| Silva et al.1212 Silva APM, Montenegro ML, Gurian MBF, Mitidieri AM, Silva LL, Benedicto PL, et al. Perineal massage improves the dyspareunia caused by tenderness of the pelvic floor muscles. Rev Bras Ginecol Obstet. 2017;39(1):26-30.
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Non-randomized clinical trial about the positive effects of perineal massage in the reduction of pain in women with D and tension in the PFM. |
The study analyzed 2 groups. The first group consisted of 8 women with D associated with increased sensitivity of the pelvic muscles.
The second group consisted of a total of 10 women who had D associated with increased sensitivity of the pelvic muscles and related to CPP.
There was a considerable improvement in both groups regarding the D indicated by the VAS and the McGill index (p<0.001).
As for sexual function, there was a considerable improvement in all factors that concern the activity of sexual functioning in the D group.
The CPP group presented significant improvement in the pain factor. |
Thiele massage performed on the perineal muscles through the vaginal canal taking into consideration the pain threshold of patients to grade the level of pressure and myofascial release. Massage application time of five minutes, once a week for four weeks. |
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| Ghaderi et al.33 Ghaderi F, Bastani P, Hajebrahimi S, Jafarabadi MA, Berghmans B. Pelvic floor rehabilitation in the treatment of women with dyspareunia: a randomized controlled clinical trial. Int Urogynecol J. 2019;30(11):1849-55.
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Randomized, controlled clinical trial with the objective of observing effectiveness of a rehabilitation program for the PFM of women with D. |
Sixty-four women with D were selected. They were divided into two groups: the experimental group (EG) consisted of 32 women who received physical therapy treatment using electrotherapy, manual therapy, and pelvic exercises. The control group (CG) was also formed by 32 participants. The EG showed satisfactory results when compared to the CG. As for perineal strength, there was a mean difference of 2.01 by the Oxford scale (0-5), and for resistance there was a mean difference of 6.26 s. In relation to the FSFI, the mean difference was 51.05. As for pain measured by the VAS, the mean difference was 7.3 (p<0.05). |
The physical therapy intervention consisted of 10 sessions, which were performed once a week for three months.
Manual techniques, such as intravaginal deep massage, as well as intravaginal myofascial releases lasting for 15 to 20 minutes.
As a resource of electrotherapy, high-frequency TENS was selected (110Hz, 80ms pulse duration, and the intensity was considered according to the maximum tolerated by the participants). The session lasted from 20 to 25 minutes.
Training of exercises aimed at the muscles of PFM with weekly progression. The participants were instructed to perform daily exercises of PFM at home, in a progressive manner with the necessary orientations. |
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| Berghmans66 Berghmans B. Physiotherapy for pelvic pain and female sexual dysfunction: an untapped resource. Int Urogynecol J. 2018; 29(5):631-8.
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A review study that sought to understand the role of the physiotherapist in the treatment of women with SD and CPP in a multidisciplinary context, since such changes may be directly related to disorders in the PFM and changes in the sensitization of nerve fibers that conduct pain impulses to the central nervous system. |
Recent scientific studies point out the relevance of physiotherapeutic treatment for women with SD and CPP through comprehensive and global treatment of the painful condition. |
Manual therapies such as perineal massage and myofascial release with deactivation of painful TP.
Use of biofeedback and electrostimulation, such as TENS. Vaginal dilators of different thicknesses and sizes.
Breathing and relaxation exercises. |
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| Piassaroli et al.1313 Piassaroli VP, Hardy E, Andrade NF, Ferreira NO, Ossis MJO. Treinamento dos músculos do assoalho pélvico nas disfunções sexuais femininas. Rev Bras Ginecol Obstet. 2010; 32(5):234-40.
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Non-randomized clinical trial in which 26 women who presented a diagnosis of sexual dysfunction (desire, arousal and orgasmic disorder and D) were included. The aim of the study was to evaluate the effect of pelvic floor muscle training (PFMT) on female sexual dysfunction. |
Significant improvement (p<0.0001) of the FSFI scores was observed at the end of the treatment when compared to the initial and intermediate evaluations.
Regarding the EMG, the amplitudes of the phasic and tonic contractions increased significantly (p<0.0001) throughout the treatment.
There was an increase in pelvic floor strength, with 69% of women showing grade 4 or 5 at the final evaluation and total improvement in sexual complaints. |
PFMT: The PFM exercises were performed in several positions (total of 10): dorsal, lateral and ventral decubitus; in the four-stand position; seated on chair and ball; standing in front of the mirror. For each position, five phase contractions (fast) and five tonic contractions (sustained) were made for 10 seconds, with a relaxation period of 10 seconds between each contraction, totaling about one hundred contractions at the end of each session. |
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| Barreto et al.1414 Barreto KL, Mesquita YA, Santos Junior FFU, Gameiro MO. Treinamento da força muscular do assoalho pélvico e os seus efeitos nas disfunções sexuais femininas. Motri. 2018;14(1):424-7.
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Prospective and quantitative study in women aged 20 to 40 years old, with active sexual life and without associated neurological diseases. |
Regarding the 34 volunteers of the study, the sexual function was evaluated by the Sexual Quotient - female version (SQ - F) and 3% (1 woman) was classified with unfavorable to regular performance, 62% (21 women) with regular to good performance, and 35% (12 women) with good to excellent performance.
Regarding the results of the evaluation of PFM function or strength, the women were classified: 9% (3 women) ranked from unfavorable to regular, 53% (18 women) ranked from regular to good, and 38% (13 women) ranked from good to excellent.
Considering the correlation between the degree of sexual satisfaction and the PFM function or strength of the women studied, in the age group of 20 to 40 years old, it was observed that the higher the PFM function or strength, the better the perception and degree of sexual satisfaction. |
Biofeedback for strengthening the muscles of the perineum, in the dorsal decubitus position. After adjusting the device, the volunteer was asked to contract the PFM for three consecutive times maintaining the contraction for as long as possible. The B force scale of the equipment was used, with a contraction time setting of 6 seconds and twice the time for resting. |
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| Kamilos and Borrelli 1515 Kamilos MF, Borrelli CL. Nova opção terapêutica na síndrome geniturinária da menopausa: estudo piloto utilizando radiofrequência fracionada microablativa. Einstein. 2017;15(4):445-51.
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A prospective pilot study, concerning the clinical effects perceived by women with GSM immediately after a treatment process using MAFRF. |
Fourteen women reporting symptoms of GSM were selected for the study.
There was a considerable improvement in the patients' quality of life, as well as significant progress in sexual function. It's worth noting that all patients no longer use vaginal lubricant during sexual intercourse.
As for the aspects evaluated by the satisfaction scale after the treatment with MAFRF, most of the patients said they were cured (29%) or much better (64%), for a total of 92.6%.
43% said they were very satisfied and 57% satisfied for a total of 100%. |
MAFRF, vaginal pen with 64 microneedles, 200μ diameter and 1 mm long.
Three applications within an interval period of 28 to 40 days. The technique time was 15 to 20 minutes. |
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