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Abstract

Primary dysmenorrhea with interferes in daily activities can have adverse effects on quality of life of women. Regarding the use of herbal medicine, the aim of this study was to assess the effect of cinnamon on primary dysmenorrhea in a sample of Iranian female college students from Ilam University of Medical Sciences (west of Iran) during 2013-2014. In a randomized double-blind trial, 76 female student received placebo (n = 38, capsules containing starch, three times a day (TDS)) or cinnamon (n = 38, capsules containing 420 mg cinnamon, TDS) in 24 hours. Visual analogue scale (VAS) was used to determine the severity of pain and nausea. Vomiting and menstrual bleeding were assessed by counting the number of saturated pads. The parameters were recorded in the group during the first 72 hours of the cycle. The mean amount of menstrual bleeding in the cinnamon group was significantly lower than the placebo group (P < 0.05 and P < 0.001, respectively). The mean pain severity score in the cinnamon group was less than the placebo group at various intervals (4.1 ± 0.5 vs. 6.1 ± 0.4 at 24 hours, 3.2 ± 0.6 vs. 6.1 ± 0.4 at 48 hours, and 1.8 ± 0.4 vs. 4.0 ± 0.3 at 72 hours, respectively) (P < 0.001). The mean severity of nausea and the frequencies of vomiting significantly decreased in the cinnamon group compared with the placebo group at various intervals (P < 0.001, P < 0.05). Regarding the significant effect of cinnamon on reduction of pain, menstrual bleeding, nausea and vomiting with primary dysmenorrhea without side effects, it can be regarded as a safe and effective treatment for dysmenorrhea in young women.
Iran Red Crescent Med J. 2015 April; 17(4): e27032. DOI: 10.5812/ircmj.17(4)2015.27032
Published online 2015 April 22. Research Article
The Effect of Cinnamon on Menstrual Bleeding and Systemic Symptoms
With Primary Dysmenorrhea
Molouk Jaafarpour 1; Masoud Hatefi 2; Fatemeh Najafi 3; Javaher Khajavikhan 4; Ali Khani 3,*
1Department of Midwifery, Nursing and Midwifery Faculty, Ilam University of Medical Sciences, Ilam, IR Iran
2Department of Neurosurgery, Medicine Faculty, Ilam University of Medical Sciences, Ilam, IR Iran
3Department of Nursing, Nursing and Midwifery Faculty, Ilam University of Medical Sciences, Ilam, IR Iran
4Department of Anesthesiology, Medicine Faculty, Ilam University of Medical Sciences, Ilam, IR Iran
*Corresponding Author: Ali Khani, Department of Nursing, Nursing and Midwifery Faculty, Ilam University of Medical Sciences, Ilam, IR Iran. Tel: +98-8432227116, Fax: +98-8432227116,
E-mail: nimakhani@gmail.com
Received: January 15, 2015; Revised: February 7, 2015; Accepted: March 8, 2015
Background: Primary dysmenorrhea with interferes in daily activities can have adverse effects on quality of life of women.
Objectives: Regarding the use of herbal medicine, the aim of this study was to assess the effect of cinnamon on primary dysmenorrhea in
a sample of Iranian female college students from Ilam University of Medical Sciences (west of Iran) during 2013-2014.
Patients and Methods: In a randomized double-blind trial, 76 female student received placebo (n = 38, capsules containing starch, three
times a day (TDS)) or cinnamon (n = 38, capsules containing 420 mg cinnamon, TDS) in 24 hours. Visual analogue scale (VAS) was used to
determine the severity of pain and nausea. Vomiting and menstrual bleeding were assessed by counting the number of saturated pads.
The parameters were recorded in the group during the first 72 hours of the cycle.
Results: The mean amount of menstrual bleeding in the cinnamon group was significantly lower than the placebo group (P < 0.05 and P
< 0.001, respectively). The mean pain severity score in the cinnamon group was less than the placebo group at various intervals (4.1 ± 0.5
vs. 6.1 ± 0.4 at 24 hours, 3.2 ± 0.6 vs. 6.1 ± 0.4 at 48 hours, and 1.8 ± 0.4 vs. 4.0 ± 0.3 at 72 hours, respectively) (P < 0.001). The mean severity
of nausea and the frequencies of vomiting significantly decreased in the cinnamon group compared with the placebo group at various
intervals (P < 0.001, P < 0.05).
Conclusions: Regarding the significant effect of cinnamon on reduction of pain, menstrual bleeding, nausea and vomiting with primary
dysmenorrhea without side effects, it can be regarded as a safe and effective treatment for dysmenorrhea in young women.
Keywords: Herbal Medicine; Complementary Therapies; Pain; Nausea; Vomiting
Copyright © 2015, Iranian Red Crescent Medical Journal. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCom-
mercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial us-
ages, provided the original work is properly cited.
1. Background
Primary dysmenorrhea is defined as a cyclic and painful
cramps pelvic, occurring just before or during menstrua-
tion which deranges daily activities (1). Primary dysmen-
orrhea is one of the most common gynecologic disorders
in young women which may affect more than half of
menstruating women (2-4). Prostaglandin production by
ovulation is the main cause of primary dysmenorrhea (5,
6). Digestive disorders including nausea, vomiting and
diarrhea are the symptoms associated with primary dys-
menorrhea, which are known due to intestinal spasms
during menstruation (7). The prevalence of dysmenor-
rhea in different populations is 50 - 90% and in Iran it is 74
- 86.1% (8, 9). Primary dysmenorrhea is a common cause of
absenteeism from work, education, or referral to physi-
cian, which may lead to decreased efficacy of occupation
and education. Although dysmenorrhea is not life threat-
ening, it could have adverse effects on quality of life (10).
In the USA, the annual economic loss of dysmenorrhea
is 600 million working hours and two billion dollars (11,
12). In a study of 664 school students in Egypt, about 75%
of the students had dysmenorrhea, rated scanty in 55.3%,
moderate in 30%, and severe in 14.7% (13). In a study on fe-
male students, 42% had a sessions absence from teaching
or daily activities due to dysmenorrhea. The study sug-
gested that 50% of girls believed that dysmenorrhea im-
pairs daily activities (14). Several methods such as drugs
(including oral contraceptive pills (OCP) consumption
and nonsteroidal anti-inflammatory drugs [NSAIDs]),
nonpharmacological treatments (including exercise,
heat therapy, acupuncture, and trans-electrical nerve
stimulation (TENS)), dietary supplements (vitamins E, B,
C, and Ca, Mg) and medicinal herbal have been used for
treatment of primary dysmenorrhea (15, 16). Synthetic
drugs, especially in long-term administration, have side
effects. Nausea, stomach irritation, ulcers, renal papillary
necrosis, and decreased renal blood flow are the side ef-
fects of prostaglandin synthesis inhibitors (14). On the
other hand, most of the young women have no tendency
to use hormones to reduce pain. Today, regarding the ef-
fects of chemical drugs and the usage of herbal medi-
cine, as well as alternative and complementary therapies
in treatment of diseases, many interested researchers
have been drawn to this area. One of these herbal medi-
cines and alternative therapies is cinnamon which has
Jaafarpour M et al.
Iran Red Crescent Med J. 2015;17(4):e270322
many applications in medicine, but has not been suffi-
ciently documented.
2. Objectives
Despite of its high prevalence, dysmenorrhea has not
been managed effectively. Therefore, due to the lack of
comprehensive studies for treatment of digestive disor-
ders accompanied with dysmenorrhea in Iran and because
of the importance of economic and social aspects of dys-
menorrhea and acceptability and availability of traditional
medicines, the aim of this study was to assess the effects of
cinnamon on menstrual bleeding and systemic symptoms
(nausea and vomiting) with primary dysmenorrhea in a
sample of Iranian female college students from Ilam Uni-
versity of Medical Sciences (west of Iran) during 2013 - 2014.
3. Patients and Methods
This was a quasi-experimental study performed at Ilam
University of Medical Sciences during 2013 - 2014. The sta-
tistical population included all female college students
living in governmental dormitories. The sample size was
calculated using the information obtained from a pilot
study with 10 patients and Equation 1:
(1) n
=
(Z1+Z2)
2(
2s
2)
d
2
=38
Z1 = 95% = 1.96
Z2 = 80% = 0.84 (test power)
S = an estimate of the standard deviation of visual ana-
logue scale (VAS) in the groups; 1.67 was obtained in a pi-
lot study.
d = the minimum of the mean difference of VAS between
the groups which showed a significant difference and was
obtained 1.1.
A simple random sampling design was used (Figure
1). After getting a written permission from the School
of Nursing and Midwifery, the researcher visited the
students of dormitories and the study objectives were
explained to them. Thereafter, from the interested
students who had the inclusion criteria using simple
random sampling of the number of the students, the
residences were divided into two groups of placebo and
cinnamon.
In a randomized double-blind trial, 76 female students
received placebo (capsules contain starch three times a
day (TDS), n = 38) or cinnamon (capsules containing 420
mg cinnamon, two capsules TDS, n = 38) in 24 hours dur-
ing the first three days of the menstrual cycle. The order of
use and the shapes of capsules were similar in the groups.
The inclusion criteria were age 18 - 30, regular menstrual
cycles, lack of chronic diseases, moderate primary dys-
menorrhea, digestive disorder (nausea or vomiting) with
primary dysmenorrhea, lack of pelvic inflammatory dis-
eases, tumor or fibroma, lack of recent stressors, and BMI
19 - 26. The exclusion criteria were the use of oral contra-
ceptive pill (OCP), receiving analgesics during the study
period, and medical or herbal allergy. We used VAS to de-
termine the severity of pain and nausea. The number of
times of vomiting was counted and menstrual bleeding
was assessed by counting the number of saturated pads.
Pain intensity, nausea, vomiting and menstrual bleeding
were monitored in the groups during the first 72 hours of
cycle (first, second, and third days of menstruation). The
pain severity was assessed in 1, 2, 3, 4, 8, 16, 24, 48 and 72
hours after the intervention. The nausea severity, vomit-
ing and the amount of menstrual bleeding were assessed
in 24, 48, and 72 hours after the intervention. The female
college students’ age, menarche age, length of menstrual
cycle, level and duration of pain, and age of dysmenorrhea
were recorded.
Assessed for eligibility (n= 138)
Excluded (n= 62)
Not meeting inclusion criteria (n=38)
Declined to participate (n= 18 )
Other reasons (n= 6 )
Randomized (n= 76 )
Allocated to intervention (n= 38)
Received allocated intervention (n=38)
Did not receive allocated intervention (give reasons )
(n=0)
Allocated to intervention (n= 38)
Received allocated intervention (n=38)
Did not receive allocated intervention (give reasons )
(n=0)
Analyzed (n= 38 )
Excluded from analysis (give reasons ) (n=0)
Analyzed (n= 38 )
Excluded from analysis (give reasons ) (n=0)
Allocation
Analysis
Figure 1. Flow Chart
Jaafarpour M et al.
3
Iran Red Crescent Med J. 2015;17(4):e27032
3.1. Ethical Consideration
The study was approved by the Institutional Ethics Com-
mittee of Ilam University of Medical Sciences, Ilam, Iran,
and informed consents were obtained from all the par-
ticipants (ethical code/92/H/184, 13/Dec/2012). In addition,
this study was registered at the Iranian Registry of Clini-
cal Trials (IRCT2013122114668N2).
3.2. Validity and Reliability
VAS rating is a standard tool for evaluation of pain sever-
ity, rated from 0 to 10.0; 0 means no pain and 10 means
the maximum pain in this scale. Regarding the severity of
nausea, 0 means no nausea and 10 means the maximum
nausea. To determine the validity of the questionnaire,
content validity was used. The questionnaire was provided
to 10 faculty members of Ilam University of Medical Scienc-
es and was used after revision. To determine the reliability
of the questionnaire, Cronbach’s alpha test was used. The
reliability of the questionnaire was determined 0.89.
3.3. Statistical Analysis
The collected data were analyzed using the statistical
software SPSS, version 16. (SPSS Inc., Chicago, IL., USA).
Descriptive statistics, independent t-test, chi-square test,
repeated measurement, Friedman test, and Man-Whitney
were performed to analyze the results. P < 0.05 was con-
sidered significant.
4. Results
Baseline characteristics of the participants are shown in
Table 1. None of the 76 enrolled females was withdrawn
for any reason. Samples characteristics were not differ-
ent among the groups (P > 0.5) (Table 1). According to
Kolmogorov-Smirnov test, data distribution was normal
and we used the parametric methods (P > 0.05) (Table 2).
Independent t-test showed that the mean pain sever-
ity score in the cinnamon group was less than the pla-
cebo group at various intervals (P < 0.001) (Table 3). The
mean duration of pain in the cinnamon group was sig-
nificantly less than the placebo group at various intervals
(P < 0.001) (Table 4). Repeated measurement analysis
showed that the mean pain score in the cinnamon group
(P < 0.001) and the placebo group (P = 0.001) were signifi-
cantly different in various intervals. The mean amount of
menstrual bleeding in the cinnamon group was signifi-
cantly lower than the placebo group at various intervals
(P < 0.05, P < 0.001) (Table 5).
According to Friedman’s test, the amount of menstrual
bleeding in the cinnamon group was significantly differ-
ent at various intervals (P < 0.001) and not significantly dif-
ferent in the placebo group at various intervals (P = 0.21).
The mean severity of nausea significantly decreased in the
cinnamon group compared with the placebo group at vari-
ous intervals (P < 0.001 and P < 0.05, respectively) (Table
6). Repeated measurement test showed that the mean
nausea score in the cinnamon group (P < 0.001) and the
placebo group (P = 0.03) were significantly different in vari-
ous intervals. The frequencies of vomiting in the cinnamon
group were less than the placebo group at various intervals
(P < 0.001, P < 0.05) (Table 6). The frequencies of vomiting
in the cinnamon group (P < 0.001) and the placebo group
(P = 0.04) were significantly different in various intervals.
Table 1. Baseline Characteristics of the Participants a
Characteristic Placebo (n = 38) Cinnamon (n = 38) P Valueb
Age, y 1.5 ± 21.3 1.1 ± 20.7 0.135
Age of menarche, y 0.8 ± 13.4 0.8 ± 13.3 0.116
Cycle, d 1.5 ± 27.8 1.5 ± 27.4 0.487
Age of dysmenorrhea, y 0.9 ± 14.6 0.5 ± 14.3 0.476
Duration of bleeding, d 6.1 ± 1.1 1.3 ± 6.3 0.090
a Values are presented as mean ± SD.
b P > 0.05.
Table 2. Kolmogorov–Smirnov Test a
Parameters K-S P Value Parameters K-S P Value Parameters K-S P Value
Age, y 0.796 0.555 Pain 8 0.813 0.638 Bleeding 24 0.629 0.429
Age of menarche, y 0.913 0.386 Pain 16 0.504 0.368 Bleeding 48 0.819 0.338
Cycle, d 0.657 0.486 Pain 24 0.681 0.593 Bleeding 72 0.749 0.628
Age of dysmenorrhea, y 0.589 0.674 Pain 48 0.938 0.654 Nausea 0.563 0.364
Duration of bleeding, d 0.847 0.538 Pain72 0.727 0.433 Nausea 24 0.486 0.377
Pain 0.719 0.439 Pain duration 0.438 0.322 Nausea 48 0.538 0.467
Pain 1 0.691 0.518 Duration 24 0.549 0.738 Nausea 72 0.613 0.489
Pain 2 0.739 0.345 Duration 48 0.582 0.623 Vomiting 24 0.764 0.513
Pain 3 0.489 0.636 Duration 72 0.648 0.389 Vomiting 48 0.839 0.360
Pain 4 0.949 0.421 Bleeding 0.864 0.512 Vomiting 72 0.693 0.459
a Abbreviation: K-S, Kolmogorov–Smirnov.
Jaafarpour M et al.
Iran Red Crescent Med J. 2015;17(4):e270324
Table 3. Outcome of Severity of Pain Between Groupsa
Pain Score by vas at Various Intervals, h Placebo (n = 38) Cinnamon (n = 38) P Value
Before treatment 1 ± 7.5 1 ± 7.4 0.569 b
1 h After intervention 7.3 ± 0.6 7.1 ± 0.7 0.00 c
2 h After intervention 7.1 ± 0.9 6.8 ± 0.7 0.00 c
3 h After intervention 6.8 ± 0.7 6.6 ± 0.4 0.00 c
4 h After intervention 6.7 ± 0.7 6.4 ± 0.6 0.00 c
8 h After intervention 6.5 ± 0.7 5.9 ± 0.9 0.00 c
16 h After intervention 6.3 ± 0.4 4.3 ± 0.7 0.00 c
24 h After intervention 6.1 ± 0.4 4.1 ± 0.5 0.00 c
48 h After intervention 5.3 ± 0.6 3.2 ± 0.6 0.00 c
72 h After intervention 4.0 ± 0.3 1.8 ± 0.4 0.00 c
a Values are presented as mean ± SD.
b P > 0.05.
c P < 0.001.
Table 4. Outcome of Duration of Pain Between Groupsa
Duration of Pain, hour Placebo (n = 38) Cinnamon (n = 38) P Value
Before treatment 2.3 ± 26.5 2.3 ± 27.2 0.359 b
24 h After intervention 25.2 ± 1.9 16.5 ± 1.6 0.00 c
48 h After intervention 21.2 ± 1.5 8.0 ± 0.9 0.00 c
72 h After intervention 18.7 ± 1.3 3.2 ± 0.4 0.00 c
a Values are presented as mean ± SD.
b P > 0.05.
c P < 0.001.
Table 5. Outcome of the Amount of Menstrual Bleeding Between Groups a
Amount of Menstrual Bleeding (Num-
ber of Used Pad)
Placebo (n = 38) Cinnamon (n = 38) P Value
Amount of menstrual bleeding before
of treatment
Scanty (1 pad) 3 (7.8) 4 (10.5) 0.251 b
Average (2-3 pads) 23 (60.5) 22 (57.8) 0.181 b
Excessive (≥ 4 pads) 12 (31.5) 12 (31.5) 0.274 b
24 h After intervention
Scanty (1 pad) 4 (10.5) 7 (18.4) 0.032 c
Average (2-3 pads) 23 (60.5) 25 (65.7) 0.061 b
Excessive (≥ 4 pads) 11 (28.9) 6 (15.7) 0.037 c
48 h After intervention
Scanty (1 pad) 6 (15.7) 17 (44.7) 0.012 c
Average (2-3 pads) 23 (60.5) 20 (52.6) 0.031 c
Excessive (≥ 4 pads) 9 (23.6) 1 (2.6) 0.00 d
72 h After intervention
Scanty (1 pad) 11 (18.4) 27 (71.05) 0.00 d
Average (2-3 pads) 23 (60.5) 11 (28.9) 0.00 d
Excessive (≥ 4 pads) 3 (7.8) 0 (0.00) 0.00 d
a Values are presented as No. (%).
b P > 0.05.
c P < 0.05.
d P < 0.001.
Jaafarpour M et al.
5
Iran Red Crescent Med J. 2015;17(4):e27032
Table 6. Outcome of Severity of Nausea and Vomiting Between Groups a, b
Nausea Score by VAS at Various Intervals, h Placebo (n = 38) Cinnamon (n = 38) P Value
Nausea score before of treatment 5.8 ± 2.1 5.6 ± 1.8 0.09
24 h After intervention 5.5 ± 1.9 4.1 ± 1.6 0.01 c
48 h After intervention 4.7 ± 2.2 2.6 ± 1.4 0.00 d
72 h After intervention 3.3 ± 1.6 0.5 ± 1.1 0.00 d
Number of vomiting
Number of vomiting before of treatment
non 25 (65.7) 26 (68.4) 0.06e
1-2 11 (28.9) 10 (26.3) 0.18e
≥ 3 2 (5.2) 2 (5.2) 0.08e
24 h After intervention
non 26 (68.4) 32 84.2) 0.01 c
1-2 10 (26.3%) 5 (13.1) 0.00 d
≥ 3 2 (5.2%) 1 (2.6) 0.04 c
48 h After intervention
non 29 (76.3) 36 (94.7) 0.00 d
1-2 7 (18.4) 2 (5.2) 0.00 d
≥ 3 2 (5.2) 0 (0.00) 0.00 d
72 h After intervention
non 31 (81.5) 38 (100) 0.00 d
1-2 7 (18.4) 0 (0.00) 0.00 d
≥ 3 0 (0.00) 0 (0.00) 0.00
a Abbreviation: VAS, Visual analogue scale.
b Values are presented as mean ± SD or No. (%).
c P < 0.05.
d P < 0.001.
e P > 0.05.
5. Discussion
Our results suggested that cinnamon significantly re-
duced pain, the amount of menstrual bleeding, nausea
and vomiting in female college students. Therefore, cin-
namon improves the severity of primary dysmenorrhea.
This finding was consistent with the previous studies on
the effects of herbal medicines such as cumin (16) thymus
vulgaris, Achillea millefolium (17), fennel (18), Matricaria
recutita (19), Rosa damascena extract (20), aromatherapy
massage and Zingiber officinale (1) in treatment of dys-
menorrhea.
Dysmenorrhea is a common problem in young females
(21, 22). Primary dysmenorrhea is caused by an increase
in the synthesis and release of prostaglandins, particu-
larly PGF2α from the uterine endometrium during the
menstrual period. This prostaglandin in turn causes
contraction of smooth muscles in many adjacent tis-
sues. Uterine smooth muscle contractions cause colicky
pains, spasmodic and labor-like pains in the lower abdo-
men and cause lower back pain which is a characteristic
of dysmenorrhea. Furthermore, prostaglandin secretion
causes smooth muscle contraction of gastric-intestinal
tract, which can lead to nausea, vomiting and diarrhea (7,
23-27). Today in herbal medicine, numerous benefits have
been found. Herbal medicines reduce the level of prosta-
glandins, have nitric oxide modulation effects, increase
the levels of beta-endorphin, block calcium channels and
improve circulation; thus, are effective in the treatment
of dysmenorrhea (28-30). Cinnamon is one of the oldest
and most traditional herbal medicines. Cinnamon is a
member of the Lauraceae family, which has been widely
used as a spice for thousands of years to improve the taste
of foods and drinks. Indications of cinnamon in medi-
cine include diarrhea treatment, as an astringent, germi-
cide, antispasmodic, dyspeptic complaints, for chronic
Jaafarpour M et al.
Iran Red Crescent Med J. 2015;17(4):e270326
bronchitis, treatment of impotence, frigidity, dyspnea,
inflammation of eye, leukorrhea, vaginitis, rheumatism,
and neuralgia, as well as wounds and toothaches, cold
and flu; but, has not been sufficiently documented. The
oil extracted of cinnamon has anti-inflammatory activity,
as a treatment for dysmenorrhea and to stop bleeding.
However, toxicology trials performed with high doses
demonstrated that the oil of this plant stimulated the
mucous membranes and instigated hematuria (1, 5).
The main component of the essential oil of cinnamon
bar is cinnamaldehyde (55 - 57%) and eugenol (5 - 18%).
Cinnamaldehyde has been reported to have an antispas-
modic effect. In addition, eugenol can prevent the bio-
synthesis of prostaglandins and reduce inflammation.
Cinnamon contains a variety of vitamins such as vitamin
A, thiamin, riboflavin, and ascorbic acid (20). In adults
and adolescents, 1.5 - 4 g daily of dried bark cinnamon
can be used. In this study, we used a total dose of 2.52 g
daily (in three divided doses), which was effective on pri-
mary dysmenorrhea and no side effects were found with
this dose. On the other hand, this was the first clinical
trial on the effects of cinnamon on menstrual bleeding
and systemic symptoms including nausea and vomiting
due to primary dysmenorrhea in female college students
in Iran, which was the strength of this study. Some of the
factors influencing pain intensity and other symptoms
with primary dysmenorrhea such as culture, genetic and
nutrition (20, 31) were uncontrollable, which were the
weak points of this study.
In conclusion, this research suggested that cinnamon
has a significant effect on reduction of pain, menstrual
bleeding, nausea and vomiting due to primary dysmen-
orrhea, and with respect to no reported side effects, cin-
namon can be regarded as a safe and effective treatment
for primary dysmenorrhea.
Acknowledgements
We thank Ilam University of Medical Sciences, partici-
pants, coordinators and data reviewers who assisted in
this study.
Authors’ Contributions
Molouk Jaafarpour, Masoud Hatefi, Fatemeh Najafi, Java-
her khajavikhan and Ali khani participated in the study
design, data analysis, literature review, preparation and
editing the manuscript.
Funding/Support
This study was supported by Ilam University of Medical
Sciences (grant No. 913007/140).
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... [1,3] The main cause of dysmenorrhea is not clearly understood, but it related to uterine prostaglandin levels, especially PGF2 which is noticeable in women who have severe dysmenorrhea, this process occurs when the uterine wall expulsion leading to release of prostaglandin from endometrial cells in the time of starting of menstruation. [4,5] Prostaglandin is responsible of contractions of the smooth muscle of the uterus, that is why it related to pain. [4,5] The highest level of prostaglandin usually occurs in the first two days of menstruation. ...
... [4,5] Prostaglandin is responsible of contractions of the smooth muscle of the uterus, that is why it related to pain. [4,5] The highest level of prostaglandin usually occurs in the first two days of menstruation. [4,5] Dysmenorrhea is divided into two types, primary and secondary dysmenorrhea. ...
... [4,5] The highest level of prostaglandin usually occurs in the first two days of menstruation. [4,5] Dysmenorrhea is divided into two types, primary and secondary dysmenorrhea. [6,7] primary dysmenorrhea refers to painful contractions without any reasons inverse to secondary type which referring to the presence of problems in the uterus or pelvis, which is resolved when the cause have been treated. ...
Article
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Dysmenorrhea is a painful contraction in the uterus region happening before and/or during menstrual cycle menstrual cycle. It is a typical issue among adults females influencing around 40-80% of them begin a couple days before menstruation and goes on for a couple of hours to a few days after start of monthly cycle. The study objective is to evaluate the cinnamon effects on primary dysmenorrhea in a sample of adult females in eastern region of Saudi Arabia. An online survey was distributed in the eastern region of Saudi Arabia. The study was conducted in Saudi Arabia between January to March 2017. The questionnaire included four sections: demographics section, concern symptoms, practice and knowledge. The total numbers of females participated in this study was 232. Regarding to females attitude to minimize the pain of dysmenorrhea, most of them used paracetamol or ibuprofen tablets 109 (47%) and 74 (31.9%) used cinnamon. Only 50 (31.25%) of them had complete pain relieving all using cinnamon, but 96 (59.66%) had partial pain while using cinnamon. Regarding the possible side effects induced by cinnamon using, the most of participants 207(89.26%) did not suffer from any side effects. Based on this study results, the effect of cinnamon on dysmenorrhea appeared to be inferior to analgesics and had moderate effect on dysmenorrhea. Further study with randomized double-blinded control design and appropriate sample size in different regions of Saudi Arabia is needed to study its real efficacy.
... Effect of cinnamon on pain was reported for perineal and pelvic pain in the previous studies and found to produce a noticeable improvement in primary dysmenorrhea and after episiotomy [17], [18], [26], [27]. ...
... The pain-reducing action found in this study is consistent with that found in other studies. [17], [18], [26], [27]. Dashti-Rahmatabadi et al. in 2009 found that cinnamon extract in high dose decreases the intensity of chronic formalin-induced pain in rats [29]. ...
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BACKGROUND: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is common, yet no curative treatment identified. Cinnamon is a herbal substance, which has many applications in medicine. AIM: The aim of the study was to study the effect of cinnamon on patients with chronic pelvic pain syndrome. METHODS: Sixty patients with documented CP/CPPS randomized into two groups during 2018 and 2019 in Baghdad. The first group received 60 capsules each contained 1 g of cinnamon. The other group received 60 capsules each contained 1 g of sugar powder (placebo). All the patients instructed to take one capsule twice daily for 1 month. National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) was reported for both groups at baseline and after 1 month of treatment. The primary outcome was a patient perceivable improvement defined as a reduction of the NIH-CPSI by 6 or more points after 1 month, whereas improvement of sub-scores of NIH-CPSI (pain, urinary symptoms, and quality of life) considered as a secondary outcome, and adverse reactions reported. RESULTS: Thirteen patients (43.3%) of the cinnamon group have 6 or more points of reduction in the total NIH-CPSI compared to four patients (13.3%) of the control groups (p = 0.01). The improvement in total NIH-CPSI score was mainly due to improvement in pain sub-score, whereas in urinary symptoms, there was marginal change with no significant change in the quality of life score. The only reported side effect was gastric upset in one patient. CONCLUSION: The study concluded that cinnamon improves NIH-CPSI in patients with CP/CPPS. REGISTRATION: The study was registered on ClinicalTrials.gov with the ID: NCT03946163.
... Including different things such as herbal medicines, Cinnamon is the oldest one and its history is also included in different Chinese books of about 4000 years back 9 . Cinnamon has been customarily cultivated in Asian countries and it is long lasting tree. ...
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Different plants are used medically and thofese therapeutic plants have great importance for healing contagious wounds. This herbal treatment is actually also a substitute of different antibiotics and having less side effects on intestinal systems of animals. The foremost concern of this study was to observe the antibacterial activity of Cinnamum zeylanicum and Acacia nilotica. Pathogenic bacteria obtained from wound samples and later identified by biochemical and molecular characterization. Methanol (an organic solvent) was used to extract Cinnamum zeylanicum and Acacia nilotica to check their antimicrobial exertion by using agar diffusion method. Different antibiotics such as, ampicillin, oflaxocin, ticarcillin and cefexime, showed their susceptibility toward antibiotics. The zone of inhibitions for antibiotic and plant extracts' antibacterial activity were measured. Pathogenic bacteria were identified as Staphylococcus aureus and Streptococcus pyogenesby molecular characterization. These bacteria showed susceptibility to antibiotics and also the plant extracts. Antibiotic oflaxocin showed maximum activity against these two pathogens (12.25 ± 0.44 and 12.375 ± 0.47) while antibiotic cefixime showed minimum effect (1.25 ± 0.28 and 0.625 ± 0.25). Plant extracts showed significant antibacterial activity with maximum activity (14 ± 0.9 by Acacia nilotica and 12 ± 0.5 by Cinnamum zeylanicum) in 100% solution. It can be concluded thatmethanolic extract of traditional therapeutic plants proved to be a promising source of antimicrobial agents against antibiotic resistant bacteria. Cinnamum zeylanicum and Acacia nilotica were observed to be competent as antibacterial tool against pathogenic bacterial strains.
... There is still not enough evidence to determine which NSAID is the safest and most effective to the healing of dysmenorrhea (Marjoribanks et al., 2010). The simplest non-pharmacological way is to try to divert pain in other activities, warm compresses, adequate sleep, massage, or light exercise (Burnett & Lemyre, 2017;Jaafarpour et al., 2015;Mirabi et al., 2014). Pain management with non-pharmacology is safer to use and does not cause side effects (Burnett & Lemyre, 2017). ...
... Study conducted by Jaafarpour et al suggested that cinnamon had a significant effect on reduction of pain and with respect to no reported side effects cinnamon can be regarded as a safe and effective treatment. 9 Several studies such as Zeraathad et al and Gebeyehu et al recommended the use of home remedies as an alternative to drugs used for menstrual symptoms as it was more beneficial with less side effects. 10,20 Also, most of the subjects used home remedies as a non-pharmacological treatment for menstrual pain. ...
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Background: Menstruation is a natural phenomena of the female reproductive cycle in which discharge of blood from the uterus exits through the vagina every month, it is the spontaneous onset of puberty. 75% of girls confront some problems associated with menstruation including delayed, irregular, painful and heavy menstrual bleeding. Menstruation can be accompanied with premenstrual and postmenstrual symptoms which include both physiological symptoms and psychological symptoms. It is important to treat both physiological and psychological symptoms with pharmacological and nonpharmacological treatment approaches.Methods: The study was a prospective observational study done with a sample size of 650 subjects of 9 to 18 age group in whom menstruation already occurred were recruited from five different schools in regions of Pathanamthitta and Alappuzha. The study was conducted in 3 phases, where initially a predesigned well-structured questionnaire was provided to assess the attitude, awareness and practices.Results: Subjects experienced some or other type of symptoms and had better knowledge regarding menstrual symptoms and its importance of management when compared to subjects from other regions of India which was imparted from a developed and supporting society but still, they lacked some adequate and updated information on symptoms and management of symptoms during menstruation.Conclusions: So, this study laid the groundwork for discussion on menstrual symptoms, various approaches of treatment to the adolescent girls, providing them the information they lacked and better guidance.
... Cinnamon is traditionally used in medicine applications. The effect of cinnamon has been studied during pregnancy(John and Shantakumari, 2015), for diabetes control(Wazaify et al. 2011), and gynecological problems(Jaafarpour et al. 2015). It's anti-inflammatory, antibacterial, antifungal, cardioprotective, antioxidative, and antimicrobial properties have also been researched (Kawatra and Rajagopalan, 2015; Yanakiev, 2020). ...
... Students were randomly included in-two in one of the two groups of A and B. After two months of qualifying students with the inclusion criteria and determining the list of students with dysmenorrhea, each student was given a number according to the list of eligible students participating in the study and provide a random list for two groups from Sealed Envelope site. 30 We used the Sealed Envelope site to provide randomization list. A list of blocks size 4 with random sequence of groups within each block generate randomly and J Evolution Med Dent Sci / eISSN -2278-4802, pISSN -2278-4748 / Vol. 9 / Issue 46 / Nov. 16,2020 Page 3448 saved to look up the treatment group for the given code. ...
Studies show that between 41% and 91.5% of young women, school-aged and university-aged, are affected by dysmenorrhea. Primary dysmenorrhea, which is caused by the production of prostaglandins, is defined as cramping pain in the lower abdomen and/or pelvis occurring just before or during menstruation, in the absence of other diseases such as endometriosis, and typically lasting 1-3 days and with a negative physical examination. Secondary dysmenorrhea presents with similar signs and symptoms but is a result of underlying pelvic pathology, for example endometriosis or uterine fibroids. Dysmenorrhea most typically presents as abdominal cramping; however, it can also present with headaches, nausea, vomiting or other generalized symptoms. The diagnosis is mainly clinical, but other tests such as a pelvic examination, a pregnancy test and STI screening may be helpful in ruling out other sources of pain. Although the mainstay of treatment for dysmenorrhea is NSAIDs and hormonal therapy, lifestyle changes and complementary/alternative medicine can also be helpful approaches. Lifestyle changes include aerobic exercise and stretching, while complementary alternative medicine include peppermint, cinnamon, ginger and other herbs and supplements. Finally, endometriosis must be considered as a potential cause for secondary dysmenorrhea and would warrant a prompt referral to gynecology.
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Objective To examine the associations between menstruation features and symptoms and hormone-immune-metabolic biomarkers. Methods Forty-one women completed questionnaires assessing characteristic menstruation symptoms, duration of menstrual cycle and number of pads used/day and completed the Daily Record of Severity of Problems (DRSP) during the consecutive days of their menstrual cycle. Menses-related symptoms (MsRS) were computed from the sum of 10 pre- and post-menses symptoms and the menstruation blood and duration index (MBDI) was computed based on the daily number of pads and duration of menses. We assayed serum levels of various biomarkers at days 7, 14, 21, and 28 of the subjects' menstrual cycle. Results MBDI was significantly associated with a) MsRS including low abdominal cramps, and gastro-intestinal (GI) and pain symptoms (positively); b) plasma levels of haptoglobin (Hp), CCL5, insulin growth factor (IGF)-1, and plasminogen activator inhibitor (PAI)1 (all positively); and c) estradiol and paraoxonase (PON)1 arylesterase activity (both inversely). MsRS were significantly predicted by CCL5 and IGF-1 (both positively) and progesterone (inversely). Low-abdominal cramps, and gastro-intestinal and pain symptoms were associated with lower progesterone levels. The MBDI+MsRS score was significantly predicted by the cumulative effects of (in descending order of importance): Hp, IGF-1, PON1 arylesterase, estradiol and PAI. Conclusion Menstruation-related features including estimated blood loss, duration of menses, cramps, pain, and gastro-intestinal symptoms are associated with hormone-immune-metabolic biomarkers, which mechanistically may explain those features. Future research should construct a cross-validated algorithm using MBDI+MsRS features in a larger study group to delineate a useful case-definition of menstruation-related distress.
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The study aims to know the medicinal plants used by farming families of communities in four municipalities of the south region of RS for the relief of menstrual cramps. It is a descriptive study that analyzed qualitative data. The subjects were 19 farmers from Cangu?u, Arroio do Padre, Morro Redondo and Pelotas. Data were collected from January and May the 2009, through semistructured interviews. Eight plants used for relieve menstrual cramps were cited. This research showed that the popular knowledge of farmers is consistent, in 100%, with the search made in the scientific literature. It is evident that the plants Apium sp., Plectranhus sp., Cinnamomum sp., Chenopodium ambrostoides, Origamun sp., Petroselimum crispum have evidence in the scientific literature, showing that the individuals in this study use the medicinal plants suitable for their purpose.
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Background: Different therapeutic methods have been applied for the treatment of dysmenorrhea and the method with the lesser side effects is preferred. The aim of this study was to compare the effects of herbal products (fennelin and vitagnus) and mefenamic acid in the treatment of primary dysmenorrhea. Materials and Methods: This ouble-blind clinical trial was carried out in 105 students with mild and moderate dysmenorrhea. The students were randomly divided into four groups which received the extracts of fennelin and vitagnus, mefenamic acid, and placebo, respectively. Severity of pain was detected by the Visual Analog Scale (VAS) during one cycle before and two cycles after the intervention. Data were analyzed by SPSS version 16 and (P < 0.05 was considered significant. Results: Demographic characteristics of the students were similar in the four groups. There was no significant difference in the mean of severity of dysmenorrhea during one cycle before the intervention between the four groups, but the difference was significant during two cycles after the intervention. Fennelin had similar effects as vitagnus on dysmenorrhea. Mefenamic acid had less effect than both the drugs (P <0.05). Conclusion: Fennelin and vitagnus had higher effect than mefenamic acid. Use of these products is suggested for dysmenorrhea.
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Dysmenorrhea is one of the most common types of cyclic pain that affects 50% of women and girls in their menstrual ages. Because of the side-effects and contraindications of chemical medicines, using herbs has been investigated in treating dysmenorrhea. The aim of this study was to determine the effect of Rosa damascena extract on primary dysmenorrhea among the students of Kowsar dormitory in Tabriz University of Medical Sciences. This study was performed in Iran on 92 single 18-24 year old students with BMI :19-25 and obtaining pain intensity score of 5-8 in Visual Analogue Scale that were randomly classified and included in two groups of 46 persons. The participants received two capsules of Mefenamic Acid and Rosa damascena with the similar physical properties in two consecutive cycles per 6 hours for 3 days in a cross-over form. The data were collected through the questionnaire of demographic characteristics and check-list of visual analogue scale. Descriptive statistics and repeated measurement test and independent samples t test by using SPSS (13/win) were used in order to determine and compare the effects of two drugs on dysmenorrheal pain intensity of the groups. There was a significant difference between the average of pain intensity at different hours of measurement in each group after the end of first cycle and second cycle (P < 0.001). There was no significant difference between the average of pain intensity in two groups in the first cycle (P = 0.35) and second cycle (P = 0.22). In this study¸ Rosa damascena and Mefenamic acid had similar effects on pain intensity of primary dysmenorrhea . With further studies, Rosa damascena which has no chemical side effects¸ can be suggested for treating primary dysmenorrhea.
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Dysmenorrhea is a common cause of sickness absenteeism from both classes and work. This study investigated the effect of aromatherapy massage on a group of nursing students who are suffering of primary dysmenorrhea. A randomized blind clinical trial of crossover design was used. In the first treatment phase, group 1 (n = 48) received aromatherapy abdominal massage once daily for seven days prior to menstruation using the essential oils (cinnamon, clove, rose, and lavender in a base of almond oil). Group 2 (n = 47) received the same intervention but with placebo oil (almond oil). In the second treatment phase, the two groups switched to alternate regimen. Level and duration of pain and the amount of menstrual bleeding were evaluated at the baseline and after each treatment phase. During both treatment phases, the level and duration of menstrual pain and the amount of menstrual bleeding were significantly lower in the aromatherapy group than in the placebo group. These results suggests that aromatherapy is effective in alleviating menstrual pain, its duration and excessive menstrual bleeding. Aromatherapy can be provided as a nonpharmacological pain relief measure and as a part of nursing care given to girls suffering of dysmenorrhea, or excessive menstrual bleeding.
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The objective was to evaluate the prevalence of dysmenorrhea and determine its effect on health-related quality of life (HRQoL) among a group of female university students. This cross-sectional study was conducted between 15 March and 15 April 2009 at Dumlupinar University, Kutahya, Health High School, Western Turkey. The study group included 623 female students. The severity of dysmenorrhea was determined with a 10-point visual analog scale. The Short Form-36 (SF-36) form was used to determinate HRQoL. Chi-square test, Student's t test, and logistic regression and variance analyses (ANOVA) were used for statistical analyses. The average age of the study group was 20.8 +/- 1.8 years (range 17-30). Prevalence of dysmenorrhea was found to be 72.7% and was significantly higher in coffee consumers, females with menstrual bleeding duration > or =7 days, and those who had a positive family history of dysmenorrhea when compared to the others (P < 0.05, for each one). By multivariate analysis, coffee consumption (OR 2.084), menstrual bleeding duration > or =7 days (OR 1.590), and positive family history of dysmenorrhea (OR 3.043) were important risk factors for dysmenorrhea. Except for social functioning, role-emotional, and mental health domains, the SF-36 points received from the other domains were higher in females with dysmenorrhea (for each one P < 0.05). With the exception of the scores received from physical functioning and role-emotional domains, the scores received from the other domains of the SF-36 scale showed a decrease with increasing severity of dysmenorrhea (P < 0.05, for each one). Dysmenorrhea is a common health problem, having negative effects on the HRQoL among university female students.
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Our objective was to examine the effect of an Iranian herbal drug in the treatment of primary dysmenorrhea. A randomized, double-blind, placebo-controlled pilot trial among 180 female students at Isfahan University dormitory aged 18 to 27 who suffered from primary dysmenorrhea was undertaken. The participants were randomly divided into three groups: herbal drug, mefenamic acid, and placebo. The herbal drug group was given 500 mg of highly purified saffron, celery seed, and anise (SCA) extracts three times a day for three days, starting from the onset of bleeding or pain. Participants were followed for two to three cycles from the beginning of menstruation through the three days of bleeding. Main outcome measures were the severity and duration of pain at 2 and 3 months. A visual analogue scale was used to record pain. There were statistically significant reductions in pain scores and pain duration scores in the groups that took SCA (P < . 001) and mefenamic acid (P < . 01). The decrease in pain score was reflected by a significant reduction in other drug use among the treatment groups compared with the women in the placebo group. The magnitude of the reduction was significantly greater in the SCA group than in the mefenamic acid and placebo groups. Both drugs effectively relieved menstrual pain as compared with the placebo. More clinical trials are needed to establish the efficacy of this herbal drug.
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Problems associated with menstruation affect 75% of adolescent females and are a leading reason for visits to physicians. This chapter begins with a review of the timing and characteristics of normal menstruation during adolescence. It then discusses the evaluation and management of adolescents with amenorrhoea, dysmenorrhoea and abnormal uterine bleeding. An approach to adolescent amenorrhoea is presented that utilizes primary versus secondary amenorrhoea, delayed versus normal pubertal development, and the presence or absence of hyperandrogenism as nodal points for decision making. The differential diagnosis of dysmenorrhoea and the management of primary dysmenorrhoea and endometriosis are reviewed. The section on abnormal uterine bleeding contrasts anovulatory dysfunctional uterine bleeding (DUB) with bleeding secondary to problems of pregnancy, uterine pathology, exogenous hormone use and systemic bleeding disorders.
Article
Context.— Research both in the United States and abroad suggests that significant numbers of people are involved with various forms of alternative medicine. However, the reasons for such use are, at present, poorly understood.Objective.— To investigate possible predictors of alternative health care use.Methods.— Three primary hypotheses were tested. People seek out these alternatives because (1) they are dissatisfied in some way with conventional treatment; (2) they see alternative treatments as offering more personal autonomy and control over health care decisions; and (3) the alternatives are seen as more compatible with the patients' values, worldview, or beliefs regarding the nature and meaning of health and illness. Additional predictor variables explored included demographics and health status.Design.— A written survey examining use of alternative health care, health status, values, and attitudes toward conventional medicine. Multiple logistic regression analyses were used in an effort to identify predictors of alternative health care use.Setting and Participants.— A total of 1035 individuals randomly selected from a panel who had agreed to participate in mail surveys and who live throughout the United States.Main Outcome Measure.— Use of alternative medicine within the previous year.Results.— The response rate was 69%.The following variables emerged as predictors of alternative health care use: more education (odds ratio [OR], 1.2; 95% confidence interval [CI], 1.1-1.3); poorer health status (OR, 1.3; 95% CI, 1.1-1.5); a holistic orientation to health (OR, 1.4; 95% CI, 1.1-1.9); having had a transformational experience that changed the person's worldview (OR, 1.8; 95% CI, 1.3-2.5); any of the following health problems: anxiety (OR, 3.1; 95% CI, 1.6-6.0); back problems (OR, 2.3; 95% CI, 1.7-3.2); chronic pain (OR, 2.0; 95% CI, 1.1-3.5); urinary tract problems (OR, 2.2; 95% CI, 1.3-3.5); and classification in a cultural group identifiable by their commitment to environmentalism, commitment to feminism, and interest in spirituality and personal growth psychology (OR, 2.0; 95% CI, 1.4-2.7). Dissatisfaction with conventional medicine did not predict use of alternative medicine. Only 4.4% of those surveyed reported relying primarily on alternative therapies.Conclusion.— Along with being more educated and reporting poorer health status, the majority of alternative medicine users appear to be doing so not so much as a result of being dissatisfied with conventional medicine but largely because they find these health care alternatives to be more congruent with their own values, beliefs, and philosophical orientations toward health and life. IN 1993 Eisenberg and colleagues1 reported that 34% of adults in the United States used at least 1 unconventional form of health care (defined as those practices "neither taught widely in U.S. medical schools nor generally available in U.S. hospitals") during the previous year. The most frequently used alternatives to conventional medicine were relaxation techniques, chiropractic, and massage. Although educated, middle-class white persons between the ages of 25 and 49 years were the most likely ones to use alternative medicine, use was not confined to any particular segment of the population. These researchers estimated that Americans made 425 million visits to alternative health care providers in 1990, a figure that exceeded the number of visits to allopathic primary care physicians during the same period. Recent studies in the United States2 and abroad3- 4 support the prevalent use of alternative health care. For example, a 1994 survey of physicians from a wide array of medical specialties (in Washington State, New Mexico, and Israel) revealed that more than 60% recommended alternative therapies to their patients at least once in the preceding year, while 38% had done so in the previous month.2 Forty-seven percent of these physicians also reported using alternative therapies themselves, while 23% incorporated them into their practices. When faced with the apparent popularity of unconventional medical practices and the fact that people seem quite willing to pay out-of-pocket for these services,1 the question arises: What are the sociocultural and personal factors (health status, beliefs, attitudes, motivations) underlying a person's decision to use alternative therapies? At present, there is no clear or comprehensive theoretical model to account for the increasing use of alternative forms of health care. Accordingly, the goal of the present study was to develop some tentative explanatory models that might account for this phenomenon. Three theories that have been proposed to explain the use of alternative medicine were tested: Dissatisfaction: Patients are dissatisfied with conventional treatment because it has been ineffective,5- 6 has produced adverse effects,6- 7 or is seen as impersonal, too technologically oriented, and/or too costly.6- 15Need for personal control: Patients seek alternative therapies because they see them as less authoritarian16 and more empowering and as offering them more personal autonomy and control over their health care decisions.14,16- 19Philosophical congruence: Alternative therapies are attractive because they are seen as more compatible with patients' values, worldview, spiritual/religious philosophy, or beliefs regarding the nature and meaning of health and illness.19- 24 In addition to testing the validity of these 3 theoretical perspectives, this study also sought to determine on an exploratory basis how the decision to seek alternative therapies is affected by patients' health status and demographic factors.
Article
To compare the effects of ginger, mefenamic acid, and ibuprofen on pain in women with primary dysmenorrhea. This was a double-blind comparative clinical trial conducted from September 2006 to February 2007. Participants were 150 students (18 years old and over) with primary dysmenorrhea from the dormitories of two medical universities who were alternately divided into three equal groups. Students in the ginger group took 250 mg capsules of ginger rhizome powder four times a day for three days from the start of their menstrual period. Members of the other groups received 250 mg mefenamic acid or 400 mg ibuprofen capsules, respectively, on the same protocol. A verbal multidimensional scoring system was used for assessing the severity of primary dysmenorrhea. Severity of disease, pain relief, and satisfaction with the treatment were compared between the groups after one menstruation. There were not significant differences between groups in baseline characteristics, p > 0.05. At the end of treatment, severity of dysmenorrhea decreased in all groups and no differences were found between the groups in severity of dysmenorrhea, pain relief, or satisfaction with the treatment, p > 0.05. No severe side effects occurred. Ginger was as effective as mefenamic acid and ibuprofen in relieving pain in women with primary dysmenorrhea. Further studies regarding the effects of ginger on other symptoms associated with dysmenorrhea and efficacy and safety of various doses and treatment durations of ginger are warranted.