Physiotherapy for pelvic pain and female sexual dysfunction: an untapped resource

Bary Berghmans
In: International Urogynecology Journal · 2018 · vol. 29(5) , pp. 631–638 · doi:10.1007/s00192-017-3536-8 · PMID:29318334 · W2782767388
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

Physiotherapy is an underused resource that can significantly contribute to the multidisciplinary assessment and treatment of chronic pelvic pain and female sexual dysfunction.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 ⓘ

This review article examines whether physiotherapy is an underused but relevant treatment within a multidisciplinary approach to chronic pelvic pain (CPP), including chronic pelvic pain syndrome without clear local pathology (CPPS), and female sexual dysfunctions such as dyspareunia and vaginism. Using computer-aided and manual searches of literature from 1990–2017 plus methodological quality assessment and expert interviews, the authors synthesize evidence on pelvic floor muscle and myofascial contributions (including trigger points, peripheral and central sensitization, and resulting pelvic floor overactivity) and summarize physiotherapeutic assessment and interventions across 32 eligible studies (including five randomized controlled trials). The key finding is that physiotherapy is supported by “recent quality studies” showing significant clinical effects for CPP and female sexual dysfunction, but the authors note limitations in available data—insufficient detailed referral data, medical information, and test results make focused physiotherapy difficult to administer adequately. This paper is centrally about endometriosis? It does not specifically discuss endometriosis; it was included in the corpus via keyword match in the upstream search index.

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Abstract

INTRODUCTION AND HYPOTHESIS: Chronic pelvic pain (CPP) in women is a complex syndrome. Pain sensation and intensity often do not correspond with the identified lesion location but are felt elsewhere, leading to muskuloskeletal and myofascial disorders and sexual dysfunction (SD). Although physical aspects are prevalent, they are often underdiagnosed and undertreated due to lack of understanding regarding its origin and distribution. Frequently, patients experience pelvic pain as psychological distress resulting in physical complaints, leading clinicians to prescribe medication or surgical intervention to correct or alleviate these symptoms, often with insufficient results. Because pelvic floor muscle disorders contribute significantly to CPP and SD, there is rationale for physiotherapy. However, physiotherapy is a widely underused and untapped resource, which has its place in the multidisciplinary approach to these health problems. METHODS: Computer-aided and manual searches and methodological quality assessment were carried out for meta-analyses, systematic reviews, and randomized controlled trials (RCTs) published between 1990 and 2017 investigating classification, assessment, and (physiotherapeutic) treatment of pelvic pain and/or female SD defined by the keywords below. Expert opinions were sought via interviews. RESULTS: Due to a lack of sufficient relevant medical information, referral data, and test results, focused physiotherapy is difficult to administer adequately. However, recent quality studies indicate significant clinical effects of physiotherapy for CPP and female SD, and experts advocate a multidisciplinary approach that includes physiotherapy. CONCLUSIONS: Because of its holistic approach, physiotherapy can contribute significantly to the multidisciplinary assessment and treatment of CPP and female SD.

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chronic_pelvic_pain

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