Dyspareunia is a genital or pelvic pain occurring before, during, or after sexual intercourse and it can be localized superficial or deep in the pelvis. This condition is often linked to pelvic floor dysfunctions such as vaginismus, muscle hypertonicity, or myofascial trigger points that cause involuntary contraction or persistent tension that makes intercourse painful. It can also result from medical conditions such as endometriosis or pelvic inflammatory diseases, as well as infections, inflammation, vaginal dryness related to low estrogen, or local trauma. At the same time, psychological factors like stress, anxiety, or relationship issues may further increase muscle tension and intensify the pain.
The aim of this study is to observe the effects of radiofrequency in the treatment dyspareunia and its benefits on improving the quality of sexual function and also if there are differences between nulliparous and parous women.

The actual study included 15 patients with symptoms related to superficial or deep dyspareunia where the main cause of the pain was muscle tension or childbirth trauma. For the treatment we used radiofrequency or TECAR (Transfer of Energy Capacitive and Resistive) that is a conservative treatment aimed to accelerate tissue healing, decrease the nociceptive stimuli and increase the vasorelaxation due to three main effects - diathermy, biological and analgesic . The patients completed 7 to 10 sessions of TECAR therapy 2 times/week, 15 minutes/session. The protocol included two main steps (Fig 1). After positioning the return plate at the sacral region, the first step was to apply the current extravaginally using capacitive (CET) and resistive (RET) electrodes, following the second step where using a bracelet placed on the forearm, the physiotherapist performed perineal massage reaching the superficial and deep pelvic floor muscle insisting on the muscle tensions, trigger points and sensitive spots that the patient’s had indicated. The diathermy we used for the protocol was set at a maximum of 30%, a standard frequency between 500-300KHz (CET-RET) where control parameters of the signals was low intensity and soft modulation of the impulse. To evaluate the outcomes the patients completed Female Sexual Function Index (FSFI) before and after the procedure. Through the analysis we compared the initial and final questionnaire scores and also highlighted the quality of the sexual activity and pain related to penetration.

Fifteen participants were enrolled, of whom 14 had baseline data (8 nulliparous, 6 parous), with a median age of 29 years (IQR 28–31.5). Baseline FSFI-SF scores, quality of life, and penetration pain were comparable between groups. In the overall cohort (n=12 with paired data), the median FSFI-SF score increased from 17 (IQR 15–19.2) to 22 (IQR 19.5–23.2), corresponding to a median change of +3.5 (p=0.0005). Quality of life improved from 2 (IQR 1.8–3) to 4 (IQR 4–4.2), with a median increase of +2 (p=0.0010). Penetration pain decreased from 5 (IQR 4.8–5) to 2 (IQR 1–2.2), representing a median reduction of −3 (p=0.0005).

FSFI-SF scores increased by +3 and +5 points, quality of life by +1.5 and +2 points, and penetration pain decreased by −2.5 and −4 points, respectively. Between-group differences were not statistically significant. Overall, 81.8% of participants achieved a clinically meaningful pain reduction (≥2 points), including 66.7% of nulliparous and 100% of parous women (p=0.455).

Radiofrequency represents a non-invasive and accessible procedure for treating dyspareunia. Even if our study was small, the outcomes regarding parous women has been satisfactory especially when taking into consideration the presence of childbirth trauma and the pain related to the post episiotomy scar. Overall, the findings have shown a positive impact on quality of intercourse in both groups and the pain related to penetration was significantly lower after the sessions.

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Ghaderi, F., Bastani, P., Hajebrahimi, S., Asghari Jafarabadi, M., & Berghmans, B. (2019). Pelvic floor rehabilitation in the treatment of women with dyspareunia: A randomized controlled clinical trial. International Urogynecology Journal, 30(11), 1849–1855. https://doi.org/10.1007/s00192-019-04019-3
Lupowitz, L. G., Ramus, L., Delacour, F., & Johnson, K. (2025). TECAR Therapy: A Clinical Commentary on its Evolution, Application, and Future in Rehabilitation. International Journal of Sports Physical Therapy, 20(4), 632–640. https://doi.org/10.26603/001c.130909