Innovating Care for Postmenopausal Women Using a Digital Approach for Pelvic Floor Dysfunctions: Prospective Longitudinal Cohort Study

Abstract BackgroundThe menopause transition is a significant life milestone that impacts quality of life and work performance. Among menopause-related conditions, pelvic floor dysfunctions (PFDs) affect ∼40%‐50% of postmenopausal women, including urinary or fecal incontinence,...

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Main Authors: Ana P Pereira, Dora Janela, Anabela C Areias, Maria Molinos, Xin Tong, Virgílio Bento, Vijay Yanamadala, Jennesa Atherton, Fernando Dias Correia, Fabíola Costa
Format: Article
Language:English
Published: JMIR Publications 2025-04-01
Series:JMIR mHealth and uHealth
Online Access:https://mhealth.jmir.org/2025/1/e68242
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Summary:Abstract BackgroundThe menopause transition is a significant life milestone that impacts quality of life and work performance. Among menopause-related conditions, pelvic floor dysfunctions (PFDs) affect ∼40%‐50% of postmenopausal women, including urinary or fecal incontinence, genito-pelvic pain, and pelvic organ prolapse. While pelvic floor muscle training (PFMT) is the primary treatment, access barriers leave many untreated, advocating for new care delivery models. ObjectiveThis study aims to assess the outcomes of a digital pelvic program, combining PFMT and education, in postmenopausal women with PFDs. MethodsThis prospective, longitudinal study evaluated engagement, safety, and clinical outcomes of a remote digital pelvic program among postmenopausal women (n=3051) with PFDs. Education and real-time biofeedback PFMT sessions were delivered through a mobile app. The intervention was asynchronously monitored and tailored by a physical therapist specializing in pelvic health. Clinical measures assessed pelvic floor symptoms and their impact on daily life (Pelvic Floor Impact Questionnaire–short form 7, Urinary Impact Questionnaire–short form 7, Colorectal-Anal Impact Questionnaire–short form 7, and Pelvic Organ Prolapse Impact Questionnaire–short form 7), mental health, and work productivity and activity impairment. Structural equation modeling and minimal clinically important change response rates were used for analysis. ResultsThe digital pelvic program had a high completion rate of 77.6% (2367/3051), as well as a high engagement and satisfaction level (8.6 out of 10). The safety of the intervention was supported by the low number of adverse events reported (21/3051, 0.69%). The overall impact of pelvic floor symptoms in participants’ daily lives decreased significantly (−19.55 points, 95% CI −22.22 to −16.88; P<PPP ConclusionsThis study demonstrates the feasibility, safety, and positive clinical outcomes of a fully remote digital pelvic program to significantly improve PFD symptoms, mental health, and work productivity in postmenopausal women while enhancing equitable access to personalized interventions that empower women to manage their condition and improve their quality of life.
ISSN:2291-5222