Menstrual Pain: Osteopathic Evaluation and Treatment

Menstrual pain, or dysmenorrhea, is one of the most common gynecological complaints and can significantly affect quality of life. While many associate menstrual discomfort with hormonal changes, structural and circulatory imbalances within the pelvis, spine, and diaphragm often contribute to the severity and persistence of pain. At a practice specializing in Osteopathic Neuromusculoskeletal Medicine, we provide comprehensive, hands-on treatment for menstrual pain, addressing both the mechanical and physiological factors that influence pelvic function and overall well-being.

Understanding Menstrual Pain

Menstrual pain occurs when the muscles of the uterus contract to help shed the uterine lining. In some cases, these contractions become overly forceful or restricted by tension in the surrounding tissues. Symptoms may include cramping in the lower abdomen, pelvic or low back pain, bloating, and fatigue.

Primary dysmenorrhea refers to menstrual pain not associated with another medical condition, while secondary dysmenorrhea is related to underlying issues such as endometriosis, fibroids, or pelvic inflammatory disease. Osteopathic medicine approaches menstrual pain by exploring how structural imbalances—especially in the pelvis, sacrum, and lower back—affect blood flow, nerve supply, and overall pelvic motion.

Common Causes and Contributing Factors

Menstrual pain can arise from a combination of systemic and structural factors, including:

·       Pelvic or lower back tension restricting blood and lymphatic flow.

·       Postural imbalance of the sacrum and pelvis.

·       Diaphragm restriction limiting circulation and mobility.

·       Chronic stress or overactivation of the sympathetic nervous system.

·       Hormonal fluctuations affecting uterine sensitivity.

·       Previous pelvic surgery, childbirth, or injury.

These factors can intensify uterine contractions or impair drainage within the pelvic region, leading to heightened discomfort. Addressing these structural relationships through Osteopathic treatment promotes balance and healthy regulation of the menstrual cycle.

Who Is Affected

Menstrual pain primarily affects a person with a uterus during their reproductive years, though the severity and pattern of symptoms vary. Adolescents may experience pain as hormone levels stabilize, while adults can develop new or worsening discomfort due to postural changes, childbirth, or other pelvic stressors. For many, menstrual pain can interfere with work, exercise, and daily activities, highlighting the need for treatment that supports both physical and functional well-being.

The Role of Osteopathic Neuromusculoskeletal Medicine

Osteopathic Neuromusculoskeletal Medicine offers a holistic and noninvasive approach to alleviating menstrual pain. An Osteopathic Physician (DO) trained in this specialty performs a detailed structural evaluation of the pelvis, lower back, diaphragm, and surrounding connective tissues to identify restrictions and imbalances that may exacerbate menstrual discomfort.

Treatment involves gentle, hands-on techniques—such as soft tissue manipulation, myofascial release, balanced ligamentous tension, and Visceral Osteopathy—to improve blood flow, relieve muscular tension, and enhance pelvic mechanics. Cranial Osteopathic methods may also be used to calm the autonomic nervous system, promoting relaxation and hormonal regulation.

By addressing circulation, posture, and neural function, Osteopathic care helps reduce pain intensity and frequency while supporting overall hormonal and pelvic health. This approach complements other therapies, including nutritional and lifestyle strategies, and provides a safe, gentle option for people seeking long-term relief.

Seeking Care for Ongoing Pelvic or Menstrual Pain

If menstrual pain disrupts your life or persists despite conventional interventions, Osteopathic evaluation may offer meaningful support. By identifying and treating underlying mechanical contributors, Osteopathic care helps reduce pain, improve pelvic mobility, and enhance comfort throughout the menstrual cycle. Many patients notice more balanced cycles, reduced cramping, and greater energy over time.

Our practice specializes in the evaluation and treatment of menstrual pain through a compassionate, individualized approach. If you experience pelvic discomfort, back pain, or recurring cramping during menstruation, we encourage you to schedule an appointment with Dr. Levi. Through gentle, hands-on care and comprehensive assessment, we can help restore balance, comfort, and a greater sense of ease throughout your cycle.