This blog discusses various results of a 12 week pelvic physical therapy intervention in women with dyspareunia after cancer (endometrial or cervical) treatment. You will know about changes of pelvic floor muscle morphology, muscle function,and short- and long term results regarding psychosexual outcomes like sexual distress.


Pelvic physical therapy intervention


  • Women in remission after completion of all oncological treatments
  • Vulvovaginal pain during intercourse 
  • Average pain rating 5 (0 no pain – 10 worst pain)



  • 12 weeks of 60 minute sessions
  • Education (e.g. chronic pain management, anatomy and physiology of pelvic floor muscles, advice on vulvovaginal behavior, sexual function)
  • Pelvic floor muscle exercises with electromyography biofeedback (e.g. relaxation techniques)
  • Manual therapy (e.g. stretch, tension release)
  • Home exercise program. Pelvic floor muscle exercises 5 times per week and exercise to desensitise tissue (insertion exercises etc)



Based on 31 women with a mean age of 55.9 years and a median of 38 months (>3 years) since oncological treatment.

Change in pelvic floor morphology (significant) 

  • Decrease in tone of pelvic floor muscle
  • Increase in tissue flexibility
  • Increase in passive force  of pelvic floor muscle
  • Improvement of contractility of pelvic floor muscle
  • Improvement of coordination and endurance of pelvic floor muscle
  • Increase in vaginal length
  • Decrease of signs of vaginal atrophy

Improvement in (significant)

  • Pain intensity
  • Sexual function and distress
  • Body image concerns
  • Pain anxiety and catastrophizing
  • Painful intercourse
  • Depressive symptoms
  • Urinary and vaginal symptoms

At one year follow-up the improvements were still significant!

(at one year: 86% of the women reported to be very much or much improved)



The results are not a randomised controlled trial and therefore caution in interpreting the results is warranted.


Clinical implications:

  1. Indication that pelvic physical therapy is a valuable therapy for gynaecological cancer survivors with dyspareunia with long term results.
  2. A cancer survivor with dyspareunia can start pelvic physical therapy even years after treatment with good results.


Cyr MP, Dumoulin C, Bessette P, Pina A, Gotlieb WH, Lapointe-Milot K, Mayrand MH, Morin M. A prospective single-arm study evaluating the effects of a multimodal physical therapy intervention on psychosexual outcomes in women with dyspareunia after gynecologic cancer. J Sex Med 2021;18:946-954


Cyr MP, Dostie R, Camden C, Dumoulin C, Bessette P, Pina A, Gotlieb WH, Lapointe-Milot K, Mayrand H, Morin M. Improvements following multimodal pelvic floor physical therapy in gynecological cancer survivors suffering from pain during sexual intercourse: results from a one-year follow-up mixed method study. Plos One 17(1):e0262844


Cyr MP, Dumoulin C, Bessette P, Pina A, Gotlieb WH, Lapointe-Milot K, Mayrand MH, Morin M. Changes in pelvic floor morphometry and muscle function after multimodal physiotherapy for gynaecological cancer survivors suffering from dyspareunia: a prospective interventional study. Physiotherapy 114 (2022) 54-62

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