Increasing Orgasm and Decreasing Dyspareunia by a Manual Physical Therapy Technique

Lawrence J. Wurn, LMT; Belinda F. Wurn, PT; C. Richard King, MD; Amanda S. Roscow, MPT; Eugenia S. Scharf, PhD; Jonathan J. Shuster, PhD

Disclosures

Discussion

Since the causes of dyspareunia and orgasmic capacity include a number of adhesion-related physiologic factors (eg, inflammation, infection),^[10] it is not surprising that a site-specific, manual soft-tissue therapy designed to treat these would prove so effective. Pain and orgasm represent 2 (ie,one-third) of the 6 domains comprising the FSFI; thus, it follows that improvements in these would automatically result in improved overall sexual function, as evidenced on the post-test FSFI full score.

On the other hand (and despite the known overlap in the diagnostic dimensions of female sexual functioning), it was surprising to find that the therapy apparently effected equally significant improvements on all quantifiable domains of this complex phenomenon, including desire, arousal, lubrication, and satisfaction. The unforeseen effectiveness of a manual physical therapy technique upon all 6 FSFI domains clearly supports the view that the "psychobiology of the experience of sexual pain"^[6] and orgasm needs to be addressed from a comprehensive perspective.

Future Research

These exceptionally encouraging results raise 2 immediate questions: (1) How would this distinctive protocol compare with a more traditional type of massage therapy (eg, Swedish) in treating women with sexual dysfunction? (2) Could this specific therapy also benefit women lacking strong indications of adhesion formation?

Accordingly, 2 planned studies of sexual dysfunction will have much larger samples of subjects, randomized into experimental (treatment) and control ("standard massage") groups. The studies will test the hypothesis that this distinctive protocol of site-specific, manual soft-tissue treatment is superior to traditional massage therapy in treating sexual dysfunction in women with and without histories of abdominopelvic adhesions.

Subsequent studies will investigate the relative efficacy of the therapy on different types of dyspareunia; ie, painful entry vs deep pain during sexual intercourse.

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Table 1. FSFI Full and Domain Scores (N = 23)
Domain	Pretreatment Median (Quartiles)	Post-treatment Median (Quartiles)	Difference (Post-Pre) Median (Quartiles)	P Value
Full Score*	19.5 (15.5; 26.7)	29.1 (23.2; 32.1)	5.2 (3.1; 12.3)	< .001
Orgasm*	4.4(2.0; 5.6)	5.6 (3.2; 6.0)	0.4 (0.0; 1.2)	< .001
Pain*	2.4(1.2; 4.0)	5.2 (4.8; 6.0)	2.0 (1.6; 4.0)	< .001
Desire	2.4 (2.4; 3.6)	3.6 (3.0; 4.2)	0.6 (0.6; 1.2)	< .001
Arousal	3.6 (2.4; 4.8)	4.5 (3.6; 5.4)	0.6 (0.0; 2.1)	.003
Lubrication	4.2 (3.0; 5.4)	5.7 (4.8; 6.0)	0.9 (0.0; 1.8)	< .001
Satisfaction	3.2 (2.4; 4.8)	5.2 (4.0; 6.0)	1.2 (0.0; 2.0)	< .001

Table 2. 10-point Pain Scale Scores* (N = 17)
Pain Scale	Pretreatment Median (Quartiles)	Post-treatment Median (Quartiles)	Difference (Pre-Post) Median (Quartiles)	P Value
Worst	8 (6; 9)	3 (1; 5)	4 (2; 5)	< .001
Best	2 (1; 4)	1 (1; 2)	1 (0; 2)	.002
Average	5 (3; 6)	1 (1; 3)	3 (1; 4)	< .001

FSFI Full and Domain Scores (N = 23)
Domain	Pretreatment Median (Quartiles)	Post-treatment Median (Quartiles)	Difference (Post-Pre) Median (Quartiles)	P Value
Full Score*	19.5 (15.5; 26.7)	29.1 (23.2; 32.1)	5.2 (3.1; 12.3)	< .001
Orgasm*	4.4(2.0; 5.6)	5.6 (3.2; 6.0)	0.4 (0.0; 1.2)	< .001
Pain*	2.4(1.2; 4.0)	5.2 (4.8; 6.0)	2.0 (1.6; 4.0)	< .001
Desire	2.4 (2.4; 3.6)	3.6 (3.0; 4.2)	0.6 (0.6; 1.2)	< .001
Arousal	3.6 (2.4; 4.8)	4.5 (3.6; 5.4)	0.6 (0.0; 2.1)	.003
Lubrication	4.2 (3.0; 5.4)	5.7 (4.8; 6.0)	0.9 (0.0; 1.8)	< .001
Satisfaction	3.2 (2.4; 4.8)	5.2 (4.0; 6.0)	1.2 (0.0; 2.0)	< .001

Table 2. 10-point Pain Scale Scores* (N = 17)
Pain Scale	Pretreatment Median (Quartiles)	Post-treatment Median (Quartiles)	Difference (Pre-Post) Median (Quartiles)	P Value
Worst	8 (6; 9)	3 (1; 5)	4 (2; 5)	< .001
Best	2 (1; 4)	1 (1; 2)	1 (0; 2)	.002
Average	5 (3; 6)	1 (1; 3)	3 (1; 4)	< .001

Table 1. FSFI Full and Domain Scores (N = 23)
Domain	Pretreatment Median (Quartiles)	Post-treatment Median (Quartiles)	Difference (Post-Pre) Median (Quartiles)	P Value
Full Score*	19.5 (15.5; 26.7)	29.1 (23.2; 32.1)	5.2 (3.1; 12.3)	< .001
Orgasm*	4.4(2.0; 5.6)	5.6 (3.2; 6.0)	0.4 (0.0; 1.2)	< .001
Pain*	2.4(1.2; 4.0)	5.2 (4.8; 6.0)	2.0 (1.6; 4.0)	< .001
Desire	2.4 (2.4; 3.6)	3.6 (3.0; 4.2)	0.6 (0.6; 1.2)	< .001
Arousal	3.6 (2.4; 4.8)	4.5 (3.6; 5.4)	0.6 (0.0; 2.1)	.003
Lubrication	4.2 (3.0; 5.4)	5.7 (4.8; 6.0)	0.9 (0.0; 1.8)	< .001
Satisfaction	3.2 (2.4; 4.8)	5.2 (4.0; 6.0)	1.2 (0.0; 2.0)	< .001

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Increasing Orgasm and Decreasing Dyspareunia by a Manual Physical Therapy Technique

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