Pain and Prostaglandin Levels
in Dysmenorrheic Women
Following Spinal Manipulation

This section is compiled by Frank M. Painter, D.C.
Send all comments or additions to:    Frankp@chiro.org

FROM:   FCER's International Conference on Spinal Manipulation, 1991; 147–149

Kokjohn, K.; Schmid, D.; Triano, J.; Brennan, P.

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It is estimated that primary dysmenorrhea, or the presence of painful menstruation not attributed to an organic pelvic pathology, affects up to fifty percent of all women and results in 100 million lost work hours per year. The current hypothesis is that primary dysmenorrhea is related to an increase in the prostaglandins E2 (PGE2) and F2a (PGF2a). This hypothesis is supported by the reduction in menstrual pain that results from administration of prostaglandin synthetase inhibitors. Prostaglandins are a group of naturally occurring fatty acids found in various tissues which stimulate contractility of smooth muscle. Thus, the abnormally high prostaglandin levels found in dysmenorrheic women during the first 48 hours of their menstrual cycle are believed to cause increased uterine contractions leading to myometrial ischemia and pain. Although prostaglandin synthetase inhibitors relieve menstrual pain in about 80% of primary dysmenorrhea sufferers, these drugs may have serious side effects. For these reasons, we undertook a small pilot study to investigate the effect of spinal manipulation (SM) on circulating plasma levels of 15-keto- 13, 14-dihydro-prostaglandin (KDPGF2a), a PGF2a metabolite, and the relationship between KDPGF2a levels, pain, measured with a visual analog scale (VAS), and menstrual distress, evaluated with a menstrual distress questionnaire (MDQ).

Mantis Database Item # 13357

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