Pelvic Massage Research Articles

(501) Past and Present Applications of Therapeutic Pelvic Massage

Abstract Introduction Pelvic massage is remarkable for being one of the oldest and most durable therapeutic medical practices, used for the treatment of genital disease from the Ancient world until the present day. Although it is most commonly associated with diseases of women, especially the historical diagnosis of hysteria, in our modern era pelvic massage is used to treat disease in all human beings regardless of sex. Through the progress of medical specialization and technology, pelvic massage has evolved to become a specialist tool utilized by a subset of physical therapists, augmented by instruments such as wands and especially vibrators. Objective To describe how the justification for and application of therapeutic pelvic massage has evolved through the Western history of medicine, as a lens through which to appreciate the limitations of our contemporary understanding of this practice. Methods Review of primary and secondary sources pertaining to pelvic massage as a treatment for disease, in historical and contemporary medical professional and popular literature. Results Since the earliest documented use of therapeutic pelvic massage to treat female patients in Ancient Egyptian medical texts, doctors have recommended internal and external genital stimulation for various reasons. For most of Western medical history, this intervention was principally used to treat various symptoms that were diagnosed as hysteria in female patients, according to the logic that a wandering womb or collection of ill-humors could be stimulated to migrate into proper position through this means. During the past century, our medical scientific understanding of women’s bodies has expanded beyond hysteria ideology, to better appreciate the anatomic and physiologic similarities between male and female genital and pelvic structures and disease conditions. This evolution has been accompanied by an expansion of the patient populations perceived to benefit from pelvic massage, to include not only females of reproductive age, but older women, men, and transgender patients. Ironically, at the same time that therapeutic pelvic massage has come to rest on a more scientifically sound foundation, its use by urologic and gynecologic surgeons decreased, and it is now practiced primarily by pelvic physical therapists and self-administered by patients utilizing pelvic wand and vibratory technologies. Conclusions Pelvic massage has stood the test of time as an empiric treatment for various diseases, but its etiologic justification has changed significantly over millennia. Whereas previously it was believed to treat specifically uterine disorders in hysterical women, it is now understood to affect the muscle and connective tissues of the pelvic floor, as well as secretory genital structures such as the vagina and prostate. Whether because of its previous attachment to now-defunct hysteria ideology or its current administration by non-physicians, the scientific study of pelvic massage continues to lag behind its application. As referrals to pelvic physical therapy and pelvic wand and vibrator sales increase, further study of the indications for and effects of these interventions is warranted to ensure the ethical and effective application of these resources. Disclosure No

Rebozo Technique for Fetal Malposition in Labor.

Fetal occiput posterior position is associated with increased maternal and fetal morbidities. Currently, clinicians have limited evidence-based techniques or tools to remedy fetal occiput posterior position. The traditional Mexican rebozo technique of pelvic massage, sifting, or jiggling offers a potentially valuable tool to help correct fetal malposition. This article reviews the adaptation of 3 rebozo techniques that can be used in labor to encourage optimum fetal positioning; outlines hospital considerations for safety, fetal heart rate monitoring, and universal precautions; and reviews the implementation plan to introduce and sustain use of the rebozo in a large academic medical center.

Persistent Genital Arousal Disorder in Women: What is Known and What is Unknown

Persistent Genital Arousal Disorder (PGAD) is a relatively newly identified and perplexing condition characterized by high levels of unrelenting genital arousal occurring in the absence of subjective interest or desire. This arousal can persist for hours, days or even weeks, despite attempts to relieve it with sexual activity or orgasm which at best provide only brief attenuation of the symptoms. The PGAD diagnosis is made based on the presence of four features (persistent genital arousal, genital arousal unrelated to subjective desire, arousal which persists despite one or more orgasms, arousal feels intrusive). Subjective distress is rated as at least moderate or severe (a score of 2 or 3 on a scale where 0= no distress and 3= extreme distress). The shame and embarrassment attached to the symptoms most likely has contributed to the phenomenon going unrecognized nd underreported until recently. Complaints by sufferers can include clitoral tingling, irritation, vaginal congestion, vaginal contractions, throbbing, pressure and pain, as well as spontaneous orgasms in some cases. Attempts to quell the genital arousal by engaging in masturbation or sexual activity often leads to brief relief, no relief, or even more arousal and activation. Compared to non-PGAD women, PGAD patients exhibit overall lower levels of sexual satisfaction, lower desire and greater pain on the Female Sexual Functioning Inventory (FSFI). They also evidence a higher incidence of anxiety, depression and obsessive symptoms than non-PGAD women. These conditions seem to pre-date rather than result from their symptoms No definitive physical, hormonal or neurological associations have been identified as causing the disorder and there is no evidence of any particular medical condition associated with PGAD with the exception that women complaining of PGAD are more likely to report chronic fatigue. A relatively high percentage of women with PGAD than non-PGAD women report having used selective serotonin reuptake inhibitors, atypical anti-depressants or tricyclic antidepressants either in the past or currently although there is no clear evidence linking the use or discontinuation of these agents with the syndrome. Although psychological factors are clearly implicated in the maintenance, if not always the genesis of the condition, there is evidence that there are brain changes associated with the report of genital arousal. Specifically, preliminary fMRI data on a small pilot sample of women indicate that there is a high level of brain activity in and extending into the posterior cingulated cortex, a region of the brain that is reported to respond to pain and itch. The fact that these fMRI findings occur in the absence of direct physical stimulation of the genitalia suggest that the symptoms of PGAD are “real” and “physiological” rather than “imaginary.” At this time, there are many unknowns about PGAD: prevalence figures are uncertain, although it is likely that there are more cases than are reported. The etiology is unknown although there are many hypotheses including a) central neurological changes (e.g., post-injury, specific brain lesion anomaly), b) peripheral neurological changes (e.g., pelvic nerve hypersensitivity or entrapment), c) vascular changes (e.g., pelvic congestion), d) mechanical pressure against genital structures, e) medication-induced changes, and f) psychological changes (stress) or some combination of all of the above. There is no generally accepted treatment for PGAD and current interventions focus largely on symptom management. Anesthetizing agents may be used initially to numb the area and pelvic massage or stretching exercises may help reduce or eliminate pelvic tension and disrupt connective tissue strictures that may contribute to the condition. Medication treatment is largely achieved by trial and error, as certain medications may be associated paradoxically with either alleviation or exacerbation of the symptoms. Cognitive-Behavioral interventions have been used to enhance coping skills and assist in interrupting the cycle of anxiety and catastrophizing of the symptoms. This cycle plays a significant role in PGAD, for anxiety worsens the symptoms by leading to increased autonomic activation, which may, in turn, lead to greater genital arousal. More research is clearly needed to clarify the prevalence, etiology and treatment of this perplexing and distressing condition.

Clinical holistic medicine: Pilot Study on the Effect of Vaginal Acupressure (Hippocratic pelvic massage)

Clinical holistic medicine: Pilot Study on the Effect of Vaginal Acupressure (Hippocratic pelvic massage)

Clinical Holistic Medicine: Holistic sexology and acupressure through the vagina (Hippocratic pelvic massage)

Clinical Holistic Medicine: Holistic sexology and acupressure through the vagina (Hippocratic pelvic massage)

Clinical Holistic Medicine: Holistic Sexology and Acupressure Through the Vagina (Hippocratic Pelvic Massage)

Many gynecological and sexological problems (like urine incontinence, chronic pelvic pains, vulvodynia, and lack of lust, excitement, and orgasm) are resistant to standard medical treatment. In our work at the Research Clinic for Holistic Medicine in Copenhagen, we have found that vaginal acupressure, or Hippocratic pelvic massage, can help some of these problems. Technically, it is a very simple procedure as it corresponds to the explorative phase of the standard pelvic examination, supplemented with the patient's report on the feelings it provokes and the processing and integration of these feelings. Sometimes it can be very difficult to control the emotions released by the technique, i.e., regression to earlier traumas from childhood sexual abuse. This review discusses the theory behind vaginal acupressure, ethical aspects, and presentation of a case story. This procedure helped the patient to become present in her pelvis and to integrate old traumas with painful emotions. Holistic gynecology and sexology can help the patient to identify and let go of negative feelings, beliefs, and attitudes related to sex, gender, sexual organs, body, and soul at large. Shame, guilt, helplessness, fear, disgust, anxiety, anger, hatred, and other strong feelings are almost always an important part of a sexual or functional problem as these feelings are “held” by the tissue of the pelvis and sexual organs. Acupressure through the vagina/pelvic massage must be done with great care by an experienced physician, with a third person present, after obtaining consent and the necessary trust of the patient. It must be followed by conversational therapy and further holistic existential processing.

Clinical Holistic Medicine: Pilot Study on the Effect of Vaginal Acupressure (Hippocratic Pelvic Massage)

This is a pilot study of 20 female patients with a long history of sexual problems (mean is 8.92 years) who received vaginal acupressure (VA) with a quantitative and qualitative evaluation: 56% experienced help and none reported setbacks, 89% rated the treatment to be of high quality, and 89% rated it as valuable. After the treatment, most reported their problems to be less serious and their general quality of life improved. Only 17% reported minor or temporary side effects. VA was found statistically and clinically significant (p < 0.05, improvement more than 0.5 step on a 5-point Likert scale) to help patients with chronic genital pains, pain or discomfort during sexual intercourse, lack of desire or orgasm, and subjective sexual insufficiency, and all patients taken as one group (about 1 step up a 5-point Likert scale). Self-evaluated physical and mental health was significantly improved for the total group; the relationship with partner, the subjective sexual ability, and the quality of life that were measured with QOL1 and QOL5 questionnaires were all significantly improved. VA or Hippocratic pelvic massage is technically a simple procedure corresponding to the explorative phase of the standard pelvic examination, supplemented with the patient’s report on the feelings provoked followed by processing and integration of these feelings, but ethical aspects are complicated. Acupressure through the vagina/pelvic massage must be done according to the highest ethical standard with great care, after obtaining consent and the necessary trust of the patient within the framework of the local laws. It must be followed by conversational therapy and further holistic existential processing.

The Technology of Orgasm: "Hysteria," the Vibrator, and Women's Sexual Satisfaction.

From the time of Hippocrates until the 1920s, massaging female patients to orgasm was a staple of medical practice among Western physicians. Hysteria, an ailment considered common and chronic in women, was thought to be the consequence of sexual deprivation. Doctors performed the routine chore of relieving patient's symptoms with manual genital massage until the women reached orgasm, or, as it was known under clinical conditions, the hysterical paroxysm. The vibrator first emerges as an electromechanical medical instrument in direct reponse to demand from physicians who, far from enjoying the implementation of pelvic massage, sought every opportunity to substitute the services of midwives and, later, the efficiency of mechanical devices. In this volume, the author offers a candid account of why such treatments were socially and ethically permissible for doctors and why women were believed to require them. She explores the diagnosis of hysteria in Western medicine thorughout the ages and examines the characterization of female sexuality as a disease requiring Medical authorities, she writes, were able to defend and justify the clinical production of orgasm in women as necessary to maintain the dominant view of sexuality, which defined sex as penetration to male orgasm - a practice that consistently fails to produce orgasm in a majority of the female population. This male-centred definition of satisfying and healthy coitus shaped not only the development of concepts of female sexual pathology but also the instrumentation designed to cope with them. Invented in the late 1880s by a British physician, the vibrator was popular with turn-of-the-century doctors as a quick, efficient cure for hysteria that neither fatigued the therapist nor demanded skills which were difficult to acquire. Some entrepreneurs even opened vibratory operating theatres. Maines describes in detail the wide range of vibratory apparatus available to physicians by 1900, from low-priced foot-powered models to the Chattanooga, which cost $200 plus freight in 1904. She shows how women presented a large and lucrative clientele for doctors, and vibrators reduced, from about one hour to ten minutes, the time required for a physician to produce results, significantly increasing the number of patients he could treat in the course of a working day. These women were ideal patients in that they neither recovered nor died from their condition but continued to require regular medical treatment. Maine traces the vibrator from its beginning as a sanctioned therapeutic instrument to its fall from respectability and disappearance from medical offices - after appearing in stage films in the 1920s - to its re-emergence in the 1960s as a sex aid.

A CLINICAL STUDY IN PELVIC MASSAGE.

The purpose and scope of this paper is not to discuss the merits or demerits of pelvic massage. This is a matter which will necessarily follow the adoption of any new treatment, and especially one that is in any way open to objection. At the very threshold of this subject it is easy to anticipate the objections which are likely to be raised relative to the handling of organs and tissues which are the local seat of sexuality and passion. Yet that liberality which characterizes the true physician and surgeon will always seek to find the level by which any new treatment can be taken. Therefore, it is not for any one to emphasize or declare the status of a treatment which must be judged entirely upon those results which accrue from its practical application. Accordingly, this paper will not only deal with the positive but with the negative results,

The Brandt Method of Pelvic Massage — Treatment of Diphtheria by Frequent Small Doses of Biniodide of Mercury — Scaling the Appropriation for the Library of the Surgeon-General's Office — Medical Notes

Editorial from The New England Journal of Medicine — The Brandt Method of Pelvic Massage — Treatment of Diphtheria by Frequent Small Doses of Biniodide of Mercury — Scaling the Appropriation for the Library of the Surgeon-General's Office — Medical Notes