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(1) Background: Female sexual dysfunction (FSD) and overactive bladder (OAB) are prevalent disorders that significantly impair women’s quality of life. While pelvic floor muscle training (PFMT) is a well-established treatment for OAB, its effectiveness for FSD remains uncertain. Recent studies suggest that intravaginal electrical stimulation (IVES) may enhance the effects of PFMT. Therefore, this study aimed to evaluate the efficacy of combining IVES with PFMT to improve sexual function and bladder control in women with OAB and FSD. (2) Methods: A total of 40 women with FSD and OAB as determined by the Female Sexual Function Index (FSFI) and Overactive Bladder Symptom Score (OABSS) were randomized into two groups: group 1, the intravaginal electrical stimulation group (IVESG) (n = 20), and group 2, the placebo control group (CG) (n = 20). Patients in both groups received PFMT during the trial, and the IVESG underwent 10 weeks of electrical stimulation. The primary outcome was the change in the FSFI score from baseline to week 4 and week 10. The secondary outcome was a comparison of the OABSS values at week 4 and week 10 of the trial. (3) Results: After treatment, the IVESG scores for the total FSFI, sexual arousal and orgasm, increased significantly (p < 0.05). After 10 weeks of treatment, the OABSS values for IVESG were significantly lower (p < 0.01). After 10 weeks of treatment, the percentage of patients with mild OAB in the IVESG and CG increased by 53.33% and 60%, respectively, while the percentage of patients with both moderate and severe OAB decreased, especially in the IVESG, where patients with severe OAB were non-existent after 10 weeks of treatment. (4) Conclusions: IVES combined with PFMT improved objective and subjective measures of FSD and OAB. There was a significant improvement in FSD (including arousal and orgasmic domain scores). This study concludes that IVES is an effective conservative treatment.