Pelvic Nerve Mobilization for Primary Dysmenorrhea (PNM-PD)

University of Hail

Status: Enrolling

Conditions: Primary Dysmenorrhea (PD)

Treatments: Other: Sham Mobilization; Other: External Pelvic Nerve Mobilization

Study type: Interventional

Funder types: Other

Identifiers

NCT07354451

HERF/Research/REC/No-2020-013

Details and patient eligibility

About

Primary dysmenorrhea is a highly prevalent condition among young women and is associated with significant pain, reduced quality of life, and academic absenteeism. Although non-steroidal anti-inflammatory drugs are commonly used, many women seek non-pharmacological alternatives due to limited effectiveness or adverse effects. Emerging evidence suggests that altered pelvic neurodynamics may contribute to dysmenorrheic pain.

This randomized controlled trial aims to evaluate the effectiveness of external pelvic nerve mobilization in reducing menstrual pain and associated symptoms among university women with primary dysmenorrhea. Participants aged 18-30 years will be randomly allocated to receive either external pelvic nerve mobilization or a sham manual therapy intervention across three consecutive menstrual cycles. Outcomes will include pain intensity, menstrual distress, quality of life, pelvic tenderness, analgesic consumption, and academic absenteeism.

Full description

Primary dysmenorrhea is characterized by painful menstruation in the absence of identifiable pelvic pathology and affects a large proportion of young women. Pain is largely mediated by excessive prostaglandin release, uterine ischemia, and sensitization of pelvic neural pathways. Recurrent nociceptive input may lead to peripheral and central sensitization, exacerbating pain severity.

External pelvic nerve mobilization is a physiotherapy-based neurodynamic intervention designed to restore physiological mobility of pelvic and lumbosacral nerves, reduce neural mechanosensitivity, and modulate nociceptive signaling. Unlike internal pelvic techniques, this approach is entirely external, non-invasive, and suitable for young and student populations.

This single-blind, parallel-group randomized controlled trial will assess whether external pelvic nerve mobilization provides superior pain reduction and functional improvement compared with a sham intervention over three menstrual cycles.

Enrollment: 60 estimated patients

Sex: Female

Ages: 18 to 30 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Female university students aged 18-30 years
• Regular menstrual cycles (24-35 days)
• Clinically diagnosed primary dysmenorrhea
• Average menstrual pain intensity ≥ 5 on Visual Analog Scale
• Willingness to participate and provide informed consent

Exclusion criteria

• Secondary dysmenorrhea (e.g., endometriosis, fibroids, pelvic inflammatory disease)
• History of pelvic or spinal surgery
• Neurological disorders
• Current pregnancy or lactation
• Current physiotherapy or manual therapy treatment
• Contraindications to manual therapy

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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60 participants in 2 patient groups

Arm 1: External Pelvic Nerve Mobilization

Experimental group

Description:

Participants will receive standardized external neurodynamic mobilization techniques targeting the lumbosacral plexus and pudendal nerve pathways. Sessions will be delivered by trained women's health physiotherapists. Each session will last approximately 30 minutes and will be administered three times per menstrual cycle across three consecutive cycles.

Treatment:

Other: External Pelvic Nerve Mobilization

Arm 2: Sham Mobilization

Sham Comparator group

Description:

Participants will receive non-therapeutic light manual contact over the lumbosacral and pelvic regions without neural gliding, joint movement, or tissue mobilization. Session duration and therapist interaction will match the intervention group.

Treatment:

Other: Sham Mobilization