Physiotherapy Intervention in Climacteric Women With Dyspareunia

Aim: To evaluate the effectiveness of physical therapy intervention techniques in the improvement of dyspareunia in climacteric women. Study design: This is a randomized controlled trial.

Search location: Menopause and Sexuality Clinic of the department of obstetrics and Gynecology and Clinical Research Center, Hospital de Clínicas de Porto Alegre (HCPA). Patients or participants: The recruited patients may not be vaginal atrophy (cytology-hormone test) and must provide the diagnosis of dyspareunia for more than six months being confirmed by one of the investigators through the pain score above grade 3 (visual analog pain scale) visual inspection, palpation and a questionnaire about the duration and location of pain. Intervention and measures: consist of evaluation of the pelvic floor muscles (Oxford Scale and Perfect), myoelectric assessment (Electromyography), quality of life (Cervantes Scale), sexual function (FSFI), level of depression (Beck Scale) and pain (visual analog pain scale) before and after physical therapy intervention. Expected results: To estimate the effectiveness of pelvic floor training techniques with physical therapy in women with dyspareunia.

superficial heat pelvic floor muscle intra vaginal manual therapy. PERFECT scale is applied in 5 sessions and based on the result of each assessment is performed the treatment plan with exercises of the pelvic floor muscles. It is performed manual therapy in iliopsoas, diaphragm and piriformis. From the fourth session, initiate treatment with electromyographic biofeedback based on the result of PERFECT scale.

To evaluate the effectiveness of physiotherapy techniques in pain improvement using visual analog scale pain

Seven meetings, twice a week, in which the first is the initial assessment and the seventh is the final evaluation totaling a maximum of one month treatment for each patient.

To evaluate the quality of life, using Cervantes Scale in climateric women in baseline and after four weeks of intervention

To evaluate sexual function, using Female Sexual Function Index, in baseline and after four weeks of intervention

To evaluate electrical activity of the pelvic floor muscles, using Electromyographic biofeedback , in baseline and after four weeks of intervention

To evaluate the pelvic floor muscle function, using PERFECT Scale in baseline and after four weeks of intervention

Inclusion Criteria: dyspareunia complaint for at least six months visual analog scale of pain above 3 trophic vagina Exclusion Criteria: vaginal atrophy neurological disorders lack of cognition and understanding urinary tract infection and / or genital infections prolapse grade 2 and 3 severe systemic disease performing physical therapy