Vaginal massage in sexual medicine and pelvic health: a narrative review.

Abstract

Introduction: Vaginal massage comprises a range of manual therapeutic techniques involving internal and external manipulation of vaginal and pelvic floor tissues. Although used in pelvic floor rehabilitation, manual therapy, and complementary medicine, its role in sexual medicine and women's pelvic health has not been comprehensively reviewed. This review summarizes and evaluates the current evidence regarding the therapeutic applications, clinical outcomes, and research gaps associated with vaginal massage.

Methods: A narrative review was conducted using 8 electronic databases. Searches included the terms "vaginal massage", "pelvic massage", "pelvic floor massage", "gynecological massage", "gynecology massage", "vaginal acupressure", and "Yoni massage". Following predefined eligibility criteria, 14 clinical studies and case reports were included and synthesized narratively.

Results: The studies were grouped into 4 clinical domains: sexual health (5 studies), pelvic floor dysfunction (PFD) (2), chronic pelvic pain (CPP) (4), and pelvic organ prolapse and uterine malposition (3). Across these conditions, vaginal massage was associated with improvements in sexual function, orgasmic capacity, dyspareunia, pelvic floor muscle function, CPP, prolapse-related symptoms, and quality of life. Proposed mechanisms included myofascial release, trigger point deactivation, improved tissue mobility and circulation, reduced pelvic floor hypertonicity, and enhanced body awareness. However, the evidence was limited by small sample sizes, heterogeneous massage techniques, poorly standardized protocols, multimodal interventions, and a predominance of case reports and uncontrolled studies.

Discussion: Current evidence suggests that vaginal massage may be a useful adjunct to multidisciplinary management of selected sexual and pelvic floor disorders, particularly CPP and PFD. However, its efficacy remains uncertain because of methodological limitations and inconsistent reporting of treatment protocols. Well-designed randomized controlled trials with standardized interventions, validated outcome measures, and explicit reporting of ethical safeguards are needed to establish the efficacy, safety, and clinical role of vaginal massage in sexual medicine and pelvic health.