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Objective This study aims to evaluate the immediate effect of a global pelvic manipulation ( GPM) technique, bilaterally applied, on low back pelvic pain in women with primary dysmenorrhea ( PD). Design A prospective, randomized, double-blind, controlled trial. Setting Faculty of Nursing, Physiotherapy and Podiatry. University of Sevilla, Spain. Methods The sample group included 40 women (30 ± 6.10 years) that were divided into an experimental group ( EG) (N = 20) who underwent a bilateral GPM technique and a control group ( CG) (N = 20) who underwent a sham (placebo) intervention. Evaluations were made of self-reported low back pelvic pain (visual analog scale), pressure pain threshold ( PPT) in sacroiliac joints ( SIJs), and the endogenous response of the organism to pain following catecholamines and serotonin release in blood levels. Results The intragroup comparison showed a significant improvement in the EG in the self-perceived low back pelvic pain ( P = 0.003) and in the mechanosensitivity in both SIJs ( P = 0.001). In the between-group comparison, there was a decrease in pain perception ( P = 0.004; F(1,38) = 9.62; R2 = 0.20) and an increase in the PPT of both SIJs, in the right side ( P = 0.001; F(1,38) = 21.29; R2 = 0.35) and in the left side ( P = 0.001; F(1,38) = 20.63; R2 = 0.35). There were no intergroup differences for catecholamines plasma levels (adrenaline P = 0.123; noradrenaline P = 0.281; dopamine P = 0.173), but there were for serotonin levels ( P = 0.045; F(1,38) = 4.296; R2 = 0.10). Conclusion The bilateral GPM technique improves in a short term the self-perceived low back pelvic pain, the PPT in both SIJs, and the serotonin levels in women with PD. It shows no significant differences with a sham intervention in catecholamines plasma levels. [ABSTRACT FROM AUTHOR]