EFFECT OF VIBRATION AND HEAT COMBINATION ON PRIMARY DYSMENORRHEA

Abstract

Background: Primary dysmenorrhoea is a common, idiopathic, chronic pelvic pain syndrome, with unknown aetiology which ‎about 50% of women with regular menstrual period suffer. This study was designed to determine the effect of vibration and heat on primary dysmenorrhea. Materials and Methods: In this clinical trial, 75 female students aged 18-22 years old were evaluated for two menstrual cycles. At the first cycle the participants received the routine pain-relief method (synthetic or herbal medicine and traditional remedies). At the second cycle for each participant combined vibration-heat device was applied for ten minutes during ‎menstrual pain. The average of perceived leg pain, lumbar pain and abdominal pain scores at two cycles were determined. The data were analyzed based on Wilcoxon and T tests by using SPSS (v 16.0) for Windows. Results: The average of all perceived pain scores at two cycles were significantly different before pain relief and after both routine methods and using the device (p<0.001). Those were more significantly reduced after using the device in comparison of using routine methods (p<0.001). Conclusion: Since “vibration-heat” is an effective pain relief method, it can be used as a complementary alternative medicine in primary dysmenorrhea reduction.

Full text

Bali Medical Journal (Bali Med J)
2015, Volume 4, Number 1: 12-16
P-ISSN.2089-1180, E-ISSN.2302-2914
Open access: www.balimedicaljournal.org and www.ojs.unud.ac.id 12
EFFECT OF VIBRATION AND HEAT COMBINATION ON
PRIMARY DYSMENORRHEA
1Mansoureh Hoseini, 2Sheida Rafiezadeh Gharahtapeh, 3Azam Jahazi.
1Master science of Nursing, A Faculty Member of Islamic Azad University, Gorgan Branch,
Islamic Azad University, Gorgan Branch, Department of Nursing, Gorgan, Iran.
2Bachelor science of Nursing, A member of Young Researcher Club, Islamic Azad University,
Gorgan Branch, Gorgan, Iran.
3Master science of Midwifery, A faculty member of Islamic Azad University, Gorgan Branch,
Islamic Azad University, Gorgan Branch, Department of Midwifery, Gorgan, Iran.
Background: Primary dysmenorrhoea is a common, idiopathic, chronic pelvic pain syndrome, with
unknown aetiology which about 50% of women with regular menstrual period suffer. This study was
designed to determine the effect of vibration and heat on primary dysmenorrhea. Materials and
Methods: In this clinical trial, 75 female students aged 18-22 years old were evaluated for two
menstrual cycles. At the first cycle the participants received the routine pain-relief method (synthetic
or herbal medicine and traditional remedies). At the second cycle for each participant combined
vibration-heat device was applied for ten minutes during menstrual pain. The average of perceived
leg pain, lumbar pain and abdominal pain scores at two cycles were determined. The data were
analyzed based on Wilcoxon and T tests by using SPSS (v 16.0) for Windows. Results: The average
of all perceived pain scores at two cycles were significantly different before pain relief and after both
routine methods and using the device (p<0.001). Those were more significantly reduced after using
the device in comparison of using routine methods (p<0.001). Conclusion: Since ―vibration-heat‖ is
an effective pain relief method, it can be used as a complementary alternative medicine in primary
dysmenorrhea reduction.
Keywords: Vibration; Heat; Dysmenorrhea; vibration.
INTRODUCTION
Primary dysmenorrhoea is a common,
idiopathic, chronic pelvic pain syndrome, with
unknown aetiology.1 It is a frequently occurring
condition affecting a large proportion of young
women. The highest prevalence has been reported
in adolescent women, where as many as 50–75%
suffer from dysmenorrhoea.2-7 Dysmenorrhea is
one of the major factors that decreases young
women's quality of life and social activities
specially if such symptoms as headache, fatigue,
nausea, vomiting, diarrhea, irritation, shivering and
muscle cramps are involved.8 About 15% of
Address of Correspondence:
Azam Jahazi
Master science of Midwifery, A faculty member of
Islamic Azad University, Gorgan Branch,
Department of Midwifery, Gorgan, Iran.
Email: ajahazi@gmail.com
adolescent and young women describe their
dysmenorrhoea as severe, causing regular
absenteeism from school and work.8-11 This
monthly disability, which interferes with daily
work several days each cycle, has been estimated to
account for 600 million lost working hours and two
billion dollars in lost productivity annually in the
USA.12 Effective management of dysmenorrhoea is
beneficial for both the afflicted individual and
society.
Systematic reviews and randomised
controlled trials have shown that non steroidal anti-
inflammatory drugs13-17 and hormonal regulation
through oral contraception18 are significantly more
effective for pain relief than placebo and are often
used for symptom control.19,20 However, some
women may not always find them effective or
acceptable. For example, owing to side effects in
the case of non-steroidal anti-inflammatory drugs.13
Non-drug treatments, including alternative and
physical Therapies such as topical heat, herbal
medicine, thiamine, vitamin E, fish oil, vegetarian
diet, low fat diet, acupuncture, acupressure and

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2015, Volume 4, Number 1: 12-16
P-ISSN.2089-1180, E-ISSN.2302-2914
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transcutaneous electrical nerve stimulation (TENS)
are increasingly being used for dysmenorrhoea.21
In different studies the effect of TENS on
primary dysmenorrhea,22 the effect of vibration on
chronic backache,23 and toothache were
identified.24 Vibration, moderate or fast
percussions and also deep pressure on painful
spots are pain relievers in dysmenorrhea.25 A
research on self-treatment patterns of young girls
for dysmenorrhea management showed that they
use heat to decrease their pain.26 Another research
study on the effect of physical activity on
dysmenorrhea showed that dysmenorrhea
prevalence in the athletic group was 3.2% less
than non-athletic group.27
The above mentioned problems of this
disorder and calls for its treatment prompted the
researcher and her colleagues to study the effect
of vibration and heat combination on
dysmenorrhea among the students of Islamic Azad
University, Gorgan Branch.
MATERIALS AND METHODS
Study design, setting and subjects: This is a
clinical trial conducted between Jun 2009 and
March 2010 in the girls’ dormitory of Islamic
Azad University of Gorgan (a city located in the
north of Iran). Seventy five 18-22 year-old girls
with a mediocre dysmenorrhea not having any
cardiovascular disease, severe anemia, chronic
headache, precedent pelvic surgery, secondary
dysmenorrhea and not being married were
studied. The sampling was purposeful and
voluntary.
Instruments
Demographic questionnaire, pain ruler and
vibration-heat device were used. Demographic
questionnaire consists of two-part: 1-demographic
characteristics (age, field of study, menarch age,
menstruation interval and the length of period)
and 2- clinical characteristic of dysmenorrhea (leg
pain, lumbar pain, abdominal pain). Vibration-
heat device vibrates with a frequency of 50 (Hz)
and heats up to 38 degrees in Celsius for ten
minutes. It is a portable, light weight (w=424gr)
and a safe device and is used as a belt on the
abdomen. Anti-dysmenorrhea 08 device with
registration no.58420 is from General Department
for Registration of Companies and Industrial
Ownership (General Department for Registration
of Documents and Landed Properties).
Data collection
During dysmenorrhea, participants were
asked to express their pain severity on a scale of
0-10 on the pain ruler, with 0 meaning no pain
and 10 meaning the most severe pain that an
individual might experience.
Each individual was studied for two
continuous menstrual periods. In both periods
participants filled out the checklists. On the first
period, no intervention was made by researchers
and participants were asked to fill out the
questionnaire according to the severity of pain
before and after using routine methods for relief
(synthetic medicine (Ibuprofen, Mefenamic Acid,
Hyoscine), herbals such as oxtongue boile,
solution of rock candy in hot water and
homemade treatments such as heating, massaging
and holding legs into belly). On the second period,
they were asked to use vibration-heat device for
ten minutes each time when the menstrual pain
began and they were told to use the device at a
maximum of three times for each pain. They were
told to avoid using other pain-relief methods as
long as possible but, if necessary, they could use
other methods. In the latter case they had to
mention the type, the quantity and the length of
that method.
Participants were referred to a gynecologist
for a pelvic ultrasonography to make sure that
there was not some pathologic factor in uterus and
ovaries (i.e. myoma, ovarian cyst).
The study was approved by the Islamic Azad
University, Gorgan branch, Medical Sciences
Research committee. The record number of study
in clinical trial site of IRAN is as IRCT:
201102195866N1. Written informed consent was
obtained from the participants before enrollment.
All ethics were observed in this study following
Helisinki Ethics.
Data analysis
Data were analyzed based on Wilcoxon and
T tests using SPSS (v 16.o) for Windows. The
confidence level was rated 95%.
RESULTS
Seventy five students were studied in two
cycles, 43% of whom were 20 years old, 82%
were Fars natives and 18% were Torkman natives.
All of participants were single. The subjects
mostly studied basic science, humanities and
medical science respectively. Menarche age of
42% of them was 13 years old. Minimum interval
between two periods was 21 days and maximum
interval was 40 days. Forty five percent of them
had a 28 day interval.
The shortest menstrual duration was 5 days
and the longest was 9 days and 53% of
participants had a 7 days menstrual duration.
The average of perceived pain score at two
cycles was significantly different before using
pain relief and after using both routine methods
and the device (P<0.001). It was more
significantly reduced after using the device in

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2015, Volume 4, Number 1: 12-16
P-ISSN.2089-1180, E-ISSN.2302-2914
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comparison of using routine methods (P<0.001).
Tables 1-3 show more details of the results.
While using the device, most of the
sample (53%) mentioned no side effect. A slight
redness of skin was reported in 8% of sample.
Table 1
Comparison of the average of pain severity
before and after routine methods
(control group)
Variable
Before pain
relief
After
routine
methods
Leg pain
4.52
3.45
Lumbar pain
5.25
4.08
Abdominal
pain
6.26
4.75
Total
5.34
4.09
p < 0.001 (Wilcoxon test)
Table 2
Comparison of the average of pain severity before
and after using the device (control group)
Variable
Before pain
relief
After using
device
Leg pain
2.93
4.52
Lumbar pain
3.34
5.25
Abdominal
pain
4.05
6.26
Total
3.44
5.34
p < 0.001 (Wilcoxon test)
Table 3
Comparison of the average of pain severity
between routine methods and using the device
Variable
After routine
methods
After using
device
Leg pain
2.93
3.45
Lumbar pain
3.34
4.08
Abdominal
pain
4.05
4.75
Total
3.44
4.09
p < 0.001 (T-test)
DISCUSSION
A study on the effects of TENS as a
treatment for primary dysmenorrhea among
students of Medical Science University of Tehran
showed that using TENS alone in the case group
had a remarkable decrease in pain in 65% of
participants in comparison with control group
(24%) and there was considerable decrease in
dysmenorrhea symptoms. Due to the results of
that study, TENS is a safe, effective and
nonopioid treatment of primary dysmenorrheal.19
Studying the effect of acupressure on Saninjiao
spot and Ibuprofen on primary dysmenorrhea on
students showed that the severity of the pain after
treatment in the first and second month hadn't a
significant difference, but the severity of pain
before and after treatment by acupressure and
Ibuprofen had a significant difference.28 In this
study the average severity of leg pain, lumbar pain
and abdominal pain during the first time before
using routine treatments and the device was 5.34,
while the average after using routine treatments
decreased to 4.09 and after using device to 3.44.
Studying the effect of physical activity on
dysmenorrhea comparing 250 students of Tarbiat
Mo'alem and 250 students of Physical Education
showed that dysmenorrhea prevalence was more
than 75% in each group. Dysmenorrhea
prevalence in the physical education group was
2.4% less than Tarbiat Mo'alem group. Prevalence
of dysmenorrhea in athletic group was 3.2% less
than non-athletic group. Prevalence and severity
of dysmenorrhea in athletic individuals
significantly decreased.27 Study on backache
reduction showed vibratory exercises in
comparison with tensive exercises had a
significant statistical relation to chronic backache
relief.20 Studying the effect of heat with
Acetaminophen showed when heat was used with
Acetaminophen, pain was decreased for a longer
time and topical heat would decrease
dysmenorrheal.29 Data gathered in this study
showed vibriation with heat had results similar to
physical exercise or other treatments such as using
synthetic medicine, herbal medicine and that
traditional remedies can be effective in decreasing
dysmenorrhea. Results of this study showed
vibration is a safe, non-invasive, non-drug way
and also during this research no considerable side
effects were observed or reported. Only a slight
side effect, that is, a moderate topical redness of
skin was observed in 8% of participants. In this
study, also, on the phase using routine methods
and on the second phase using the device, a
significant decrease was observed, therefore,
using the vibration-heat device was shown to be
more effective in pain relieving in comparison
with routine methods. A Study on the effect of
topical pressure and vibration on muscular pain
showed, when pressure is used with vibration, it
would decrease the pain by 11%. Vibration can
block the function of vast neurological fibers and
sciatic nerve and relieve the pain.30-32 The effect
of vibration on the pain reduction in the
mentioned study confirms vibratory effect of the
vibration device on pain reduction in our research.
CONCLUSION
Because this method is safe, it may be used
with common medicines or as an alternative
treatment for dysmenorrhea. Since this is the first
study on the relationship between vibration-heat
and dysmenorrhea, it is recommended in future

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2015, Volume 4, Number 1: 12-16
P-ISSN.2089-1180, E-ISSN.2302-2914
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studies should be done on different nationality
groups, other age classes and married individuals.
ACKNOWLEDGEMENT
We wish to thank the Research deputy of
Islamic Azad University, Gorgan Branch, Young
Researchers Club of Islamic Azad University,
Gorgan Branch, Students participating in this
study and all those who helped us. We would also
like to thank very much, Mr. shahin Hosseinian
MA in English, Mr. Reza Mokaram Ms in
Statistics and Dr. Zohre Montazeri, gynecologist .
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