BACKGROUND: Dyspareunia is a genital pain during or after penile-vaginal sexual intercourse. It is a painful spasm of the pelvic muscles that partly or entirely disables vaginal penetration. OBJECTIVES: We examined the effect of extracorporeal shock wave therapy (ESWT) on idiopathic non-organic dyspareunia in women. A prospective, randomized, double-blind, placebo-controlled study was conducted. METHODS: The study included 62 women who reported dyspareunia. Patients in the treatment and placebo groups received ESWT perineally weekly for 4 consecutive weeks; placebo patients received placebo stand-off treatment. The grade of dyspareunia was estimated by using the Marinoff Dyspareunia Scale and subjective pain intensity on a visual analog scale (VAS) before and after treatment. Follow-ups were conducted 1, 4 and 12 weeks after the final ESWT session. RESULTS: The study included 61 women. The treatment but not placebo group differed by the Marinoff Dyspareunia Scale and VAS. Differences before and after treatment within groups were all P<0.001 and between groups, P<0.001. Pain reduction was always>30%. The effect sizes were both large: Marinoff 0.825 and VAS 0.883. CONCLUSIONS: ESWT significantly reduced subjective pain in our women treated for dyspareunia.

Department of Obstetrics and Gynaecology 1st Faculty of Medicine Charles University Budinova 2 18000 Prague Czech Republic

OBGYN Department Amedeana Prague Czech Republic

OBGYN Department Gynport Prague Czech Republic

Sports Motoric Laboratory Faculty of Physical Education and Sport Charles University Prague Czech Republic

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Hypoxia as a potential cause of dyspareunia