Introduction: Dysmenorrhea is a common gynecological condition characterized by menstrual pain and significant impact on quality of life. It is classified as primary or secondary. Although pharmacological and hormonal treatments are widely used, current therapeutic options are not always effective or well tolerated. Manual therapy has emerged as a potential non-pharmacological alternative. Objective: To evaluate recent evidence on the efficacy of manual therapy in symptom management and quality of life improvement in women with primary and secondary dysmenorrhea. Materials and methods: A bibliographic search was conducted in May 2025 in PubMed, PEDro, Web of Science, CINAHL, and Scopus. Randomized controlled trials published in the previous 5 years, in which at least one manual therapy intervention was applied, were included. The review followed the PRISMA 2020 guidelines and was registered in PROSPERO (CRD420251090867). Results: 16 randomized controlled trials were included. Interventions were heterogeneous and comprised connective tissue techniques, myofascial release, osteopathic approaches, and visceral or pelvic manual treatment. All studies reported significant pain reduction and several also demonstrated improvements in menstrual symptoms and quality of life, along with autonomic, functional, and emotional benefits. Conclusion: Manual therapy appears to provide clinically relevant benefits; however, the overall certainty of the evidence is low due to pervasive risk of bias and heterogeneity. Further rigorous and standardized trials are needed to strengthen clinical recommendations.
Martínez-Bustelo et al. (Mon,) studied this question.