Use of low-intensity shockwave therapy in the treatment of vaginismus and vulvodynia: a case report

Abstract

Vaginismus and vulvodynia are among the leading causes of female sexual pain, significantly affecting quality of life, emotional health and interpersonal relationships. Low-intensity extracorporeal shockwave therapy (LI-ESWT) has been investigated as a therapeutic alternative in regenerative gynecology owing to its capacity to promote analgesia, improve microcirculation and modulate muscle activity. The aim of this study was to describe the clinical response of a patient with concomitant vaginismus and vulvodynia treated with low-intensity shockwave therapy. This is a case report of a 45-year-old patient with a history of superficial and deep dyspareunia, intolerance to vaginal penetration and marked impairment of sexual function. A protocol of eight LI-ESWT sessions was performed. Progressive improvement in superficial dyspareunia, reduced involuntary pelvic floor contraction and partial resumption of sexual activity were observed during treatment. However, vestibular pain persisted and there was partial recurrence of symptoms after the protocol ended. The results suggest that LI-ESWT may represent a complementary therapeutic alternative in the management of female sexual pain disorders, particularly when combined with a multidisciplinary approach.