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Chiropractic Research Review

Dysmenorrhea and Pelvic Dysfunction Linked?

Dysmenorrhea involves menstrual pain that lasts 48-72 hours, starting with each menstruation cycle; primary dysmenorrhea is not related to pelvic pathology, unlike secondary dysmenorrhea. Primary dysmenorrhea is medically managed with treatments including oral contraception, NSAIDs and cervical dilation, but these methods are not always effective and may involve side-effects.

Spinal manipulation has been used as an alternative approach to dysmenorrhea management, under the assumption that spinal dysfunction and sacroiliac joint dysfunction (SJD) may affect the function of the autonomic nervous system.

To determine if there is a clinical relationship between dysmenorrhea and SJD, 36 women ages 21-32 completed a Moos Menstrual Distress Questionnaire (MDQ) to determine the presence of dysmenorrhea symptoms. Three examiners independently performed three motion palpation procedures to assess SJD or normal sacroiliac function in each subject. The palpation techniques used were the Gillet test, the standing flexion test and the distraction (gapping) test. If two of the three examiners agreed that SJD was positive in two out of three tests, SJD was considered present. Also, Gonstead radiographic analyses were performed on each womans A-P pelvis X-rays.

There was a "strong correlation" between SJD and dysmenorrhea based on the menstrual questionnaire. The correlation between Gonstead radiographic analysis and either dysmenorrhea or SJD was of poor statistical relevance in this sample, however.

"This positive result should encourage colleagues to undertake further research in this area of organ-segment relationship using larger sample groups to improve statistical relevance," the authors write.

Genders WG, Hopkins SS, et al. Dysmenorrhea and pelvic dysfunction: A possible clinical relationship. Chiropractic Journal of Australia 2003:33(1), pp. 23-29.
www.chiropractors.asn.au/cjournal/cjamain.htm

Chiropractic Research Review

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