Intervention in Menorrhagia Through Chiropractic and Spondylotherapy: A Case Report

Intervention in Menorrhagia Through Chiropractic
and Spondylotherapy: A Case Report
William J. Boro, D.C., C.C. | Annapolis, MD | www.nosnappingnocracking.com

Dr. William J. Boro™, Advanced ChiropracticTechniques™
Hey Doc, you gotta help me!

I don’t want surgery!

“I’ve never had regular periods.
I’ve been bleeding heavily
for over two weeks.
My gynecologist says “deal with it.”
Can you help?”

Menorrhagia
“Surgical management has been the standard of
treatment in menorrhagia due to organic causes
(eg, fibroids) or when medical therapy fails to alleviate
symptoms. Surgical treatment ranges from a simple D&C
to a full hysterectomy.”

Why Chiropractic?
• According to the National Board of Chiropractic Examiners
job analysis report, ‘menstrual disorder is the only female
reproductive condition that chiropractors see more than
rarely’
• 72% of patients with dysmenorrhea also have low back pain

Incidence of Common Female Problems
Fibroids
Benign tumors on the
uterus
Affects 4-18% of
women

Adenomyosis
Endometrial tissue
grows into wall of
uterus
Affects 20% of women

Endometriosis
Uterine lining becomes
implanted outside the
uterus
Affects about 10% of
women, 25-35% of
infertile women

• Dysmenorrhea—pain during menstruation that interferes
with daily activities (50%)
• Menorrhagia—heavy bleeding (20%)

Normal Menstrual Cycles
• 21-35 day cycle, with 3-5 days of
bleeding
• Average blood loss 25-80 ml

Normal Tampon Use in a Whole Menstrual Period
In a typical period, a woman will lose 25-80 ml of blood.
If regular tampons used, this will soak 9 tampons.

Menorrhagia Tampon Use in 2 Days
This patient was going through a super plus tampon every
hour and a half for 2 days straight. This amounts to 32 super
plus tampons, each holding 12-15 grams.

Menorrhagia Facts
• Affects up to 10 million American women in their 40’s and 50’s
(that’s 20%)
• Only about a third ever discuss it with their doctor
• Many doctors prescribe:
• NSAIDs help reduce blood loss and relieve cramps
• Hormone therapy regulates cycles and reduces episodes of prolonged bleeding
• IUD (progestin) makes the uterine lining thin and decreases blood flow and
cramping
• Tranexamic acid controls heavy bleeding

Menorrhagia Symptoms
• Blood loss more than 80 ml
• Period lasting more than 7 days
• Soaking of one or more sanitary products every hour for
several consecutive hours

Normal Blood Loss Compared to Menorrhagia
Normal Menorrhagia

Surgical Options
• Hysteroscopy allows a view of the uterine cavity to
possibly remove polyps
• D&C scrapes the lining of the uterus
• Endometrial resection removes the lining of the uterus
• Endometrial ablation destroys the lining of the uterus
• Hysterectomy removes the uterus and cervix

Case History
• 37 year old woman
• 5’4”, 164 lb.
• No children
• History of severe pain in left hip, headaches and asthma
• Nonstop menstrual bleeding for 2 weeks
• Similar bout of nonstop bleeding the previous spring

Case History
• Since the age of 16, never had a normal menstrual cycle
• Migraines and significant cramping every month
• Typical cycles were 36-45 days, with bleeding lasting 7 days
• On days 2 and 3, she needs to use a super plus tampon every 1-1½
hours
• This calculated to more than 80 ml of blood on each of these
days, which is the high side of normal for an entire period

Case History—MRI (3/29/11)
• Moderate postero-central disc protrusion with annular tear
at L4/5, pressing on L5 nerve root bilaterally. Also, mild left
lateral stenosis at L4/5.
• Large central and left posterior herniation at L5/S1 with
posterior displacement contacting S1 nerve root bilaterally.
• Moderate postero-central disc protrusion with annular tear
at L5/S1, pressing on L5 nerve root bilaterally.

Prior Doctor’s Visits
• Gynecologist suspected fibroids
• No fibroids observed on ultrasound
• Hormone levels were normal
• Gynecologist recommended that the patient “just deal with it”
• Patient said to me, “Because you fixed my back and I
thought...what the hell? I was willing to try. Plus no
cramps, etc. since seeing you.”

Treatment—Three Sessions Over Ten Days
• Positive Trendelenberg
• Positive sitting SLR
• SOT™ CAT II indicators
Assessment—Limited Examination

Visit One—11/6/12
• SOT™ CAT II supine block placement
• Standing lumbar adjustment with range of motion
• Adjustment to femoral heads bilaterally

Spondylotherapy—Visits One and Two
• 200 beats per minute
• C7, 4 minutes
• L3, 2 minutes
• L5, 2 minutes
Plexor
Pleximeter

Spondylotherapy Applied to C7

Patient reported
bleeding had stopped by
the morning after the
first treatment

Visit Two—11/13/12 (one week later)
• Adjustment to T3,T5,T7,T9 vertebral levels and discs, using
disc plexor
• Spondylotherapy, 200 beats per minute
• C7, 4 minutes
• L3, 2 minutes
• L5, 2 minutes

Visit Three—11/16/12 (on the 10th day)
• Adjustment to lumbar spine, discs and associated muscles
• Adjustment to cranium using anterior cranial pattern according to
Van Rumpt protocol

Anterior Pattern Findings

Challenging for Pattern Determination
Posterior
sphenoid
Anterior
sphenoid

Anterior Pattern Correction

Interview with Patient—3/5/14 (1 ½ years later)
• Patient reports more normal periods
• Mostly every 28 days
• Not very heavy
• Minimal cramping

Spondylotherapy Explained
• Developed by Albert Abrams around 1903
• He believed that visceral reflexes can be evoked by concussion of the
spinous processes
• In his words:
“The author has thus far examined about fifty patients who suffer from
painful menstruation and has noted points of tenderness located either
to the right or left side or both sides of one or more of the spines of the
first four lumbar vertebrae. Firm pressure with the end of the thumb
over one or more sensitive areas will abolish the pain for several hours
or during the entire period of menstruation.”

Spondylotherapy Explained
• Alva Gregory, DC stated that “spinal concussion, combined with
adjustment is more effective than either method alone.”
• Spondylotherapy was part of the curriculum at the National College of
Chiropractic in the 1940’s
• Stimulation of C7 induces a very decided and general vaso-constriction
• Stimulation of L1-3 produces the following results:
• Excites uterine contraction, overcomes uterine hemorrhage
• Overcomes atonic constipation
• Excites contraction of liver, spleen, stomach and intestines
• Increases tone of colon and intestines

Conclusion
• There is little research correlating the relationship of menorrhagia to low
back pain.
• There is little research discussing the use of spondylotherapy as a
treatment protocol.
• The chronicity of the patient symptoms and the temporal relationship
between treatment and response to care is of interest.
• While there have been few studies reported utilizing conservative
chiropractic methods in the care of menorrhagia, it appears that such
treatment can provide therapeutic benefit to those suffering from this
disorder.
• It is hoped that this study may generate greater interdisciplinary
cooperation so that patients can have an option of therapy that offers a
lower risk than surgery.

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http://emedicine.medscape.com/article/255540-treatment#a1128

Intervention in Menorrhagia Through Chiropractic and Spondylotherapy: A Case Report

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