Effect of Myofascial Release on Pain and Uterine Artery Hemodynamic Indices in Women with Primary Dysmenorrhea: A Randomized Controlled Trial

<b><i>Background</i></b>: Primary dysmenorrhea (PD) is a common gynecological condition among women of reproductive age, often leading to pain and functional limitations. Myofascial release (MFR) has been suggested as a potential non-pharmacological intervention. This study aimed to investigate the immediate effects of a single MFR session on pain intensity, menstrual symptoms, and uterine artery hemodynamics in women with PD. <b><i>Methods</i></b>: In this randomized controlled trial, 34 women with PD were randomly assigned to either the MFR group (<i>n</i> = 18) or the placebo MFR group (<i>n</i> = 16). All participants received 10 min of thermotherapy followed by 30 min of either MFR or placebo MFR. Pain intensity (NRS), pressure pain thresholds (PPT) at myofascial trigger points, menstrual symptoms (MDQ-T), and uterine artery pulsatility index (PI) and resistance index (RI) were assessed at three time points: baseline, immediately after the intervention, and 3 h post-intervention. <b><i>Results</i></b>: Both groups demonstrated significant within-group reductions in pain intensity and menstrual symptoms post-intervention (<i>p</i> < 0.01), with no significant group-by-time interaction. However, significant interaction effects were observed for the PI and RI of the right uterine artery, showing greater reductions in the MFR group compared to the placebo group at 3 h post-intervention (<i>p</i> < 0.05). <b><i>Conclusions</i></b>: A single MFR session resulted in improvements in uterine hemodynamics, suggesting autonomic modulation as a potential mechanism. Although subjective symptom improvements were observed in both groups, only MFR showed objective vascular benefits. These findings support the physiological plausibility of MFR in PD management and suggest its potential application as a personalized, non-pharmacological intervention. Further studies are warranted to explore its long-term and individualized therapeutic effects.