Primary dysmenorrhea (PD) is a very common gynecological disorder affecting 84.1% of women during childbearing age. The most common symptoms of PD include lower abdominal pain that can radiate to both thighs and/or to the low back. Other symptoms include tiredness, headache, nausea, constipation, and diarrhea. The condition precedes menstruation (in the absence of any organic pathology) and lasts approximately 48-72 hours. Primary dysmenorrhea is the most common reason for absenteeism from work or school, thus interfering with quality of daily life, which is associated with many direct and indirect costs.
There have been MANY proposed interventions for PD reported in the scientific literature. Most common are non-steroidal anti-inflammatory drugs (NSAIDs) and oral contraceptives, as both work similarly—they affect the cause of pelvic pain, which is reportedly mediated by the hormone-like fatty acid called prostaglandin factor 2x. However, both approaches carry negative side effects such as bleeding in the gut and hormone issues such as bloating and edema, respectively. Thus, the demand for new and alternative approaches with less associated risks has increased.
Spinal manipulative (SM) techniques for PD has been previously studied and proven to have positive benefits on pain perception and menstrual cramps, as well as affecting plasma (blood) levels of some chemical pain mediators. However, there appears to be a lack of agreement on where spinal manipulation should be applied. One study recommended that SM should be applied to the lumbosacral region (L5-S1) for symptom reduction in dysmenorrhea.
A more recent study found that “global pelvic manipulation” (GPM) performed on both sides of the pelvis to mobilize the sacroiliac joint (SIJ) and L5-S1 facet joint resulted in improvements related to low back pain and pressure pain thresholds in the SIJ, with a significant increase in serotonin.
Doctors of chiropractic specialize in the use of spinal manipulation therapy and are trained in many different techniques of lumbo-pelvic manipulation. For those struggling with PD, including a chiropractor as a member in your healthcare “team” makes perfect sense!
