Connective Tissue Massage and Music-Based Progressive Muscle Relaxation in Primary Dysmenorrhea

The Effects of Connective Tissue Massage and Music-Based Progressive Muscle Relaxation on Pain Intensity, Pressure Pain Threshold, and Menstruation-Related Symptoms in Women With Primary Dysmenorrhea: A Randomized Controlled Trial

This randomized controlled clinical trial aims to investigate the effects of Connective Tissue Massage (CTM) and music-based Progressive Muscle Relaxation Training (PMRT) on pain intensity, pressure pain threshold, analgesic use, and menstruation-related symptoms in women with primary dysmenorrhea. Participants will be randomly assigned to one of three groups: CTM, music-based PMRT, or control. Baseline assessment will be conducted during menstrual days 1-2 of Cycle 0. The interventions will be applied during the premenstrual intervention window of Cycle 0, from the estimated ovulation day, calculated as cycle length minus 14 days, until Cycle 1 Day 1. Post-intervention assessment will be conducted during menstrual days 1-2 of Cycle 1. No intervention will be applied after the post-intervention assessment, and follow-up assessment will be conducted during menstrual days 1-2 of Cycle 2. Outcomes including pain intensity, pressure pain threshold, analgesic use, menstrual symptoms, attitudes toward menstruation, functional and emotional impact of dysmenorrhea, and pain catastrophizing will be evaluated across menstrual cycles. Participant satisfaction and adherence to the interventions will also be assessed.

Inclusion Criteria:

• Having a diagnosis of primary dysmenorrhea made by a Gynecology and Obstetrics specialist
• Being between 18-30 years of age
• Being nulliparous
• Having a regular menstrual cycle (28 ± 7 days)
• Having menstrual pain intensity greater than 4 cm on the Visual Analog Scale for the last 6 months
• Voluntarily agreeing to participate in the study

Exclusion Criteria:

• Having been diagnosed at least 6 months prior with gastrointestinal, urogynecological, autoimmune, or psychiatric diseases and/or chronic pain syndromes
• Having any neurological or systemic disease
• Having a history of childbirth or previous pregnancy
• Being pregnant
• Using an intrauterine device (IUD)
• Having any pelvic pathology or history of pelvic surgery
• Chronic use of medications, including oral contraceptives or antidepressants
• Currently receiving anti-inflammatory, analgesic, or psychotherapeutic drug treatment
• Having irregular menstrual cycles (<21 or >35 days and/or cycle variation >4 days)
• Presence of pathology indicating secondary dysmenorrhea