Connective tissue massage improves symptoms, autonomic dysfunctions and wellbeing in erectile dysfunction: a randomized controlled trial

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. 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. 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, DASS-21-anxiety and DASS-21-stress scores decreased in the CTM group, while there was no significant change for any parameter in the control group. Moreover, IIEF-5 ( p = 0.037) and SF-36-mental health ( p = 0.002) scores were higher, COMPASS-31 and DASS-21-depression scores were lower in the CTM group compared to the control group. This study provides preliminary evidence that CTM may improve ED symptom severity, autonomic dysfunction, and wellbeing. These findings require confirmation in larger, long-term trials with active control groups before any clinical recommendations can be made. ClinicalTrials.gov, TRN: NCT06163157, Registration date: 21 December 2023.