Context 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). Objectives This study aims to analyze the effect of VM on dysmenorrhea, irregular, delayed, and/or absent menses, and premenstrual symptoms in PCOS patients. Methods Thirty Egyptian women with PCOS, with menstruation-related complaints and free from systematic diseases and/or adrenal gland abnormalities, prospectively participated in a single-blinded, randomized controlled trial. They were recruited from the women’s health outpatient clinic in the faculty of physical therapy at Cairo University, with an age of 20–34 years, and a body mass index (BMI) ≥25, <30 kg/m2. Patients were randomly allocated into two equal groups (15 patients); the control group received a low-calorie diet for 3 months, 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 sessions over 3 months. 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), respectively, at baseline and after 3 months from interventions. Data were described as mean, standard deviation, range, and percentage whenever applicable. Results Of 60 Egyptian women with PCOS, 30 patients were included, with baseline mean age, weight, BMI, and menstruation domain score of 27.5 ± 2.2 years, 77.7 ± 4.3 kg, 28.6 ± 0.7 kg/m2, and 3.4 ± 1.0, respectively, for the control group, and 26.2 ± 4.7 years, 74.6 ± 3.5 kg, 28.2 ± 1.1 kg/m2, and 2.9 ± 1.0, respectively, for the study group. Out of the 15 patients 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, 40%). At baseline, there was no significant difference (p>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 ± 4.2 kg, and 26.4 ± 0.8 kg/m2, respectively) and the diet + VM group (69.2 ± 3.7 kg; 26.1 ± 0.9 kg/m2, respectively). For the improvement in the menstrual complaints, a significant increase (p<0.05) in the menstruation domain mean score was shown in diet group (3.9 ± 1.0), and the diet + VM group (4.6 ± 0.5). 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 + VM group. Conclusions 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 alone in treating that condition.

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Background Pelvic floor dysfunction (PFD) is a wide term, involving a large array of conditions that negatively impact many women around the world. Polycystic ovarian syndrome (PCOS) is another disorder with long-term serious consequences. Being a disease of hormonal imbalances, PCOS may possibly affect the function of the pelvic floor muscles leading to PFD. Thus, the current study aimed to explore the prevalence of PFD among women with PCOS. Methods This is an observational, case-control study. A total of 368 women, aged from 20 to 35 years, with a body mass index (BMI) range of 20 to 30 kg/m2 recruited from Kasr El-Ainy teaching hospital shared in the study. They were classified into case group (PCOS patients; n=184) and control group (non-PCOS participants; n=184), with matched age and BMI for comparison. All case-group women were diagnosed with PCOS, based on Rotterdam diagnostic criteria, while the control group women had regular menstrual cycles. Pelvic Floor Distress Inventory-20 (PFDI-20) was used to identify PFD in the tested groups. The demographic features of the two groups were compared using the unpaired t test, while the chi-squared test was used to determine the prevalence of PFD among women with PCOS. Also, multiple linear regression was done to asses other PFD risk factors in both groups. Results Out of 380 women, 368 were involved in the study with mean ± standard deviation (SD) for the age and BMI of 28.48±4.87 years and 25.9±5.8 kg/m2, respectively, for the control group, and 28.76±5.33 years and 27±6.1 kg/m2, respectively, for the PCOS group, without a significant difference in either of the age and BMI between groups (P > 0.05). The frequency distribution of women with and without PFD in both groups revealed that the PCOS group included 68 (37%) women with PFD. While the control group included 12 (6%) women with PFD, with a significant difference (P=0. 03) in the prevalence between both groups. Also, multiple regression revealed that PCOS condition significantly affected PFD. Conclusion PFD was prevalent among women with PCOS, compared to the control group, suggesting a possible link between both conditions.