Dysmenorrhea and dyspareunia. Big words for extremely painful menstruation and painful sex during penetration, respectively. In other words, cringe-worthy conditions that are complicated, frustrating, and emotionally draining.
For women living with these issues, massage therapy is one of the treatment options that can significantly improve your symptoms and your quality of life.
Preliminary research performed in 2004, 2010, and 2011 all strongly indicate manual therapy has a high level of effectiveness in decreasing the pain from both dysmenorrhea and dyspareunia. In two of the research trials addressed here, the aim was to reduce the severity of these conditions as symptoms of endometriosis. The other was focused on improving the overall quality of women’s sexual experiences.
Though it is not entirely clear if internal massage techniques were utilized at any point, provided examples of maneuvers clearly show that external massage was an essential part of the treatment. Working over the abdomino pelvic area, either a massage therapist or a physical therapist depending on the study worked to release adhesions (fascial build-up and scarring) from around the clients’ uterus, bladder, viscera, and musculature. The results were, in my opinion, incredible.
The first study, reported by Wurn et al, used the Female Sexual Function Index (FSFI) to measure results. Areas assessed for sexual function were pain, orgasm, desire, lubrication, arousal, and satisfaction. Only pain was addressed for menstruation. In the 2004 study, pain levels during intercorse saw an average improvement from 2.4 to 5.2 (the higher the number here, the better for the FSFI) and average overall experience jumped from 19.5 to 29.1. Twenty-three women were involved in this trial.
Wurn et al’s second study included measurements for pain before, during and after menstruation as well as during sex. It was unclear what measurement system the 18 women participating in this study were asked to use to rate their pain. Whatever the rating system, clients reported an average decrease of pain from 8.5 to 6.3 over the entire course of their menstrual period. The largest improvement was seen during the women’s period from which pain dropped from 4.1 to 2.8. Sexual pain during intercourse lessened from 2.4 to 1.7 on average after manual therapy. Both of post-study follow-up for this and the previous trial were performed six weeks after the end of the massage sessions, allowing the body time to assimilate the changes.
Valiani et al performed multiple follow-up surveys which allowed for the comparison between immediate and
longer-term results, employing the visual analog scale (VAS) for pain measurements. Interestingly and wonderfully, the follow up questionnaires revealed the effects of the massage intervention increased with time. Six weeks after the treatments, even with no other therapies used in the interim, pain reports were even lower than immediately after the last session. Out of the 23 participants, the number of women declaring severe pain (7-10 on the VAS) dropped from 12 to 4 immediately after the treatment’s conclusion and dropped again to 0 women by the six week mark. Women who reported no pain rose from 0 at the beginning of the trial to 8 immediately after intervention and increased again to 15 six weeks out. Of the remaining participants, 7 rated their pain between 1-3 (mild) and 1 said it to be a 4-6 (moderate).
More research is needed to confirm these results in larger and more diverse populations. However, the astounding improvements in the quality of life the women in these studies reported offers a fantastic base on which to start and gives hope that non-invasive measures can have huge impact on diminishing the effects of dysmenorrhea and dyspareunia. Read the full studies below.
Wurn, L. J., Wurn, B. F., Roscow, A. S., King, C. R., Scharf, E. S., & Shuster, J. J. (2004). Increasing Orgasm and Decreasing Dyspareunia by a Manual Physical Therapy Technique. Medscape General Medicine, 6(4), 47.
Wurn BF.,Wurn LJ.,Patterson K.,King CR.,Scharf ES. (2011). Decreasing dyspareunia and dysmenorrhea in women with endometriosis via a manual physical therapy: results from two independent studies. Journal of Endometriosis, 3(4), 188-196.
Valiani, M., Ghasemi, N., Bahadoran, P., & Heshmat, R. (2010). The effects of massage therapy on dysmenorrhea caused by endometriosis. Iranian Journal of Nursing and Midwifery Research, 15(4), 167–171.
What interventions have helped you? What do you think of this research? Share your experience with dysmenorrhea and dyspareunia in the comments!