Effects of Extracorporeal Shockwave Therapy Versus Pulsed Electromagnetic Field Therapy in Females With Sexual Dysfunction: a Randomized Controlled Trial

Inclusion Criteria: Female participants aged 20-50 years diagnosed with female sexual dysfunction (FSFI score \<26.55), reporting symptoms of reduced sexual desire, arousal dysfunction, orgasmic dysfunction, or dyspareunia. Premenopausal women in a stable sexual relationship for at least 6 months and sexually active during the previous month. Symptoms persisting for at least 3 months before enrollment. Ability to understand study procedures and provide written informed consent. Willingness to refrain from initiating any additional treatment for sexual dysfunction during the study period Exclusion Criteria: Pregnancy or planned pregnancy during the study period. Pelvic surgery within the previous 6 months. Active pelvic inflammatory disease, genital infection, or unexplained vaginal bleeding. Neurological disorders affecting pelvic floor or sexual function. Severe pelvic organ prolapse, severe urinary incontinence, or significant pelvic anatomical abnormalities. Current hormonal therapy or use of medications known to affect sexual function, including antidepressants or antipsychotics. Severe psychiatric disorders or cognitive impairment limiting participation. Menopause or perimenopausal status. Uncontrolled systemic diseases such as diabetes mellitus, hypertension, cardiovascular disease, or thyroid disorders. Presence of malignancy, pelvic radiation history, or severe chronic pelvic pain disorders. Contraindications to ESWT or PEMF including cardiac pacemakers or i…