Connective Tissue Massage Improves Symptoms, Autonomic Dysfunctions and Wellbeing in Erectile Dysfunction: A Randomized Controlled Trial

Background One of the most common sexual dysfunctions in men is erectile dysfunction (ED). Connective tissue massage (CTM) is a physiotherapy approach that produces autonomic response through cuteno-visceral reflexes. However, there are no studies investigating the effect of CTM on erectile functions. To investigate the effects of CTM on symptom severity, autonomic dysfunction severity and wellbeing such as psychological status and quality of life in individuals with ED. Methods This randomized controlled study included sexually active individuals aged 20–65 years with ED. They were divided into 2 groups as CTM (n = 15, age = 44.67 years, body mass index = 25.51 kg/m ² ) and control (n = 15, age = 45.67 years, body mass index = 28.07 kg/m ² ) groups. The control group received standard treatment and the CTM group received CTM 3 days a week for 4 weeks in addition to standard treatment. ED severity (International Index of Erectile Function (IIEF-5)), autonomic dysfunction symptoms (Composite Autonomic Symptom Score (COMPASS-31)), psychological status (Depression Anxiety Stress Scale (DASS-21)), and quality of life (Quality of Life-Short Form Survey (SF-36)) were evaluated before and after the intervention. The study began in December 2023 and ended in December 2024. Results When the pre- and post-intervention scores of the groups were compared, IIEF-5 (p = 0.018), SF-36-physical (p = 0.004) and SF-36-mental health (p < 0.001) scores increased, COMPASS-31 (p = 0. 005), DASS-21-anxiety (p = 0.015) and DASS-21-stress scores (p = 0.013) decreased in the CTM group, while there was no significant change for any parameter in the control group (p > 0.05). Moreover, IIEF-5 (p = 0.037) and SF-36-mental health (p = 0.002) scores were higher, COMPASS-31 (p = 0.037) and DASS-21-depression (p = 0.049) scores were lower in the CTM group compared to the control group. Conclusion CTM was found to improve ED and autonomic dysfunction severity, psychological status and quality of life in individuals with ED. According to these results, CTM can be used as a complementary application in the treatment of ED.