PROBLEM
Dolor menstrual y pelvis
Listen to what you’re feeling in your pelvis.
Some periods are painful.
And others that practically force you to organise several days of the month around managing the pain.
Abdomen.
Lower back.
Pelvis.
Sacrum.
A sensation of pressure or deep tightness.
When menstrual pain is accompanied by significant physical tension, we can also assess how the body is responding.
Primary and secondary dysmenorrhoea
Menstrual pain can have various causes.
Primary dysmenorrhoea occurs without any identifiable pelvic pathology, whilst secondary dysmenorrhoea is associated with conditions such as endometriosis or other gynaecological problems.
If a gynaecological assessment is required, this is the right course of action.
Which aspect can I assess?
We can check for the presence of:
- severe lower back pain during menstruation
- stiff sacrum
- tight pelvis
- permanently tense abdomen
- hips with limited mobility
- restricted breathing during pain.
Abdomen, diaphragm and pelvis
Breathing, the abdominal wall and the pelvic floor coordinate changes in pressure during movement.
When breathing is held in and the abdomen remains tense, the body has less freedom of movement during those days.
What the evidence says
A systematic review from 2024 found promising results for various manual therapies for primary dysmenorrhoea, but the overall evidence was of low or very low quality.
A 2025 randomised trial found favourable results with individualised osteopathic treatment for primary dysmenorrhoea.
These are interesting facts, not a guarantee of results.
How I work
Depending on our findings, we can assess:
- pelvis
- sacrum
- lumbar
- hips
- abdomen
- fascia
- diaphragm and breathing.
The session is tailored to the patient’s pattern and stage of their cycle.
Follow-up care matters
One session provides information. The next cycle offers a different perspective.
We look to see if there are any changes:
- intensity
- duration
- lumbar
- pelvic pressure
- mobility
- ability to lead a normal life.
The aim
To reduce the musculoskeletal tension associated with pain and improve mobility and physical comfort during those days.
If your body follows the same pattern every month, it’s worth considering what we can actually change.
Sources and further reading
To find out more
References that expand on the points discussed.
View sources
- Li X et al. Manual Therapy in Primary Dysmenorrhoea: systematic review and meta-analysis · View source
- Plathner M et al. Effectiveness of osteopathic treatment in women with primary dysmenorrhoea: RCT · View source