Pelvic Disorders & Dysmenorrhea (Painful Menstruation)
by Dr. Scott J. Heun & Steve Troyanovich, D.C.(1)

In a study(2) published in The Journal of Manipulative and Physiological Therapeutics, it was found that a variety of gynecological, sexual and bowel disorders may be successfully managed under chiropractic care.

The most detailed report cited the case of a 41-year-old woman who had experienced several years of low back and pelvic disorders, including difficulty in urination. After chiropractic examination, it was determined that the woman had a disk herniation in the low back. Adjustment by a chiropractor brought relief from the pain and an end to her urinary problems.

In yet another study(3), forty-five women wilh a history of primary dysmenorrhea were randomly assigned to groups receiving either side posture manipulative procedtures (n=24) or a same side posture manipulation (n=21).

Back pain and abdominal pain were assessed using visual analog scales, and menstrual symptoms were assessed via questionnaire administered 15 minutes prior to, and 60 minutes following treatment interventions. Blood samples were collected at those same times and tested for plasma levels of prostaglandins.

Bolh groups reported significant improvement in menstrual distress symptoms and decrease in back and abdominal pain, however, the effect was approximately twice as great in the group receiving the true spinal manual therapy. These effects were associated with significant decreases in post-manipulative plasma levels for both groups.

In another case report(4), Doctor Hubbs presents a case of a 28-year-old female with a chronic history of low back pain and symptoms of premenstrual syndrome, consisting of intermittent cramping for 24 hours prior and during early menstrual flow, depression, bloating, agitation, and nervous eating. Spinal manual adjustments applied lo the L1 area resulted in the patient reporting a significantly diminished pre- and peri-menstruation cramping time (approximately 30 minutes versus 24 hours) and the ease of other PMS symptomatology. The patient's lumbar spine pain also remissed.

Doctor Hubbs postulates that reflex sympathetic vasoconstriction to the uterine smooth muscle may result in diminished amounts of ovarian hormones reaching the uterus during menstruation, causing the patient's cramping and other associated symptoms. Normalization of sympathectic outflow through chiropractic adjustment to the upper lumbar spine might have accounted for the patient's improvement.

Chiropractors are not the only members of the health care sciences to describe the positive effects of spinal adjustments on dysmenorrhea. While describing his results with spinal manual therapy in women with dysmenorthea, Lewit (a medical neuroligist) states, "In a group of 70 women with menstrual pain and negative gynecological findings, treatment of the spine mainly by manipulation gave excellent results in 43 cases, favorable in 13, and no change in 14... From these data we may conclude that...Menstruation pain with otherwise normal gynecological findings, especially when localized in the low back, is usually of vertebrogenic origin and often the first clinical manifestation of disturbance in the lumbosacral region."

Reference

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