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The Efficacy of Manual Therapy for Treatment of Dyspareunia in Females

A Systematic Review

Trahan, Jennifer SPT1; Leger, Erin SPT1; Allen, Marlena SPT1; Koebele, Rachel SPT1; Yoffe, Mary Brian SPT1; Simon, Corey DPT, PhD1; Alappattu, Meryl DPT, PhD2; Figuers, Carol PT, EdD, MS1

Journal of Women’s Health Physical Therapy: January/March 2019 - Volume 43 - Issue 1 - p 28–35
doi: 10.1097/JWH.0000000000000117
Systematic Review

Background: Pelvic floor physical therapy is a noninvasive option for relieving pain associated with dyspareunia, genital pain associated with sexual intercourse. Manual therapy is a clinical approach used by physical therapists to mobilize soft tissues, reduce pain, and improve function. To date, the systematic efficacy of manual therapy for treating dyspareunia has not been investigated.

Objective: To examine the efficacy of manual therapy in reducing pelvic pain among females with dyspareunia.

Study Design: Systematic review.

Methods: A systematic literature search was conducted in MEDLINE, EMBASE, and CINAHL databases for articles published between June 1997 and June 2018. Articles were reviewed and selected on the basis of defined inclusion and exclusion criteria. The articles were assessed for quality using the PEDro and Modified Downs and Black scales.

Results: Three observational studies and 1 randomized clinical trial met inclusion criteria. The primary outcome measured was the pain subscale of the Female Sexual Function Index. All studies showed significant improvements in the pain domain of the Female Sexual Function Index (P < .5), corroborating manual therapy as a viable treatment in relieving pain associated with dyspareunia. However, the quality across studies ranged from poor to good.

Conclusions: Although these findings support the use of manual therapy for alleviating pain with intercourse, few studies exist to authenticate this claim. Moreover, the available studies were characterized by small sample sizes and were variable in methodological quality. More extensive research is needed to establish the efficacy of manual therapy for dyspareunia and the specific mechanisms by which manual therapy is beneficial.

1Doctor of Physical Therapy Division, Duke University, Durham, North Carolina

2Department of Physical Therapy, University of Florida, Gainesville, Florida

The authors declare no conflicts of interest.

Copyright © 2019 by the Section on Women's Health, American Physical Therapy Association.
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