canal must be able to relax adequately to allow penetration, and stretch to easily accommodate the penis (or any instrument or object used for penetration).
During sex, their muscle tone progressively increases until orgasm, in which the characteristic rhythmic contractions take place.
The bulbo-cavernous and ischio-cavernous muscles are connected to the female erectile tissue; they position the head of the clitoris and they too contract rhythmically during orgasm.
The erection occurs thanks to a cascade of hormonal and vascular events; the muscles at the base of the penis (bulbo-cavernous and ischio-cavernous) with their contraction help to maintain an erection by increasing the intracavernous pressure. At the moment of expulsion they are then fundamental: their contraction is part of the ejaculation event, pushing the seminal fluid outwards.
We have understood the involvement of the pelvic floor muscles: this will give us the opportunity to understand how the dysfunctions involving the pelvic floor impact sexuality, and consequently the quality of life.
Miriam Balduzzi is a physiotherapist who deals with pelvic floor rehabilitation, active in Valle Camonica and Val Seriana.
He graduated in Physiotherapy in 2018, with a thesis entitled 'What is "Conventional Therapy"? A 10-years Review on Physical Rehabilitation in Multiple Sclerosis' (which is used as a poster at the 2019 Society of Neuroscience conference in Chicago). He began his career in neurological rehabilitation, and then specialized through specific training courses in pelvic floor rehabilitation.
It deals with the management of problems of the genitourinary-anal area, present in both men and women.