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

Abstract

[EN] 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 treat‑ ment 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 shock‑ wave therapy. The meta‑analysis showed significant results for the variables pain and quality of life with the interven‑ tions 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 strength‑ ening 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.