decreasing dyspareunia and dysmenorrhea in women with endometriosis via a manual physical therapy*: results from two independent studies

Purpose: To assess the efficacy of a non-invasive, site-specific manual physiotherapeutic technique in ameliorating dyspareunia and dysmenorrhea, commonly associated with endometriosis, by performing a retrospective and prospective analysis, respectively. Methods: Human female subjects, all surgically diagnosed with endometriosis, were enrolled in each of the studies post informed consent. Each subject underwent 20 hours of site-specific manual physical therapy (Wurn Technique) designed to address adhesions and restrictions in soft tissue mobility in the abdomen and the pelvic floor. Post-test was completed 6 weeks after treatment. Evaluation incorporated outcome prediction based on Female Sexual Function Index (FSFI) for analyzing the effect on dyspareunia and sexual function (n=14) and quantitative differences in ratings of average pain during menstrual cycle and intercourse based on the Mankoski Pain Scale for analyzing the effect on dysmenorrhea and dyspareunia (n=18), respectively. Data was analyzed by the Wilcoxon signed-rank test (two-sided). results: FSFI Full Scale score showed overall statistically significant improvements (P=.001) for all domains of sexual function, inclusive of dyspareunia (P<.001) in the retrospective analyses. Mankoski Pain Scale exhibited statistically significant improvements in menstrual cycle (P<.014), dysmenorrhea (P=.008) and dyspareunia (P=.001) in the prospective analyses. conclusion: Site-specific manual physiotherapy might offer a non-pharmacologic and non-surgical alternative in the treatment of dyspareunia and dysmenorrhea in endometriosis patients. Further randomized, blinded, and multi-center assessment of the technique is warranted to validate the results and gauge any potential pitfalls.