The Effect of Foot Reflexology on the Sexual Function of Lactating Women

Reflexology (originally called ‘zone therapy’ by its inventor) is a manual technique where pressure is applied to the sole of the patient’s foot (and sometimes also other areas such as the hands or ears). It must be differentiated from a simple foot massage that is agreeable but makes no therapeutic claims beyond relaxation. Reflexology is said to have its roots in ancient cultures. Its current popularity goes back to the US doctor William Fitzgerald (1872–1942) who did some research in the early 1900s and thought to have discovered that the human body is divided into 10 zones each of which is represented on the sole of the foot.

Reflexologists thus drew maps of the sole of the foot where all the body’s organs are depicted. Numerous such maps have been published and, embarrassingly, they do not all agree with each other as to the location of our organs on the sole of our feet. By massaging specific zones which are assumed to be connected to specific organs, reflexologists believe to positively influence the function of these organs. Reflexology is mostly used as a therapy, but some therapists also claim they can diagnose health problems through feeling tender or gritty areas on the sole of the foot which, they claim, correspond to specific organs.

The assumptions made by reflexologists contradict our current knowledge of anatomy and physiology and are thus not biologically plausible. Reflexology has been submitted to clinical trials in numerous different conditions. A systematic review concluded that “the best clinical evidence does not demonstrate convincingly reflexology to be an effective treatment for any medical condition.” Recent review tend to be more positive suggestin, for instance, that foot reflexology produced significant improvements in sleep disturbances , or that reflexology may provide additional nonpharmacotherapy intervention for adults suffering from depression, anxiety, or sleep disturbance. However, due to the poor quality of most of the primary studies, such statements must be interpreted with caution.
[references see my book]

This randomized clinical trial investigated the effect of foot reflexology on the sexual function of lactating women. It was conducted in selected health centers of Isfahan in 2022 on 64 lactating women (32 women in each group of intervention and control). The samples were selected using the convenience sampling method and were randomly divided into two groups using a random number table. Each participant in the intervention group received 10 sessions of foot reflexology, and each session lasted for 50 minutes (25 minutes for each foot) and was held every three days. The female sexual function index (FSFI) questionnaire was completed by all participants before the intervention and four weeks after the end of the treatment period. The control group received routine care and completed the questionnaire before the intervention and 9 weeks later. Data were analyzed using SPSS version 20 and independent/paired t-tests.

Results showed that the subjects of the two groups were homogeneous in demographic and fertility characteristics at the beginning of the study. The total mean score of sexual function in the intervention group was 20.36 ± 4.16 before the intervention and 28.05 ± 2.89 after the intervention. In the control group, this score was 20.51 ± 3.75 before the intervention and 20.54 ± 3.71 nine weeks after it. A comparison of the total mean score of sexual function and dimensions showed a significant difference between the two groups four weeks after the intervention (p <0.001). In the intervention group, significant changes were observed in the total mean score of sexual function and its dimensions four weeks after the intervention compared to before the intervention. However, in the control group, there were no significant changes in this score and its dimensions nine weeks later compared to before the intervention.

The authors concluded that lactating women in the two groups did not have a desirable sexual function before the intervention. However, foot reflexology in the present study could effectively improve the sexual function of women in the reflexology group. Therefore, it is recommended to employ foot reflexology therapy in health centers to help lactating women restore their sexual function.

This conclusion might hold if we assume that firstly reflexology was a plausibe therapy (which it is not, see above) and secondly postulated that patient-blinding and placebo effects (features that the present trial did not have) are unimportant in such a study. Yet, the latter assumption cannot be true. A total of 500 minutes of a foot massage must surely prompt a placebo response! Therefore, the notion that the reflexology treatment caused the observed outcomes is unwarranted – almost certainly the effects were mainly due to placebo.

So, what we have here is a hugely over-optimistic conclusion, something we all long got used to in the realm of so-called alternative medicine (SCAM). But far worse, in my view, is the fact that the authors do not even leave it at that. They also issue a gerneral and far-reaching recommendation for foot reflexology as a means for restoring sexual function to lactating women.

This is not just poor science, it is stupid and irresponsible!