This prospective clinical trial evaluates the effects of a non-pharmacological intervention combining muscle energy technique (MET) and myofascial chain (MFC)-based pelvic stabilization training in women with primary dysmenorrhea (PD). The study aims to determine whether this combined approach can improve pelvic alignment, reduce menstrual pain, and enhance static balance. Participants are assigned to either an experimental group receiving MET + MFC-based training or a control group receiving conventional physiotherapy. Outcomes include radiographic pelvic parameters, pain intensity, and balance performance.

Primary dysmenorrhea (PD) is a common gynecological condition characterized by cyclic lower abdominal pain without an identifiable organic cause. Biomechanical factors such as pelvic misalignment and myofascial imbalance are increasingly recognized as contributing to the persistence and severity of PD.

This prospective non-randomized controlled trial investigates whether a combined intervention of muscle energy technique (MET) and myofascial chain (MFC)-based pelvic stabilization training can improve pelvic structure and reduce clinical symptoms in women with PD. Participants are women aged 18-45 years with moderate-to-severe PD and radiographic evidence of pelvic misalignment. They are assigned to one of two groups:

Experimental group: MET plus MFC-based core stabilization exercises. Control group: Interferential current therapy and deep friction massage. Interventions are administered three times per week for four weeks. The primary outcomes include changes in pelvic sagittal parameters (pelvic tilt, sacral slope, pelvic incidence), pelvic symmetry, menstrual pain (measured by VAS), and static balance (eyes-closed single-leg stance). Assessments are conducted at baseline, 4 weeks, and 12 weeks post-intervention.

The study aims to explore whether biomechanical correction of pelvic alignment contributes to pain modulation and functional improvement in women with PD, providing a basis for non-pharmacological rehabilitation strategies.

Inclusion Criteria:

• Females aged 18-45 years
• Regular menstrual cycles
• Clinically diagnosed with primary dysmenorrhea
• Visual Analog Scale (VAS) score ≥ 4 during menstruation for at least six consecutive months
• Radiographic evidence of pelvic tilt, sacral slope deviation, or frontal pelvic asymmetry

Exclusion Criteria:

• Secondary dysmenorrhea or diagnosed gynecological pathologies (e.g., endometriosis, ovarian cysts)
• Pregnancy or lactation
• Current use of hormonal contraceptives or hormone therapy
• Ongoing or recent physical therapy targeting the pelvis
• History of pelvic or spinal surgery
• Congenital or structural musculoskeletal disorders affecting the lumbopelvic region

This study specifically targets biologically female participants of reproductive age who experience moderate to severe primary dysmenorrhea, as defined by VAS ≥ 4.

De-identified individual participant data (IPD) underlying the primary and secondary outcome results reported in the manuscript will be shared. This includes demographic information, baseline measurements, and outcome data at each time point (e.g., VAS, pelvic alignment, and balance test results). No personally identifiable information will be disclosed.

IPD and supporting documentation will be available from 6 months after publication of the results in a peer-reviewed journal. The data will be accessible for a period of 2 years via request to the corresponding author (luoshanjiao@gmail.com).

Qualified researchers with a methodologically sound proposal may request access to the de-identified individual participant data (IPD) and supporting documents. Requests should be directed to the corresponding author via email (luoshanjiao@gmail.com). Access will be granted on a case-by-case basis after approval by the study team.

This was an open-label study without any masked parties.