Muscle Energy Technique and Myofascial Chain Training for Menstrual Pain in Primary Dysmenorrhea (METPD-25)

Combined Muscle Energy Technique and Myofascial Chain Stabilization Reduces Menstrual Pain and Improves Pelvic Alignment in Women With Primary Dysmenorrhea: A Prospective Study

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