Effectiveness of physiotherapy and its impact on the quality of life of patients compared to other therapeutic approaches in the management of female sexual dysfunction in non-menopausal adult population: a systematic review

Abstract

Introduction: Female sexual dysfunction (FSD) affects quality of life, presenting as reduced sexual desire, arousal issues, pain, and orgasm difficulties. Its multifactorial causes include physical and psychological factors, with about 43% of women in the United States affected.

Objective: To evaluate the efficacy of physiotherapy compared to other treatments (medical, psychological, pharmacological) in improving sexual function and quality of life in adult women with sexual dysfunction, excluding menopausal women. It synthesizes evidence on physiotherapeutic treatments, such as pelvic floor exercises, manual therapy, biofeedback, electrotherapy, and pelvic function education.

Methods: Following PRISMA guidelines, a comprehensive search was conducted in PubMed, Scopus, and Web of Science. Inclusion criteria encompassed studies evaluating the effectiveness of physiotherapy in adult women with sexual dysfunction, excluding postmenopausal. Data extraction and quality assessment were performed using standardized tools.

Results: Of the 708 identified studies, 8 met the inclusion criteria. The studies demonstrated significant improvements in Female Sexual Function Index (FSFI) domains following physiotherapeutic interventions, notably reducing pain and enhancing desire and arousal. However, heterogeneity among studies precluded meta-analysis, necessitating qualitative synthesis.

Discussion: Physiotherapy, particularly pelvic floor muscle training and multimodal approaches, proved effective in enhancing sexual function and reducing pain. While physiotherapy offers a non-invasive alternative with fewer side effects compared to surgical options, variability in intervention protocols indicates the need for standardization. Psychological and emotional factors are key in sexual dysfunction, highlighting the value of integrated treatments. Capacitive resistive monopolar radiofrequency with manual therapy improved sexual function in women with dyspareunia, though benefits were short-lived, underscoring the need for maintenance strategies.

Conclusions: Physiotherapy is an effective intervention for FSD, significantly improving quality of life. Incorporating physiotherapy into clinical rehabilitation programs is recommended. Further research with standardized protocols and long-term follow-ups is necessary to consolidate evidence and optimize treatment strategies.

Keywords: biofeedback; efficacy of physiotherapy; female sexual dysfunction; multimodal therapy; pelvic floor exercises; quality of life.