Pilates may help treat female sexual dysfunction, new study indicates

A new study published in BMC Urology provides evidence that Pilates may offer meaningful improvements for women experiencing female sexual dysfunction. Researchers found that women who participated in a 12-week Pilates program reported better sexual function, reduced symptoms of depression, and improved overall sexual satisfaction compared to those who did not engage in the exercise regimen.

Female sexual dysfunction is a common and complex issue that can affect a woman’s well-being, self-esteem, and relationship satisfaction. Although aging is associated with higher rates of sexual difficulties, recent findings indicate that a significant number of premenopausal women also experience issues related to desire, arousal, orgasm, and pain during intercourse. These difficulties tend to be shaped by a combination of psychological, physiological, and interpersonal factors, including depression, anxiety, and pelvic floor muscle function.

Previous studies have explored the general benefits of exercise on sexual well-being, but there has been limited research focused specifically on the effects of Pilates. Pilates is a mind-body practice that targets flexibility, posture, core strength, and breathing. It has also been linked to improved pelvic floor muscle control and mental health outcomes. Given these benefits, the researchers aimed to evaluate whether Pilates could support women with female sexual dysfunction by improving both physical and psychological factors related to sexual health.

The study included 93 sexually active premenopausal women between the ages of 18 and 50. All participants were in stable, monogamous heterosexual relationships and had been with the same partner for at least three months. To be included in the study, women had to have a baseline score indicating sexual dysfunction on the Female Sexual Function Index (a total score of 26.55 or lower) and a regular frequency of sexual activity. Women with psychiatric disorders, certain medical conditions, or anatomical causes of sexual dysfunction were excluded.

Participants were divided into two groups. The intervention group took part in a Pilates program, while the control group continued with their normal routines. Both groups completed three questionnaires at the start and again after 12 weeks: the Female Sexual Function Index (FSFI), the Arizona Sexual Experiences Scale (ASEX), and the Beck Depression Inventory (BDI).

The Pilates group attended 60-minute sessions twice per week for 12 weeks. Each session included a 10-minute warm-up, 45 minutes of core Pilates movements using equipment, and a short cool-down and breathing exercise. These sessions were led by qualified Pilates instructors and held in a dedicated studio. The exercises followed classical Pilates principles, emphasizing controlled movements, concentration, and breathwork.

The FSFI measured various aspects of sexual function across six domains: desire, arousal, lubrication, orgasm, satisfaction, and pain. The ASEX questionnaire focused on sexual drive, arousal, lubrication, orgasm ability, and orgasm satisfaction. Higher ASEX scores indicate greater dysfunction. The BDI assessed symptoms of depression.

At the start of the study, both the Pilates group and the control group had similar scores across all three questionnaires. After 12 weeks, significant improvements were observed in the Pilates group but not in the control group.

The women who participated in the Pilates sessions showed marked improvements in all FSFI domains. These included increased desire, better arousal and lubrication, enhanced orgasm ability, higher satisfaction, and reduced pain during intercourse. On average, the improvements exceeded 95 percent across all FSFI categories.

The Pilates group also showed significantly lower scores on the ASEX questionnaire, suggesting a reduction in sexual dysfunction symptoms. Similarly, their scores on the Beck Depression Inventory improved, indicating decreased symptoms of depression.

In contrast, the control group, which did not engage in the exercise intervention, showed no meaningful changes in sexual function or depressive symptoms over the same time period.

When the researchers compared the post-intervention scores of both groups, the differences were statistically significant. This suggests that the improvements observed were likely due to the Pilates intervention rather than natural changes or external factors.

These findings align with earlier studies indicating that pelvic floor muscle training and psychological support can improve female sexual function. Pilates, as a form of exercise that engages the pelvic floor muscles and promotes body awareness and mental focus, may offer a dual benefit—strengthening the physical systems involved in sexual activity while also enhancing mood and emotional well-being.

The study adds to a growing body of research indicating that non-pharmacological interventions may play a role in improving sexual health. While medications and therapies are commonly used to treat sexual dysfunction, exercises like Pilates may offer a more holistic and accessible approach, especially for individuals who are reluctant to pursue pharmaceutical options or who experience side effects from those treatments.

The researchers also point out that difficulties with orgasm can lead to psychological distress, which in turn can perpetuate sexual dysfunction. This cycle of negative emotions, avoidance, and decreased self-esteem may be interrupted by interventions that target both physical and psychological components, such as Pilates.

In addition, the study suggests Pilates may have benefits for conditions like dyspareunia, or pain during intercourse. Since dyspareunia is often linked to pelvic floor tension and muscular imbalances, the muscle toning and control developed through Pilates may help reduce pain and increase comfort during sexual activity.

While the study suggests promising benefits, the authors acknowledge some limitations. First, the sample size was relatively small, and future research would benefit from larger and more diverse participant groups. The study also did not account for variations in menstrual cycle, which could influence mood and sexual function. In addition, the nature of partner relationships was not assessed, despite the potential influence of interpersonal dynamics on sexual satisfaction.

The researchers also note that they did not evaluate whether participants had underlying gynecological pain syndromes such as endometriosis or vulvodynia, which may affect sexual function and response to exercise interventions. Future studies may benefit from including a broader health assessment to control for these variables.

The study, “The effects of pilates exercise on female sexual dysfunction in women: a controlled, prospective study,” was authored by Recep Burak Degirmentepe, Deniz Gul, Yasir Muhammed Akca, Haci Ibrahim Cimen, and Hasan Salih Saglam.