General Gynecology · Pelvic Pain
Kohli N, Jarnagin B, Stoehr AR, Lamvu G
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This research is the first to evaluate the effectiveness of trans-vaginal photobiomodulation therapy (TV-PBMT) for chronic pelvic pain.
Observational analysis of 128 women, undergoing TV-PBMT for chronic pelvic pain. Minimal clinically important difference, defined as ≥2-point drop on a 0-10 numeric pain rating scale (NPRS), and effect size Cohen d coefficient, was calculated over nine treatments for overall pain, and pain with activities.
Compared with baseline, 64.5% of women showed improvement in overall pain, pain with bowel movement, intercourse, exercise, urination, sitting and vulvar pain (minimal clinically important difference = -2.4, -2.0, -2.4, -2.1, -2.1, -2.0, -3.1; d = 0.9, 0.7, 0.9, 0.7, 0.7, 0.7, 0.9) by treatment 9.
In this cohort, TV-PBMT resulted in improvement of pelvic pain without serious adverse events.
Butrick CW et al., 2022 · Urology
Interstitial Cystitis/ Bladder Pain Syndrome (IC/BPS) is characterized by pelvic/bladder pain, associated with pelvic muscle tenderness, urgency, frequency, and dysuria. Prior studies show that transvaginal photobiomodulation (TV-PBM) reduces pain in women with chronic pelvic pain (CPP). Our objective was to obtain preliminary data on treatment effect and adherence, in women with IC/BPS who selected TV-PBM therapy for management of pelvic pain. Before-and-after observational cohort study of women with IC/BPS who received TV-PBM in 17 US practices. Pain was measured using a 0-10 numeric rating scale (NRS). The primary outcome was a minimal clinical important difference (MCID); reduction of overall pelvic pain severity by ≥2 NRS points from baseline compared to after 8 treatments. Cohen d coefficient measured effect size (low effect size d<0.2, medium 0.20.8). Of 140 patients with IC/BPS who self-selected to start TV-PBM therapy, 89.3% (n=125) completed 4 treatments and 59.3% (n=83) completed 8. Improvement ≥1 NRS point was reported by 73.5% (n=61) and meaningful improvement (≥2 points) was reported by 63.9% (n=53) after 8 treatments. In this group, patients with severe / moderate pain decreased from 83.1% (n=44) to 38.5% (n=20); p<0.001. Pain levels decreased as follows: overall pelvic pain MCID=-2.7, d=1.07, pain with urination MCID=-2.6, d=1.0; pain with exercise MCID=-2.6, d=0.91, pain with intercourse MCID=-2.5, d=0.82. In real-world clinical settings, 2/3 women with IC/BPS who opted to undergo TV-PBM therapy reported significant decrease in pelvic pain and dysuria. These findings are promising; however, controlled studies are needed.
Zipper R et al., 2021 · Women's health reports (New Rochelle, N.Y.) · Free full text on PubMed Central
Chronic pelvic pain (CPP) is a common and debilitating condition that affects millions of U.S. women. Most treatments are ineffective and innovative new therapies are desperately needed. Large, controlled studies show that photobiomodulation (PBM) can reduce pain in patients with other chronic pain conditions, such as low back pain, neck pain, and fibromyalgia. The objective of this pilot study was to determine if transvaginal PBM (TV-PBM) can reduce pain in women with CPP. We conducted a before and after, observational, pilot study. Patients completed the Short Form-McGill Pain Questionnaire (SF-MPQ) at baseline, 1 week, 3 months, and 6 months after nine treatments of TV-PBM. Clinicians completed the Clinical Global Impression Scale (CGI) assessing patient illness severity at the same time. Wilcoxon rank-sum t-tests and effect size using Cohen's d coefficient (low effect size if d < 0.2, medium if 0.2 < d > 8, and high if d > 0.8) was used to measure degree of pain improvement, which was also considered clinically significant if pain reduction was >30%. Thirteen women completed 9 treatments, and 10 women were successfully followed to 6 months. At baseline, the mean SF-MPQ score was 19.7 (standard deviation [SD] ± 5.9). Compared with baseline, 60% improved; the mean SF-MPQ score decreased to 10.0 (SD ±7.5, p = 0.004, d = 1.6) at 1 week after treatment, to 9.7 (SD ±7.9, p = 0.005, d = 1.7) at 3 months, and 8.2 (SD ±8.1, p = 0.002, d = 1.9) at 6 months. Transvaginal PBM provided significant and sustained pain relief to women with CPP up to 6 months. Further controlled studies are needed to confirm these findings, however, in this initial pilot, TV-PBM shows promise.
Yeung PP Jr et al., 2013 · JSLS · Free full text on PubMed Central
To serve as a pilot feasibility study for a randomized study of excision versus ablation in the treatment of endometriosis by (1) estimating the magnitude of change in symptoms after excision only at multiple referral centers and (2) determining the proportion of women willing to participate in a randomized trial. We performed a multicenter prospective study of women undergoing excision for endometriosis (Canadian Task Force class II-3) at Duke University Center for Endometriosis Research & Treatment (currently the Saint Louis University Center for Endometriosis), Center for Endometriosis Care, Northshore University Health System, Memorial University (Canada), and Florida Hospital. The study comprised 100 female patients, aged 18 to 55 years, with endometriosis-suspected pelvic pain. The intervention was laparoscopic excision only of the abnormal peritoneum suspicious for endometriosis. The main outcome measures were quality of life, pelvic pain, dysmenorrhea, dyspareunia, and bowel and bladder symptoms. The mean follow-up period was 8.5 months. Excision of endometriosis showed a significant reduction in all pain scores except bowel symptoms, as well as significant improvement in quality of life. Of the patients, 84% were willing to participate in a randomized study. Quality of life is a needed primary outcome for any randomized study comparing excision versus ablation. A multicenter comparative trial is feasible, although quality assurance would have to be addressed. Patients were willing to be randomized even at surgical referral centers.
Vieira LR et al., 2026 · Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
Breast cancer survivors undergoing hormone therapy frequently experience vaginal pain and sexual dysfunction, which negatively affect quality of life. These symptoms are often undertreated, and new therapeutic approaches are needed. To evaluate the effects of photobiomodulation (PBM) on vaginal pain, sexual function, safety, and tolerability in women with breast cancer undergoing hormone therapy. A prospective, quasi-experimental clinical study was conducted with 24 women presenting hormone therapy-induced sexual dysfunction, who underwent four weekly intra- and extra-cavitary PBM sessions (blue LED-440 nm, 8 min; red LED-660 nm, 20 min). Eight eligible participants who declined the intervention due to embarrassment were followed as an untreated observational group. Assessments were performed before and after the intervention using the Female Sexual Quotient Questionnaire (QS-F) and the Visual Analog Scale (VAS) for vaginal pain. At baseline, 82.6% of participants reported maximum vaginal pain (VAS = 10), and 78.2% presented absent or severely impaired sexual function. After four PBM sessions, 79.1% of the women reported complete absence of pain, with mean VAS scores decreasing from 9.46 ± 0.98 to 1.04 ± 2.17 (p < 0.0001). Sexual function also improved significantly, with mean QS-F scores increasing from 23.25 ± 23.47 to 87.21 ± 17.93 (p < 0.0001), and 95.8% of participants reporting good to excellent sexual function after treatment. The intervention was well tolerated, with no adverse events reported. The observational group showed no changes in the evaluated outcomes. PBM proved to be safe, well tolerated, and clinically effective in reducing vaginal pain and improving sexual function in women with breast cancer undergoing hormone therapy, representing a promising therapeutic alternative.
Abdoelmagd SR et al., 2025 · Photobiomodulation, photomedicine, and laser surgery
This study was conducted to investigate whether the addition of photobiomodulation therapy (PBMT) to pelvic floor exercises (PFEs) is more effective in treating postpartum coccydynia compared with either modality alone. Postpartum coccydynia is a widespread condition that significantly affects the quality of life. Inflammation as a response to childbirth trauma and weakening of the muscles and ligaments attached to the coccyx are presumed causes of postpartum coccydynia. Finding effective modalities to manage this condition will help the quality of life for most women. Sixty women aged 25-35 years with postpartum coccydynia ≥6 weeks were randomly allocated to Group A (PBMT + hot pack + PFEs), Group B (PBMT + hot pack), and Group C (placebo PBMT + hot pack + PFEs). All groups received 12 sessions over 4 weeks of hot packs plus their allocated active treatment (PBMT and/or PFEs). Outcomes were pain intensity (visual analog scale), lumbar flexion range of motion (ROM) (modified Schober test), and self-reported disability (Oswestry Disability Index). The assessors were blinded to group allocation. All the measured outcomes showed significant differences (p < 0.001), with the superiority of Group A over the other groups (p < 0.001). Within groups, all groups showed statistically significant improvement from baseline across outcomes (p < 0.05). Adding PBMT to PFEs is recommended in the management of postpartum coccydynia as this combination resulted in greater reductions in pain and disability, along with improved lumbar flexion ROM.
Forret A et al., 2023 · Bulletin du cancer
Anticancer treatments induce vulvovaginal complications that alter the quality of life and sexuality of patients. New technologies, such as photobiomodulation, could address this problem, for which few effective therapeutic solutions exist. The objective of this study was to describe the characteristics of patients seeking treatment and to observe the effects of photobiomodulation. This is a prospective cohort of patients treated for cancer, in failure of first-line medical treatment, managed at the University Hospital of Nîmes. The history, symptoms and impact of the disorders on their quality of life were collected. At follow-up, improvement was assessed using the PGI-I and FSFI questionnaires. Twenty-eight patients were treated. They were all menopausal, half of them after anticancer treatments [chemotherapy (78%), radiotherapy (36%), hormone therapy (36%)]. The main symptom reported was vaginal dryness (72%). Seventy-one percent of patients (n=20) felt that their daily life was affected≥8/10. All patients had sexual dysfunction. Twenty-two patients received at least 6 sessions of photobiomodulation. Seventy-two percent (n=18) of patients felt better or much better after treatment (PGI-I≤2). The median improvement estimated by the patients was 65% (Q1=50%; Q3=72.5%). There was also a significant clinical improvement. No serious adverse events were reported. Due to the small number of patients in a heterogeneous population with no control group, we cannot extrapolate our results. However, the objective was to assess the status of these pathologies and the contribution of photobiomodulation in patients who have failed first-line treatment; and these results are encouraging.
Moraes BHM et al., 2026 · Research Square (preprint)
Abstract To evaluate the effects of PBMT (λ = 660 nm) on pain, breastfeeding quality, and healing of nipple injuries. This randomized, double-blind, controlled pilot trial included 20 lactating postpartum women with nipple trauma. Participants were divided into PBMT (standard care + active PBMT) and Placebo (standard care + sham) groups. Interventions occurred up to seven sessions over 15 days. PBMT parameters: 660 nm, 40 mW, 10 J/cm², and 0.4 W/cm² for 10s per point (one central and four peripheral points). Assessments included the Visual Analogue Scale (VAS), LATCH Scale, Nipple Trauma Score (NTS), and photogrammetry. Most participants (90%) presented bilateral excoriations or fissures. The PBMT group showed significantly greater pain reduction from the third session onward (p < 0.05), achieving total analgesia by the seventh, whereas the Placebo group maintained higher VAS scores. Although both groups improved their breastfeeding technique, the PBMT group showed superior post-intervention LATCH scores. Furthermore, PBMT significantly accelerated tissue repair from the third session onward. The PBMT group reached complete lesion regression (NTS = 0), while the Placebo group maintained residual trauma (NTS = 1). PBMT combined with clinical management is effective for pain relief, tissue repair, and improving breastfeeding quality. It serves as a promising adjuvant resource to prevent complications and support the maintenance of exclusive breastfeeding.