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Dysmenorrhea

Dysmenorrhea and pelvic adhesions can cause moderate to severe pelvic pain.

Dysmenorrhea is a condition characterized by frequent and severe uterine cramps and pain associated with menstruation. The prevalence of dysmenorrhea is estimated at 45% to 95% in reproductive age women; it is a leading cause of absenteeism from work and school.

Primary dysmenorrhea begins with a woman’s first menstrual cycle and may recur until menopause. It can occur when there is no pelvic pathology. Secondary dysmenorrhea has a later onset, and may first appear after identifiable conditions such as surgery, endometriosis, inflammation (PID), infection, or trauma. Secondary dysmenorrhea has also been linked to structural abnormalities inside or outside of the uterus, such as adhesions or an intrauterine device (IUD).

Menstrual pain patterns may vary widely from person to person. Pain may increase or decrease at night, may be continuous or not, and may intensify suddenly. It can feel like a weighty, pulling sensation and may radiate to the lumbar, sciatic, pelvic floor, or groin areas. The pain may be accompanied by nausea, vomiting, diarrhea, migraines, fainting, fatigue, or dizziness.

The main symptom of dysmenorrhea is pain concentrated in the lower abdomen and pelvis. Pain can radiate into the thighs and lower back, and may cause headache.

Causes of Dysmenorrhea

The initial onset of primary dysmenorrhea may result from certain chemical or hormonal conditions. For example, hormones such as prostaglandin and arachidonic acid are known to cause uterine contractions. Prostaglandins are released during menstruation, due to the periodic destruction of endometrial cells and the release of their contents. As the menstrual period progresses, the levels of prostaglandins decrease, thus lowering the pain.

Dysmenorrhea can be due to spasm, endometriosis, or tightness or adhesions affecting the ligaments, fascias or connective tissues which attach the uterus to surrounding structures. Women with secondary dysmenorrhea may also experience pain due to mechanical factors, such as restricted mobility of the reproductive and urogenital structures due to adhesions.


Adhesions

Adhesions can form wherever we heal from injury, surgery, or inflammation. Pelvic adhesions join structures with strong glue-like bonds that can last a lifetime.

Adhesions can accompany or cause dysmenorrhea, as the body reacts to trauma, inflammation, infection, surgery, or chronic spasm. Adhesions are composed of tiny but strong strands of collagen that form around traumatized tissue to help it heal. Acting like glue, the adhesions isolate the injured tissue while it heals from infection, inflammation, surgery, or trauma. Once the healing process has passed, the adhesions remain in the body as tiny straight-jackets, binding structures that should be mobile and independent. These adhesions can attach to pain-sensitive structures in the pelvis, causing pain. Wherever they form, adhesions join structures with strong glue-like bonds that can last a lifetime (see our general adhesions page for more detail.)


Treating Pelvic Adhesions with Surgery

Lysis of pelvic adhesions involves surgery and anesthesia.

Until recently, lysis of adhesions was the only choice to treat pelvic adhesions. This involves cutting or burning the pelvic adhesions under general anesthesia, via laparoscopy or laparotomy (open surgery).

While lysis of pelvic adhesions can be effective, surgery has two major drawbacks:

  1. it carries risks from anesthesia and infection, and
  2. despite the best skills of the finest surgeon, the body creates more pelvic adhesions as it heals from the surgery designed to remove them.

Lancet: The British Journal of Surgery reported that 55% to 100% of patients developed adhesions following open pelvic surgery. Another study in that same journal reported that 35% of all open abdominal or pelvic surgery patients were readmitted to the hospital more than twice to treat post-surgical adhesions during the 10 years after their original surgery. Thus, pelvic surgery itself has been implicated as a major cause of adhesion formation and many patients become trapped in a cycle of surgery-adhesions-surgery – with no end in sight.


Treating Pelvic Adhesions with Clear Passage Therapies®

Belinda Wurn, PT treats a patient with her manual physical therapy which has been shown to reduce adhesions, decrease pain, and improve function, in peer-reviewed medical journals.

We know pelvic adhesions well. We faced this situation 20 years ago when the physical therapist director of Clear Passage Therapies®, Belinda Wurn, developed severe adhesions after pelvic surgery and radiation therapy. Unable to work due to chronic pelvic pain, and having seen the devastating and debilitating effects of pelvic adhesions in her own patients, she was determined to find a non-surgical way to address chronic pelvic pain and adhesions.

With her husband, massage therapist Larry Wurn, Belinda took a much deeper look at the etiology and biomechanics of adhesion formation. They found that the chemical bonds that attached each of the tiny collagen fibers to its neighbor appeared to dissipate or dissolve when placed under sustained pressure over time. With this knowledge, they developed the Wurn Technique® to unravel the bonds between the crosslinks that comprise adhesions.

The “hands-on” work practiced at Clear Passage Therapies® clinics is designed to reduce or eliminate adhesions crosslink by crosslink. It has been shown in peer-reviewed medical journals to reduce adhesions, decrease pain, and improve soft tissue mobility, without the risks of surgery or drugs.

Visit our “what treatment is like” web page for more information, or click the link at the bottom of this page now, to complete a medical history questionnaire and apply for a free, in-depth consultation.