Dysmenorrhea is a chronic, recurrent pain that manifests as Menstrual cramps or painful periods. It is the most common Gynecologic problem in women of all ages and races, and one of the Most common causes of pelvic pain . There are two types of dysmenorrhea; primary dysmenorrhea, and Secondary a dysmenorrhea. Primary dysmenorrhea (PD) is defined as Colic pain in the suprapubic region and lower abdomen with Irradiation to the lumbar region and thighs that occurs before or During menstruation in the absence of pelvic diseases. The Manifestation of it usually appears 6 months after menarche. The pain Starts shortly before or at the onset of menses and may last for 3 days ,While, secondary Dysmenorrhea is usually associated with pelvic diseases Inside or outside the uterus that could account for their Symptoms; such as endometriosis, adenomyosis, or uterine Fibroids pharmacological therapies include physiotherapeutic treatments such as the use of heating pads and regular physical exercise, dietary supplements (such as vitamins B, D, and E, or omega-3 fatty acids), acupuncture, yoga, massage, and herbal remedies in the management of PD . The pilates exercises is one of the physiotherapy methods, which improves mental and physical well-being, increases Flexibility, and strengthens muscles through controlled movements done as mat exercises and strengthen the body
. Pilates exercise has a positive effect on health Physical fitness as it increases the muscular Strength, muscular endurance, flexibility, cardiorespiratory endurance and a positive effect on Female sex hormone. Pilates exercise is a good one for the promotion of physical metabolism and Physiological function by positive change of immunoglobulin and sex hormone . The Gym exercises is One of the physiotherapy methods, which is known for strengthening core muscles and being effective in improvement of muscular function of abdominal and low back in addition to range of motion and pain relief. Gym exercises focus on strengthening muscles in the abdominal, leg, arm, and back regions. Additionally, they improve balance, stability, and blood circulation, ultimately contributing to the alleviation of menstrual pain .Intense physical activity is thought to trigger the secretion of beta-endorphins, which function like natural painkillers, thereby alleviating menstrual pain often connected with primary dysmenorrheoea .
