Decreasing Dyspareunia and Dysmenorrhea in Women with Endometriosis via a Manual Physical Therapy * : Results from Two Independent Studies

Abstract

Keywords

Adhesion Dysmenorrhea Dyspareunia Physical Therapy Physiotherapy Sexual Dysfunction Wurn Technique

Purpose

To assess the efficacy of a non-invasive, site-specific manual physiotherapeutic technique in ameliorating dyspareunia and dysmenorrhea, commonly associated with endometriosis, by performing a retrospective and prospective analysis, respectively.

Methods

Human female subjects, all surgically diagnosed with endometriosis, were enrolled in each of the studies post informed consent. Each subject underwent 20 hours of site-specific manual physical therapy (Wurn Technique) designed to address adhesions and restrictions in soft tissue mobility in the abdomen and the pelvic floor. Post-test was completed 6 weeks after treatment. Evaluation incorporated outcome prediction based on Female Sexual Function Index (FSFI) for analyzing the effect on dyspareunia and sexual function (n=14) and quantitative differences in ratings of average pain during menstrual cycle and intercourse based on the Mankoski Pain Scale for analyzing the effect on dysmenorrhea and dyspareunia (n=18), respectively. Data was analyzed by the Wilcoxon signed-rank test (two-sided).

Results

FSFI Full Scale score showed overall statistically significant improvements (P=.001) for all domains of sexual function, inclusive of dyspareunia (P<.001) in the retrospective analyses. Mankoski Pain Scale exhibited statistically significant improvements in menstrual cycle (P<.014), dysmenorrhea (P=.008) and dyspareunia (P=.001) in the prospective analyses.

Conclusion

Site-specific manual physiotherapy might offer a non-pharmacologic and non-surgical alternative in the treatment of dyspareunia and dysmenorrhea in endometriosis patients. Further randomized, blinded, and multi-center assessment of the technique is warranted to validate the results and gauge any potential pitfalls.

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