Pelvic floor modalities for the management of female sexual dysfunction: a narrative review.

Female sexual dysfunction (FSD) affects 40-45% of women worldwide and can significantly impact quality of life. While hormone therapy and counseling are common treatments, they often come with side effects or may not work for everyone. Researchers reviewed 49 studies involving 2,742 women to examine whether physical therapy approaches, including acupuncture, could help improve sexual function without medication. The review looked at various non-invasive treatments including pelvic floor muscle training, electrical stimulation, radiofrequency therapy, dilator therapy, and acupuncture. All of these approaches showed promise in improving different aspects of sexual dysfunction, including desire, arousal, orgasm, pain during intercourse, and overall satisfaction. These physical therapy methods work by addressing the underlying physical issues that contribute to sexual problems, such as weak pelvic floor muscles, poor blood flow, or nerve dysfunction. For women considering acupuncture specifically, this review suggests it may be a helpful option as part of a comprehensive treatment plan for sexual difficulties. The main advantage of these physical therapy approaches is that they offer non-medication alternatives or additions to existing treatments, with generally fewer side effects than hormonal therapies. However, the researchers noted that the quality of evidence varies, and more large-scale studies with standardized treatment protocols are needed to fully understand which approaches work best for specific types of sexual dysfunction and how long the benefits last. If you're considering acupuncture or other physical therapy for sexual health concerns, seek a qualified, licensed practitioner with specialized training in pelvic health.

This narrative review evaluated physical therapy modalities for female sexual dysfunction (FSD) management, analyzing 49 clinical studies with 2,742 participants. The systematic search followed PICO framework across PubMed, Embase, and Web of Science through April 2025, including RCTs, cohort studies, and case reports. Interventions examined included electromagnetic therapy, electrical stimulation, radiofrequency therapy, pelvic floor muscle training, multimodal pelvic floor physical therapy, vibratory stimulation, dilator therapy, and acupuncture. All modalities demonstrated potential efficacy in improving FSD-related outcomes including sexual function scores, vaginal laxity, pain reduction, and orgasmic function through neuromuscular, vascular, and structural mechanisms. Clinical takeaway: Physical therapy approaches, including acupuncture, represent viable non-invasive alternatives or adjuncts to conventional hormone therapy and psychobehavioral interventions for FSD management. However, evidence quality varies significantly across interventions, necessitating large-scale RCTs with standardized protocols to establish optimal treatment algorithms and confirm long-term efficacy before definitive clinical recommendations can be made.