The evaluation of progesterone and dysmenorrhea levels after the manual therapy in young women in relation to the use of non-steroidal anti-inflammatory drugs

Introduction: In spite of many studies, the pathomechanism of dysmenorrhea (DM) still remains unclear. Previous studies have demonstrated that DM is a complex process that may depend on many factors including an early age of the menarche, stress, menstruation time-period and intensity, the occurrence of premenstrual syndrome (PMS) as well as periodic changes in hormone levels.

The study was aimed at evaluating the levels of progesterone and 17-beta oestradiol, and the severity of dysmenorrhea in six young women, including three after the use of manual therapy and the other three after the administration of ibuprofen.

Material and methods: In six patients aged 21.8±1.6 gynaecological and physiotherapeutic examinations were completed. Moreover, a two-fold determination of progesterone and 17-beta oestradiol levels were carried out. The intensity of dysmenorrhea was assessed in the numerical pain rating scale (NPRS, range 0-10). The group of patients was divided into two subgroups. Subgroup A (n=3) was subjected to manual therapy (3 x 45 min), while in subgroup B (n=3) the patients were administered ibuprofen 3 x 400 mg/24 h during menstruation.

Results: Lower progesterone levels were detected in the blood of the 3 women from subgroup A after manual therapy and in 2 of the women from subgroup B after administrating ibuprofen. After the therapy, the level of 17-beta oestradiol was lower in one woman from subgroup A and in two from subgroup B. Once the manual therapy had been instituted in subgroup A, dysmenorrhea was reduced on average from 8 down to 4 points in the NPRS. Furthermore, its duration time was shortened by one day on average (3/2 days). In subgroup B receiving ibuprofen dysmenorrhea was decreased on average from 8 to 3 points in the NPRS, yet no changes in its duration time were observed (3/3 days).

Conclusions: It has been demonstrated that manual therapy alleviated dysmenorrhea to a similar degree as ibuprofen. However, only the manual therapy exerted an effect on the shortening of dysmenorrhea duration time. The use of manual therapy probably influenced the diminution of progesterone level. Further studies using a greater number of patients are required.