{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T17:48:47Z","timestamp":1790358527643,"version":"4.1.0"},"reference-count":49,"publisher":"Walter de Gruyter GmbH","issue":"8","license":[{"start":{"date-parts":[[2022,5,2]],"date-time":"2022-05-02T00:00:00Z","timestamp":1651449600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jom-2021-0255_abs_001\">\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Research is lacking regarding osteopathic approaches in treating polycystic ovary syndrome (PCOS), one of the prevailing endocrine abnormalities in reproductive-aged women. Limited movement of pelvic organs can result in functional and structural deficits, which can be resolved by applying visceral manipulation (VM).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jom-2021-0255_abs_002\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>This study aims to analyze the effect of VM on dysmenorrhea, irregular, delayed, and\/or absent menses, and premenstrual symptoms in PCOS patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jom-2021-0255_abs_003\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Thirty Egyptian women with PCOS, with menstruation-related complaints and free from systematic diseases and\/or adrenal gland abnormalities, prospectively participated in a\u00a0single-blinded, randomized controlled trial. They were recruited from the women\u2019s health outpatient clinic in the faculty of physical therapy at Cairo University, with an age of 20\u201334 years, and a body mass index (BMI)\u00a0\u226525, &lt;30\u00a0kg\/m<jats:sup>2<\/jats:sup>. Patients were randomly allocated into two equal groups (15\u00a0patients); the control group received a low-calorie diet for\u00a03\u00a0months, and the study group that received the same hypocaloric diet added to VM to the pelvic organs and their related structures, according to assessment findings, for eight\u00a0sessions over 3\u00a0months. Evaluations for body weight, BMI, and menstrual problems were done by weight-height scale, and menstruation-domain of Polycystic Ovary Syndrome Health-Related Quality of Life Questionnaire (PCOSQ),\u00a0respectively, at baseline and after 3\u00a0months from interventions. Data were described as mean, standard deviation, range, and percentage whenever applicable.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jom-2021-0255_abs_004\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 60 Egyptian women with PCOS, 30 patients were included, with baseline mean age, weight, BMI, and menstruation domain score of 27.5\u00a0\u00b1\u00a02.2 years, 77.7\u00a0\u00b1\u00a04.3\u00a0kg, 28.6\u00a0\u00b1\u00a00.7\u00a0kg\/m<jats:sup>2<\/jats:sup>, and 3.4\u00a0\u00b1\u00a01.0, respectively, for the control group, and 26.2\u00a0\u00b1\u00a04.7\u00a0years, 74.6\u00a0\u00b1\u00a03.5\u00a0kg, 28.2\u00a0\u00b1\u00a01.1\u00a0kg\/m<jats:sup>2<\/jats:sup>, and 2.9\u00a0\u00b1\u00a01.0, respectively, for the study group. Out of the 15\u00a0patients in the study group, uterine adhesions were found in 14 patients (93.3%), followed by restricted uterine mobility in 13 patients (86.7%), restricted ovarian\/broad ligament mobility (9, 60%), and restricted motility (6,\u00a040%). At baseline, there was no significant difference (p&gt;0.05) in any of demographics (age, height), or dependent variables (weight, BMI, menstruation domain score) among both groups. Poststudy, there was a statistically significant reduction (p=0.000) in weight, and BMI mean values for the diet group (71.2\u00a0\u00b1\u00a04.2\u00a0kg, and 26.4\u00a0\u00b1\u00a00.8\u00a0kg\/m<jats:sup>2<\/jats:sup>, respectively) and the diet\u00a0+\u00a0VM group (69.2\u00a0\u00b1\u00a03.7\u00a0kg; 26.1\u00a0\u00b1\u00a00.9\u00a0kg\/m<jats:sup>2<\/jats:sup>, respectively). For the improvement in the menstrual complaints, a significant increase (p&lt;0.05) in the menstruation domain mean score was shown in diet group (3.9\u00a0\u00b1\u00a01.0), and the diet\u00a0+\u00a0VM group (4.6\u00a0\u00b1\u00a00.5). On comparing both groups poststudy, there was a statistically significant improvement (p=0.024) in the severity of menstruation-related problems in favor of the diet\u00a0+\u00a0VM group.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jom-2021-0255_abs_005\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>VM yielded greater improvement in menstrual pain, irregularities, and premenstrual symptoms in PCOS patients when added to caloric restriction than utilizing the low-calorie diet\u00a0alone in treating that condition.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jom-2021-0255","type":"journal-article","created":{"date-parts":[[2022,4,30]],"date-time":"2022-04-30T08:31:32Z","timestamp":1651307492000},"page":"411-422","source":"Crossref","is-referenced-by-count":10,"title":["Effect of visceral manipulation on menstrual complaints in women with polycystic ovarian syndrome"],"prefix":"10.1515","volume":"122","author":[{"given":"Mahitab M.","family":"Yosri","sequence":"first","affiliation":[{"name":"Women\u2019s Health Department, Faculty of Physical Therapy , Cairo University , Giza , Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamada A.","family":"Hamada","sequence":"additional","affiliation":[{"name":"Department of Biomechanics, Faculty of Physical Therapy , Cairo University , Giza , Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amel M.","family":"Yousef","sequence":"additional","affiliation":[{"name":"Women\u2019s Health Department, Faculty of Physical Therapy , Cairo University , Giza , Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2022,5,2]]},"reference":[{"key":"2022080308480240076_j_jom-2021-0255_ref_001","doi-asserted-by":"crossref","unstructured":"Azziz, R. 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Endocr Regul 2018;52:208\u201321. https:\/\/doi.org\/10.2478\/enr-2018-0026.","DOI":"10.2478\/enr-2018-0026"},{"key":"2022080308480240076_j_jom-2021-0255_ref_009","doi-asserted-by":"crossref","unstructured":"Brower, M, Brennan, K, Pall, M, Azziz, R. The severity of menstrual dysfunction as a predictor of insulin resistance in PCOS. J Clin Endocrinol Metab 2013;98:E1967\u201371. https:\/\/doi.org\/10.1210\/jc.2013-2815.","DOI":"10.1210\/jc.2013-2815"},{"key":"2022080308480240076_j_jom-2021-0255_ref_010","doi-asserted-by":"crossref","unstructured":"Jeong, JY, Kim, MK, Lee, I, Yun, J, Won, YB, Yun, BH, et al.. Polycystic ovarian morphology is associated with primary dysmenorrhea in young Korean women. Obstet Gynecol Sci 2019;62:329\u201334. https:\/\/doi.org\/10.5468\/ogs.2019.62.5.329.","DOI":"10.5468\/ogs.2019.62.5.329"},{"key":"2022080308480240076_j_jom-2021-0255_ref_011","doi-asserted-by":"crossref","unstructured":"Martin, ML, Halling, K, Eek, D, Krohe, M, Paty, J. 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