The Efficacy of Manual Therapy for Treatment of Dyspareunia in Females: A Systematic Review

Trahan, Jennifer; Leger, Erin; Allen, Marlena; Koebele, Rachel; Yoffe, Mary Brian; Simon, Corey B.; Alappattu, Meryl; Figuers, Carol

doi:10.1097/jwh.0000000000000117

Cited by 11 publications

(8 citation statements)

References 21 publications

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“…Thiele's massage involves a transvaginal massage using longitudinal slides along each muscle with a pressure that is tolerable for the patient. One of its advantages is its ease of learning, allowing the patient and her partner to perform it at home, and it has no contraindications [ 36 ]. Research studies utilizing this method have shown significant improvements in pain [ 28 – 30 ] (in one study, only in the intensity of superficial dyspareunia but not deep dyspareunia [ 30 ]), sexual desire and lubrication [ 26 ] as well as levator ani contractility [ 28 , 30 ].…”

Section: Resultsmentioning

confidence: 99%

Effectiveness of physical therapy interventions in women with dyspareunia: a systematic review and meta-analysis

et al. 2023

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Background Dyspareunia is defined as the occurrence of pain during or after sexual intercourse, which directly affects physical, sexual, and mental health. This condition can lead to depression, anxiety, and low self-esteem in women who experience it. Objectives The aim of this research was to evaluate the effectiveness of physical therapy interventions for the treatment of female dyspareunia. Design A systematic review and meta-analysis was conducted. Method Search of publications was conducted in Scopus, Medline, Pubmed, Cinahl and Web of Science. Treatment effects were defined as standardized mean difference and their 95% confidence intervals. Statistical heterogeneity was assessed using Crohan's Q test and quantified using the I2 index. Results Of the 19 articles selected, six applied multimodal physiotherapy treatments; five, electrotherapy; three, Thiele's massage; two, interdisciplinary interventions or pelvic floor muscle training; and one, extracorporeal shockwave therapy. The meta-analysis showed significant results for the variables pain and quality of life with the interventions based on electrotherapy and electrotherapy combined with pelvic floor muscle training. These interventions did not show significant results for the improvement of sexual function. Conclusions Physiotherapy techniques are effective and procedures have been identified with reliable results in improving pain and quality of life in patients with dyspareunia. One of the most important aspects is the strengthening of the perineal musculature and the application of Transcutaneous Electrical Nerve Stimulation. Furthermore, manual trigger point release therapy and Thiele massage, optimize and guarantee the reduction of pain intensity. Prospero registration CRD42021236155.

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Section: Resultsmentioning

confidence: 99%

Effectiveness of physical therapy interventions in women with dyspareunia: a systematic review and meta-analysis

et al. 2023

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“…7,8,15,24 This improvement of pain in patients with endometriosis could also be compared to the analgesic effects observed in other urogynecologic pathologies such as chronic pelvic pain (which often includes endometriosis), primary dysmenorrhea, and dyspareunia, as multiple studies have reported that treatment with physiotherapy is capable of alleviating painful syndromes located in the urogynecologic region. [18][19][20][27][28][29][30][31][32][33] Pelvic pain decrease may be related to different neurophysiologic mechanisms such as reduction of nociceptive inputs, decrease of inflammatory prostaglandin levels, or increased release of endorphins. 28,30,34 In addition, previous authors have investigated how pelvic floor dysfunction is very frequent in women with deep endometriosis.…”

Section: Discussionmentioning

confidence: 99%

Benefits of physical therapy in improving quality of life and pain associated with endometriosis: A systematic review and meta‐analysis

Abril-Coello

Correyero-León

Ceballos‐Laita

et al. 2023

Intl J Gynecology & Obste

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Objective: To assess whether non-pharmacologic conservative therapeutic interventions are beneficial in improving pain intensity and quality of life in women with endometriosis compared with placebo. Methods:A systematic review with meta-analysis was designed. A literature search was performed in the following databases: PubMed, PEDro, Embase, CINAHL, Isi Web of Science, Enfispo, and Cochrane. Randomized controlled trials included women with endometriosis treated with conservative treatment versus placebo. The quality of the studies was assessed using the PEDro scale, and the risk of bias of the individual studies was assessed using the Cochrane Risk of Bias tool. For the overall quality of the studies, the GRADE guidelines were used.Results: Meta-analysis included six studies. Significant results were obtained for pain intensity (standardized mean difference [SMD] -0.89; 95% confidence interval [CI] -1.21 to −0.57; I 2 69%) and concerning quality of life, significant results were only obtained for the sub-variable physical function (SMD -1.49; 95% CI -2.88 to −0.10; I 2 95%). No statistically significant differences were found for the rest of the variables analyzed. Conclusion:Non-pharmacologic conservative therapies are a therapeutic option for women with endometriosis for improving pain intensity and physical function.

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“… 21 , 23 Such programs often required the patient to attend therapy for an average of 1–2 visits per week for 8–12 weeks. 24 , 25 Moreover, MBDT promotes patient autonomy, empowerment, and self-efficacy and correlates with subjective reduction in pain consistently within the first 4–6 weeks of use in the privacy of one's home.…”

Section: Discussionmentioning

confidence: 99%

Low Dose, High Frequency Movement Based Dilator Therapy for Dyspareunia: Retrospective Analysis of 26 Cases

Miles

2021

Sexual Medicine

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Introduction: While two-thirds of women will experience dyspareunia and vaginal dilators are often used to treat dyspareunia, outside of a single case report, no study has investigated the potential of low-dose, high frequency movement-based dilator therapy for dyspareunia in premenopausal female patients. Aim: To determine the utility of low-dose, high frequency movement-based dilator use for dyspareunia in premenopausal female patients. Methods: Retrospective study of women presenting to outpatient hospital-based pelvic floor physical therapy office in a tertiary care center. All adult premenopausal female patients who were referred to pelvic floor physical therapy for dyspareunia and completed movement-based dilator therapy (MBDT) and met study criteria (n = 26) were included for analysis. Main Outcome Measure: Patient change in pain level status using Numeric Pain Rating Scale with intercourse was compared between initial evaluation and time of discharge from pelvic floor physical therapy. Results: Among the 26 women who met criteria for this study, the average pain score decreased from 8.3 (SD 2.2) before treatment to 1.3 (SD 2.0) after treatment and was statistically significant (P< .001). Complete resolution of dyspareunia was reported in 58% of patients. Patients completed between 2 and 6 total pelvic floor physical therapy visits (average 3.7, SD1.5), over 0−44 weeks (mean 9.6 weeks, SD 8.3). Conclusion: Low-dose, high frequency, movement-based dilator therapy significantly reduced or resolved the experience of pain with penetrative vaginal intercourse with dyspareunia. Future prospective studies with larger samples and the inclusion of sexual functional status should be considered to explore the full potential of this modality in treatment of premenopausal patients with dyspareunia. K Miles, S Miles. Low Dose, High Frequency Movement Based Dilator Treatment for Dyspareunia: Retrospective Analysis of 26 Cases. Sex Med 2021;9:100344.

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The Efficacy of Manual Therapy for Treatment of Dyspareunia in Females: A Systematic Review

Cited by 11 publications

References 21 publications

Effectiveness of physical therapy interventions in women with dyspareunia: a systematic review and meta-analysis

Effectiveness of physical therapy interventions in women with dyspareunia: a systematic review and meta-analysis

Benefits of physical therapy in improving quality of life and pain associated with endometriosis: A systematic review and meta‐analysis

Low Dose, High Frequency Movement Based Dilator Therapy for Dyspareunia: Retrospective Analysis of 26 Cases

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