A sensitive practice framework for treating genitopelvic pain in women with sexual trauma

Abstract

Introduction: Sexual trauma and sexual dysfunction are cause–effect related. Treatment includes specialized physical therapy to manage trauma triggers. Nevertheless, few studies have examined physical therapy approaches in women after sexual trauma. Objective: To propose approaches for genito-pelvic pain in women with sexual trauma. Methods: Twenty-four women were evaluated. Dyspareunia was assessed before and after the treatment of sexual pain by comparing anxiety score, level of distraction during sex, and touch aversion. A detailed protocol of sensitive practice for approach and treatment was developed to deal with the signs and symptoms of trauma. A structured framework of approach for the treatment of women with a history of sexual abuse history was presented. Results: Women treated with our sensitive care approach showed high baseline levels of anxiety and cognitive distraction during sex (n = 8; 33.3%; Cronbach’s α = 0.8 for ‘sexual abuse thoughts’ and 0.75 for ‘partner´s lack of affection’). However, anxiety (1.7 ± 2.1 vs. 0.1 ± 0.5), sexual pain intensity (6.0 ± 3.2 vs. 0.7 ± 0.8) and pain during physical therapy assessment (4.6 ± 1.9 vs. 0.3 ± 0.5) were all significantly reduced after treatment (p < 0.05). The total number of sessions until therapy discharge was 7.4 (± 4.1). Conclusion: Our study provides a framework for physical therapists of how to deal with women with dyspareunia after sexual trauma. However, a prospective study with a control group should be encouraged to test the effects of sensitive approaches on the treatment outcomes.