Manual Therapy in Improving Quality of Life in Women With Dyspareunia

Summary

Health-related quality of life refers to how a person feels in their daily life. It includes the body, the mind, emotions, daily activities, and relationships with other people. All of this depends on how each person perceives their own health.

One of these problems is dyspareunia, which is pain during vaginal penetration. This condition affects many women worldwide, between 3% and 18% of the population. In Portugal, sexual dysfunctions may affect up to 70% of women. Dyspareunia is more common after vaginal childbirth that causes injuries to the intimate area.

Many women feel embarrassed or afraid to talk about their sexual health. Because of this, they avoid discussing these issues with doctors and other health professionals. This difficulty in talking about the problem can cause the pain to continue and may also lead to anxiety and depression.

Some habits and factors also increase the risk of these problems, such as lack of physical activity, poor sleep quality, sexual abuse, type of childbirth, and obesity. In the case of superficial dyspareunia, the pain may be related to tense muscles in the pelvic floor, which supports organs such as the bladder and the uterus.

Although dyspareunia is a common problem, more studies are needed to identify the most effective treatments. One treatment option is fascial manipulation, a manual therapy technique used to treat muscle pain. Another technique is perineal massage, which is applied to the intimate area. So far, there are no studies that examine the effect of combining fascial manipulation with perineal massage for this type of pain.

Therefore, the aim of this study is to assess whether the combined use of fascial manipulation and perineal massage provides more benefits than perineal massage alone in women with superficial dyspareunia.

The study will be conducted with Portuguese women receiving care at the Guimarães Health Center and at the Hospital of Guimarães. Research methods combining numerical data and participants' personal reports will be used.

To evaluate the results, questionnaires will be used to measure sexual function, pain, emotional well-being (such as anxiety, depression, and stress), as well as physical activity levels and sleep quality.

The participants will be divided into two groups:

Group 1: will receive both treatments combined (fascial manipulation and perineal massage).

Group 2: will receive only perineal massage.

The treatments will take place once a week for five weeks. Evaluations will be carried out before the start of treatment, in the 6th week, and in the 12th week.

In addition to the questionnaires, some women will take part in interviews, where they can describe how they felt during the treatment. This will help to better understand their experiences and the effects of the therapies.

Conditions

• Female
• Dyspareunia

Interventions

PROCEDURE

Experimental Group 1 (GE1) - Fascial Manipulation and Perineal Massage

Experimental Group 1 (GE1) - Fascial Manipulation and Perineal Massage Description: Patients assigned to treatment with the Stecco Fascial Manipulation method underwent a protocol of 5 weekly sessions, each lasting 60 minutes. The intervention focuses on the lumbar, pelvic, and thigh segments, and the treatment points (CC and CF) will be defined individually, based on the identification of the most dysfunctional and painful areas of the deep fascia. The manipulation consists of deep friction with the elbow, applied for 2 to 4 minutes at each point, until tissue densification is reduced. Effectiveness will be assessed by increased tissue mobility and decreased pain. After fascial manipulation, patients underwent perineal massage performed in the lithotomy position, with pressure adjusted to the patient's comfort, for five minutes on each side.

PROCEDURE

Experimental group 2 (GE2) - Perineal massage

Participants in Experimental Group 2 (EG2) will receive perineal massage exclusively, maintaining the same procedure and positioning described for EG1 in the previous section. The principal investigator of the study will be responsible for administering these therapies, and due to the specific nature of the interventions, she cannot be unfamiliar with the type of treatment administered. Anonymity will be maintained with respect to the other investigators, ensuring the methodological integrity of the study.

Sponsors & Collaborators

• University of Trás-os-Montes and Alto Douro

  lead OTHER

Principal Investigators

• Ronaldo C Gabriel, Professor · Universidade de Trás-os-Montes e Alto Douro

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

SEQUENTIAL

Eligibility

Min Age

18 Years

Max Age

45 Years

Sex

FEMALE

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-02-01

Primary Completion

2025-12-15

Completion

2026-01-15

Countries

• Portugal

Study Locations