Pelvic Floor Physical Therapy for Sexual Abuse Survivors With Pelvic Pain

~15% of French women report lifetime sexual violence; this review flags intravaginal PT as a trauma conflict for pelvic pain patients

Journal: Gynécologie, Obstétrique, Fertilité & Sénologie | Published: 2025-12-17 | Type: Review | PMID: 41419155 Authors: Juliette Quentin (Sorbonne Université, Paris; Le Bouscat, France) Funding/COI: Funding not reported; author declares no conflicts of interest

Summary

This single-author narrative review examines pelvic floor physical therapy for women with genito-pelvic pain and penetration disorders (vaginismus, dyspareunia) who have a history of sexual violence. The core tension: standard rehabilitation techniques often involve intravaginal manual therapy, which can be retraumatizing for this population. The paper calls for adapted assessment and treatment protocols but offers no new clinical data.

Claims

• Approximately 15% of women in France report experiencing sexual violence during their lifetime
• Chronic pelvic pain, genito-pelvic pain, and penetration disorders are frequently associated with a history of sexual violence
• Gynecological examinations are documented to increase anxiety and pain in women with histories of sexual violence
• Pelvic floor physical therapy, which commonly includes intravaginal techniques, requires specific adaptations for trauma survivors
• A multidisciplinary approach is described as necessary for this population

Study Quality

This is a narrative review with no reported search strategy, no inclusion/exclusion criteria, and no PRISMA flow. There is no original data. The abstract does not specify how many papers were reviewed, which databases were searched, or how evidence quality was assessed. For a review addressing a population with genuine clinical stakes, the methodological transparency is thin.

Single-author, single-institution work with no funding disclosure. The conclusions are largely descriptive and hortatory rather than evidence-synthesizing — the paper tells us a problem exists without quantifying how large it is or which adapted protocols have been tested.

Red Flags

• Narrative review with no disclosed search methodology — selection bias cannot be evaluated
• No sample sizes, effect sizes, or statistical data anywhere in the abstract
• Single author with no independent review of literature selection
• Full text is in French; English abstract only — limits accessibility and verification
• No funding disclosure
• "Adapted protocols are needed" is asserted without presenting evidence for what those protocols should be or whether any have been evaluated

Strengths

• Identifies a clinically real and underexamined tension between standard intravaginal PT techniques and trauma-informed care
• The 15% lifetime prevalence figure grounds the scope of the problem
• No financial conflicts of interest declared
• French-language clinical literature on this intersection is sparse; indexing this topic in PubMed has some value

Verdict

A genuine clinical problem — that pelvic floor PT's standard intravaginal techniques sit badly with trauma-informed care — gets a methodologically insubstantial treatment. The paper reads as a scoping opinion piece rather than a review that advances the evidence base. Clinicians in this space already know the tension exists; what's needed is protocol evaluation data, not another call for multidisciplinary care. The lack of a search strategy and the absence of any quantitative synthesis make this paper useful mainly as an entry point for a reading list, not as evidence for clinical practice.