Medical Studies

Treating endometriosis pain with a manual pelvic physical therapy

Wurn LJ, Wurn BF, King CR, Roscow AS, Scharf ES, Shuster JJ

Fertility and Sterility , September 2006

Eighteen patients with endometriosis confirmed via laparoscopy or laparotomy and reporting pain with intercourse, ovulation, pre-menstruation, and/or menstruation received a series of manual pelvic physical therapy sessions designed to address restricted soft tissue mobility due to micro-adhesions and adhesions. The primary outcome measures were post-test vs. pretest scores on various pain scales (i.e., each patient acted as her own control).

Follow-up tests six weeks after the last therapy session showed improvements in all areas, with the greatest pain decreases during menstruation and intercourse – typically the most painful times. Sixty-one percent (61%) of the women reported decreased pain with menstruation and sixty-nine percent (69%) reported lower to totally eliminated pain with intercourse. Thirty-nine percent (39%) experienced decreased pre-menstrual pain and fifty percent (50%) reported decreased pain with ovulation.

The Wilcoxon Sign-Rank Test (2-sided) showed a statistically significant improvement in sexual intercourse pain (dyspareunia) and in the total difference at all three phases of the cycle, including pre-menstruation, menstruation and ovulation (P = 0.014). Decreased menstrual pain was significant (P = 0.008), and decreased sexual intercourse pain was also significant (P = 0.001).