April 2024

Physical manifestations of stress in women. Correlations between temporomandibular and pelvic floor disorders

Authors: Isabel Minguez-Esteban 1, 2, 3, Monica De-la-Cueva-Reguera 1, Carlos Romero-Morales 1, Beatriz Martinez-Pascual 1, Jose A. Navia 1, 4, Maria Bravo-Aguilar 1, Vanesa Abuin-Porras 1


  1. Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odon, Madrid, Spain
  2. Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
  3. OnelifeCentre, Multidisciplinary Centre for the Prevention and Treatment of Pain, Alcorcon, Spain
  4. Facultad de Educacion, Universidad de Alcala , Alcala de Henares, Espana

Journal: PLOS ONE - April 2024, Volume 19, Issue 4, Article no. e0296652 (DOI: 10.1371/journal.pone.0296652)

Introduction: Stress is characterized as a challenging occurrence that triggers a physiological and/or behavioral allostatic response, alongside the demands typically encountered throughout the natural course of life. A sustained state of stress gives rise to secondary effects, including insomnia and neck pain. Also, the risk of musculoskeletal problems in the cervical and lumbar spine can be increased due to a sustained state of stress. The present study main objective is to study the association between orofacial and pelvic floor muscles in women in Spain.

Methodology: An observational, cross-sectional, retrospective analytical study was designed and carried out in the laboratories of the European University of Madrid. Sixty-five participants were recruited with a mean age of 29.9 ± 7.69. Measurements were taken by myotonometry on natural oscillation frequency (Hz), dynamic stiffness (N/m), elasticity (N/m2), mechanical stress relaxation time (ms) and creep, for the following muscles: right and left masseter, right and left temporalis and central fibrous nucleus of the perineum (CFPF). On the other hand, the subjects completed the following questionnaires: perceived stress scale (PSS-14), anxiety scale (STAI), self-reported bruxism questionnaire (CBA), Fonseca Anamnestic Index and the Pittsburgh Sleep Quality Scale (PSQI).

Results: Significant correlations were found in several parameters between the right temporalis and CFPF (p<0.05). Highlighting the correlation between TMDs and lubrication r = -0.254 (p = 0.041) and bruxism with pain in sexual intercourse r = 0.261 (p = 0.036).

Conclusion: The results support the proposed hypothesis. To the author’s knowledge, this is the first study which relates both locations, and it is suggested to continue with the research and expand the knowledge of it.


Keywords: sleep, bruxism, pain, psychological stress, lubrication, questionnaires, sexual dysfunction, relaxation time

In conclusion, the results of this study support the relationship between the orofacial region and the pelvic region. Furthermore, it is worth highlighting the association found between TMDs and vaginal lubrication, as well as bruxism and pain.

On the one hand, stress, anxiety, and poor sleep quality seem to be possible triggers of TMDs. On the other hand, good sleep quality seems to be associated with better arousal, lubrication and orgasm.

Further research and knowledge in this area should be considered due to the lack of previous evidence. New studies are proposed with the use of electromyography, as well as in subjects with previously diagnosed temporomandibular dysfunctions and in different population groups.