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Effect of yoga on the menstrual pain, physical fitness, and quality of life of young women with primary dysmenorrhea
... For each of the sub-categories or for each of the components, a higher score indicates a better state of health for each dimension. Scores are generally transformed to a range from 0 to 100 for the 8 subscales (Stull et al., 2014;Yonglitthipagon et al., 2017). ...
... All statistical analyses were performed with SPSS v.23 (IBM inc.). SF-36 subdomains' scores were transformed into a 0-100 score as previously described (Stull et al., 2014;Yonglitthipagon et al., 2017). All the outcomes were reported on the database by a researcher (MM) who was blinded to the participant's allocation in the different intervention groups. ...
... According to the literature, quality of life is reduced in females with primary dysmenorrhea (Karanth and Liya, 2018), and in particular, 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 (Unsal et al., 2010). Low-dose estrogen/progestin resulted in significanrt improvements in mental component summary and 7/8 domains (role physical, bodily pain, general health, role emotional, mental health, vitality, and social functioning) (Yoshino et al., 2022). ...
Background: Primary dysmenorrhea represents one of the most common causes of pelvic and low back pain. Pharmacological treatment can present some side effects, and non-pharmacological treatments should be considered to improve the symptoms of primary dysmenorrhea. The aim of this study was to evaluate the efficacy of manual therapy (MT), pelvic floor exercises (PFE), and their combination (MT + PFE) to improve clinical outcomes and pain sensitivity in women with primary dysmenorrhea. Methods: A prospective observational study was conducted. Thirty females (age 25.0 ± 6.1 y) with history of primary dysmenorrhea participated to 8 sessions of 60 min of either MT, PFE or MT + PFE, twice per week. They participated to the different treatments according to the different services offered by the school of physiotherapy. A 0-10 numeric rating scale (NRS) was administered to assess subjective pain, while short-form 36 (SF-36) was used to evaluate quality of life. The pressure pain threshold (PPT) was assessed with a portable algometer on different pelvic and lumbar areas. Results: Independently from the treatment, significant improvements were reported for general pain NRS (p < 0.001; pη 2 = 0.511), as well as most the domains of the SF-36, although the general health domain did not reach statistical significance (p = 0.613; pη 2 = 0.010). PPT revealed a general improvement in all tested body areas, although on the quadratus lumborum, the PFE treatment did not induce a significant improvement compared to the MT and MT + PFE protocols (p = 0.039). Conclusions: These findings highlight the importance of proposing physiotherapy treatments to females with primary dysmenorrhea to improve symptoms, with manual therapy combined with active pelvic floor exercise providing the best outcomes including an improvement of lumbar pain thresholds.
... However, the frequency, time, and duration of exercise have been documented in literature [6,57,58]. According to the data, exercising for 30-60 min per day, two-three times per week, or more can help reduce PD discomfort [6,57,58]. ...
... However, the frequency, time, and duration of exercise have been documented in literature [6,57,58]. According to the data, exercising for 30-60 min per day, two-three times per week, or more can help reduce PD discomfort [6,57,58]. However, only 31.25% of apps provided users with information on how often to exercise, and only 43.75% of apps provided users with information on how long to exercise. ...
Background
Primary dysmenorrhea (PD), common in women below 25 years, occurs as pain in the absence of any identifiable pelvic pathology. Menstrual tracking applications (MTAs) may help women manage their PD symptoms. No systematic assessment has been performed on MTA quality with respect to physical therapy management exercise.
Objectives
This study evaluated the quality of MTAs available in Saudi Arabia for mobile users in both the App Store and Google Play Store and assessed the quality and completeness of exercise regimens provided in these apps using the FITT principle as a guideline for managing PD symptoms.
Methods
In this cross-sectional study, apps were collected from the App Store and Google Play Store using two strategies for each store independently: Scraper and SimilarWeb. The app quality was evaluated using the Mobile Application Rating Scale (MARS), and exercise content was evaluated based on the recommended Frequency, Intensity, Time, and Type (FITT) principles.
Results
Final evaluation included 16 apps, of which 87.5% required subscription. The mean app quality score ranged from 2.54 (worst-rated app) to 4.45 (best-rated app) with a mean score of 3.54 ± 0.58. In addition, only three apps provided all the FITT components in the exercise content.
Conclusion
This study assessed the quality of exercise provided within these applications as interventions for managing PD symptoms. This evaluation contributes to the understanding of mobile health technologies for PD management in the region, and highlights areas for improvement in app development and content quality to better serve individuals with PD.
... Beberapa faktor yang menyebabkan dismenore antara lain kelebihan berat badan (7), usia menarche, riwayat keluarga dan perilaku makan (8), aktivitas fisik dan tingkat stres (9), dukungan keluarga dan kecemasan (10). Remaja biasanya mengatasi dismenore dengan berbagai cara, seperti mengonsumsi obat-obatan, minum jamu, menggunakan pereda nyeri, atau melakukan peregangan dan olahraga (11). Dismenore dapat berdampak pada berbagai aspek kehidupan sehari-hari, seperti kesehatan fisik, prestasi akademik, suasana hati, hubungan sosial, pola makan, aktivitas fisik, dan kualitas tidur (12). ...
... Terapi yoga adalah salah satu metode relaksasi yang disarankan untuk mengurangi tingkat dismenore. Pelatihan yang terstruktur dan dilakukan secara rutin diyakini dapat mengurangi nyeri haid dan meningkatkan kesehatan tubuh secara keseluruhan (11). ...
Dismenorea adalah kondisi umum yang dialami oleh perempuan selama menstruasi, yang sering kali menyebabkan ketidaknyamanan dan mengganggu aktivitas sehari-hari. Dampaknya meluas ke berbagai aspek kehidupan, termasuk kesehatan fisik, kinerja akademik, suasana hati, hubungan interpersonal, pola makan, olahraga, dan pola tidur. Penelitian ini bertujuan untuk mengeksplorasi pengaruh exercise terhadap intensitas nyeri dismenorea pada remaja. Literature review dilakukan dengan mencari secara sistematis melalui basis data elektronik, termasuk Google Scholar, PubMed, dan ScienceDirect, menggunakan kata kunci "Adolescents AND Exercise AND Dysmenorrhea pain." Kriteria inklusi mencakup artikel yang diterbitkan di jurnal nasional dan internasional terakreditasi antara tahun 2018 hingga 2023, artikel dengan teks lengkap, akses terbuka, dan merupakan penelitian asli. Kriteria eksklusi meliputi artikel ulasan, prosiding konferensi, serta protokol atau proposal penelitian. Pencarian menghasilkan sekitar 24.921 artikel dari tiga basis data. Setelah meninjau judul dan menghapus artikel duplikat, 21 artikel berhasil disaring. Selanjutnya, 12 artikel yang memenuhi kriteria inklusi dianalisis secara penuh. Analisis dilakukan menggunakan tabel matriks dan kerangka kerja PRISMA. Ada dua temuan utama: (1) olahraga secara efektif dapat mengurangi intensitas nyeri dismenorea, dan (2) olahraga yang dikombinasikan dengan intervensi tambahan lebih lanjut dapat menurunkan intensitas nyeri. Olahraga fisik yang dilakukan secara teratur meningkatkan kadar oksigen dalam tubuh, yang mendorong relaksasi otot dan meningkatkan kesehatan serta kebugaran secara keseluruhan. Secara khusus, peningkatan pasokan oksigen ke rahim memiliki peran penting dalam meredakan nyeri dismenorea. Olahraga merupakan solusi komplementer non-farmakologis yang ekonomis dan aman untuk mengatasi dismenorea pada remaja. Manfaatnya tidak hanya terbatas pada pengurangan nyeri, tetapi juga berkontribusi pada peningkatan kesejahteraan fisik dan emosional.
... This mechanism is supported by the sequential practice of yoga, which combines exercise, relaxation, and deep breathing techniques [21] . Yonglitthipagon et al., 2017 suggest that yoga activates the brain's pain-modulating system, enhancing beta-endorphin secretion, and improving quality of life (QOL) domains like vitality, mental health, and general well-being. The integration of movement and breathing triggers a relaxation response, benefiting metabolism, heart rate, blood pressure, and muscle tension [22] . ...
... Yonglitthipagon et al., 2017 suggest that yoga activates the brain's pain-modulating system, enhancing beta-endorphin secretion, and improving quality of life (QOL) domains like vitality, mental health, and general well-being. The integration of movement and breathing triggers a relaxation response, benefiting metabolism, heart rate, blood pressure, and muscle tension [22] . ...
Dysmenorrhea, the most frequent menstrual problem in adolescence, is a widespread condition affecting women globally. It is highly prevalent, affecting around 50–90% of the female population, with a global prevalence rate of 71.1% according to a meta-analysis spanning 38 countries. Primary dysmenorrhea (PD) is a common menstrual disorder affecting many women and significantly impacting their quality of life. The symptoms of PD are lower abdominal or pelvic pain, which may radiate to the back or legs, typically starting 6 to 12 months after menarche. Dysmenorrhea caused significant effects, including school absenteeism, poor performance, difficulty in daily activities, and social life disruption. Yoga, as nonpharmacological alternative medical intervention, has been increasingly studied for its potential benefits in managing PD. The purpose of this review is to highlight Yoga therapy as most effective alternative treatment in this cutting-edge era for primary dysmenorrhea. This study reviewed English-language literature published from 2000 to 2024, searching databases like PubMed, Google Scholar, and Scopus using keywords “yoga” and “menstrual pain” or “dysmenorrhea.” Out of 1,453 articles, 12 studies met the selection criteria and were included in the final review. This review of 12 RCTs’ highlights the effectiveness of yoga therapy for managing primary dysmenorrhea. Various yoga practices, including asanas, Yoga Nidra, and pranayama, significantly alleviated pain and improved symptoms. This study concludes the positive effectiveness of yoga therapy in managing primary dysmenorrhea. Yoga practices significantly alleviated pain and improved physical, psychological and social aspects of health, suggesting yoga as a holistic and beneficial treatment for dysmenorrhea.
... Ten of the sixteen studies explicitly reported the method of generating randomized sequences were evaluated as low risk, and four of these studies properly described the method of allocation 13,31,37,38 All blinding methods were rated as high risk due to the need for informed consent, self-reported assessments, and variability in exercise interventions. 40,41 Two studies may be biased due to data completeness, while others were evaluated as low risk. ...
... week 13,15,29,30,36,38 (six studies), three times per week (nine studies), 14,31,34,35,37,39,43 and >three times per week (two studies). 28,32 The ...
Introduction
Aerobic exercise has been confirmed to alleviate primary dysmenorrhea (PD) in adolescents and young women. However, the effect of the aerobic exercise type and dosage on PD alleviation was unclear. This research aims to assess the effect of aerobic exercise on PD and investigate the dose–response relationships.
Material and Methods
Systematic literature searches of Web of Science, Embass, Cochrane Library, PubMed, PsycNET, CINAHL, CNKI, Baidu Scholar, Google Scholar, and other Complimentary Medicine Database. PICOS standards were adopted in this research: participants were nonathlete women with PD; intervention was aerobic exercise of at least one menstruation cycle; comparator was any comparator; outcomes were pain intensity or pain duration; and study type was randomized controlled trials. The Cochrane Collaboration risk of bias tool was used to assess the quality of the research. Random‐effect meta‐analysis was conducted for pain intensity and pain duration, with prespecified subgroup analyses based on aerobic exercise components. The strength of the evidence was assessed using GRADE. This systematic review and meta‐analysis was registered in PROSPERO (CRD42024533544).
Results
The study identified 16 eligible studies, with 15 involving adolescents, totaling 918 participants aged 15 to 43, with an average age of 21.26 ± 13.15. The results confirmed that aerobic exercise can alleviate PD's pain intensity (standard mean difference (SMD) = −1.728 (p = 0.00), 95% CI [−2.26 to −1.31]) and pain duration (weighted mean difference (WMD) = −12.53 h, p = 0.01, 95% CI: −21.38 to −3.68). However, the heterogeneity of these two results was high. Subgroup analysis showed that Pilates (SMD = −3.17, 95% CI [−4.26 to −2.07]), low intensity (SMD = −1.64, 95% CI [−2.10 to −1.19]), 31–45 min duration (SMD = −3.05, 95% CI [−5.36 to −0.75]), ≤2 times per week frequency (SMD = −2.24, 95% CI [−3.36 to −1.12]), and a period cycle of 2 menstrual cycles (SMD = −2.21, 95% CI [−3.13 to −1.28]) had the maximum effect size.
Conclusions
Aerobic exercise was able to alleviate pain intensity and pain duration in adolescents and young women with PD. Moderate‐quality evidence indicates that Pilates, low intensity, 46–60 min, ≤two times per week, or two menstrual cycles showed more efficiency in alleviating PD. Due to the limited data, future research should prioritize conducting randomized controlled trials of aerobic exercise interventions in younger age groups to develop personalized treatment strategies for adolescents.
... Participants who met the following criteria were eligible for inclusion in the study: women aged 18 to 43 with regular menstrual cycles [9,15,17,20] who experienced pain rated between 4 and 10 on the Visual Analog Scale (VAS) [9,15] in the suprapubic region, abdomen, lower back, perineum, and/or inner thighs during half of their yearly menstrual cycles (as a minimum) and/or in the last three cycles. Exclusion criteria included women with an implanted intrauterine device or those undergoing hormonal treatment [9,15,20,37]; individuals diagnosed with secondary dysmenorrhea by their gynecologist within the last 18 months (such as endometriosis or ovarian cysts) [9,12,15,20]; women who have had surgeries in abdominal or pelvic regions during the study or who have given birth in the previous 6 months [12,15]; having skin lesions, including scars or erosions, on the inner upper aspect of the ankles; pregnant women [12,15,18,20]; and those with pacemakers, uncorrected coagulopathies, severe comorbid conditions, cancer (currently or in the past 5 years), severe mental disorders, or neuropathies in lower limbs [17,18,38,39]. Additionally, women who have received physiotherapy treatment for this condition within one month prior to the study will also be excluded [39]. ...
... Participants who met the following criteria were eligible for inclusion in the study: women aged 18 to 43 with regular menstrual cycles [9,15,17,20] who experienced pain rated between 4 and 10 on the Visual Analog Scale (VAS) [9,15] in the suprapubic region, abdomen, lower back, perineum, and/or inner thighs during half of their yearly menstrual cycles (as a minimum) and/or in the last three cycles. Exclusion criteria included women with an implanted intrauterine device or those undergoing hormonal treatment [9,15,20,37]; individuals diagnosed with secondary dysmenorrhea by their gynecologist within the last 18 months (such as endometriosis or ovarian cysts) [9,12,15,20]; women who have had surgeries in abdominal or pelvic regions during the study or who have given birth in the previous 6 months [12,15]; having skin lesions, including scars or erosions, on the inner upper aspect of the ankles; pregnant women [12,15,18,20]; and those with pacemakers, uncorrected coagulopathies, severe comorbid conditions, cancer (currently or in the past 5 years), severe mental disorders, or neuropathies in lower limbs [17,18,38,39]. Additionally, women who have received physiotherapy treatment for this condition within one month prior to the study will also be excluded [39]. ...
Background: Primary dysmenorrhea is a leading cause of chronic cyclic pelvic pain, contributing to a reduced quality of life and sleep disturbances in women. The objective of this study was to assess the effectiveness of transcutaneous tibial nerve stimulation (TTNS) in improving the quality of life, sleep, and overall health perceptions of participants compared to a control group of women with dysmenorrhea over short-term, medium-term, and long-term periods. Methods: A single-blind, controlled clinical trial was conducted, with participants randomly assigned to an experimental group (receiving TTNS) or a control group (receiving sham TTNS). Both groups underwent 12, weekly 30 min sessions using the NeuroTrac™ PelviTone electrostimulation device. Outcomes related to quality of life, sleep deficiency, and overall improvement were evaluated at three time points: short-term (post-treatment), medium-term (1–3 months), and long-term (6 months). Results: Of the 61 participants initially randomized (31 in the experimental group and 30 in the control group), 55 completed the study and were included in the final analysis. A statistically significant improvement was observed in the experimental group in both physical and mental health components, as measured by the SF-36v2® questionnaire, following 12 weeks of intervention, compared to the control group, persisting 6 months after the intervention. Additionally, statistically significant differences in overall improvement were noted between the two groups, as measured by the PGIC questionnaire at the end of treatment (p = 0.0103) and 6 months post-treatment (p = 0.0432). Conclusions: TTNS appears to be a safe and effective strategy for enhancing quality of life and overall health in women with PD, potentially reducing the reliance on pharmacological treatments or more invasive methods.
... In other words, exercise may act as a non-specific pain reliever (12,(20)(21)(22). Despite this evidence, a large body of research supports the positive effects of yoga (especially poses, breathing exercises, and deep relaxation) that can help reduce dysmenorrhea (23)(24)(25). In this regard, Kirca and Celik reported that yoga exercises can help reduce menstrual pain in women with primary dysmenorrhea (26). ...
... Concerning the investigation of Yonglitthipagon et al., women with primary dysmenorrhea aged between 18 and 22 who practiced yoga (12 weeks/twice a week/30 min per day) at home were able to control the severity of menstrual pains and improve physical wellness and the quality of life. Therefore, they proposed that yoga may be a conceivable complementary treatment for primary dysmenorrhea (25). Concerning the role of yoga exercise on dysmenorrhea, the evidence shows that it can suppress pain, along with the reduction of prostaglandin production and inhibition of myometrial ischemia. ...
Background: Dysmenorrhea (painful menstruation) is a common health problem in women of reproductive age, affecting the individual’s health, job performance, and quality of life. Objectives: This research investigated the effect of three ten-day yoga courses and zinc sulfate on primary dysmenorrhea in non-athlete girls. Methods: Forty-eight girls (18 to 25 years old) suffering from dysmenorrhea in Karaj participated in this clinical trial. Cluster sampling was used to select the subjects, and they were allocated to four groups: the placebo group, the yoga and placebo group, the zinc sulfate group, and the yoga and zinc sulfate group. Before the research, the serum levels of prostaglandin E were measured in the laboratory using the ELISA method. Then, the yoga training group (from the 22nd day of menstruation to the third day of bleeding for ten days, 45 minutes every day) performed yoga exercises. The exercise program of this research was five asanas. Also, yoga, stretching, strength training, and breathing and relaxation techniques were performed between the asanas training, which mainly involved the abdomen and lower back. Results: The results showed that yoga exercises and zinc sulfate supplementation significantly affected (decreased) the levels of prostaglandin E in non-athlete girls (F1,43 = 17.564, P = 0.001, η = 0.290). Also, exercise alone affected prostaglandin E levels significantly (P < 0.05) compared to other groups. However, the supplement alone did not influence prostaglandin E levels significantly (P > 0.05). In addition, exercises and zinc sulfate supplementation significantly affected anthropometric measures. Conclusions: According to the results, three ten-day yoga exercise programs and zinc sulfate supplements improved primary dysmenorrhea.
... Studies suggest that yoga may be a beneficial adjunctive treatment for IBS [135]. Additionally, yoga has been shown to help relieve primary dysmenorrhea and improve physical fitness and quality of life [136]. Research also indicates that yoga positively impacts the quality of life and balance in post-menopausal osteoporosis and contributes to overall physical and psychological well-being in women during the perimenopausal period [137,138]. ...
The techniques used in yoga have roots in traditions that precede modern science. Research shows that yoga enhances quality of life and well-being, positively impacting physical and mental health. As yoga gains acceptance in Western countries, scientific studies on the subject increase exponentially. However, many of these studies are considered inconsistent due to the diverse methodologies and focuses in the field, which creates challenges for researchers and hampers progress. This study aims to develop a comprehensive framework for existing literature on yoga, facilitating multidisciplinary collaboration and bringing new light to relevant aspects. Given the complexity of the subject, advanced modeling techniques are necessary. Contemporary artificial intelligence methods have advanced Bioinformatics, including text mining (TM), allowing us to employ vector representations of texts to derive semantic insights and organize literature effectively. Based on TM resources, we provided a better general understanding of yoga and highlighted the relationships between yoga practice and various domains, including biochemical parameters and neuroscience. It also reveals that practitioners can learn to engage with their bodies and environments actively, enhancing their quality of life. However, there is a lack of research exploring the mechanisms behind this learning and its potential for further enhancement. Vector TM has made it possible to bolster and improve human analysis. The set of resources developed allowed us to determine the mapping of the literature, the analysis of which revealed 4 dimensions (exercise, physiology, theory and therapeutic) divided into 9 cohesive groups, representing the trends in the literature. The resulting platforms are available to Yoga researchers to evaluate our findings and make their forays into the existing literature.
... Regarding research blinding, four studies reported single-masked procedures (19,26,28,30), while one reported double-masked methods (29), all of which were considered low risk. Studies that lacked blinding of participants and outcome assessors were rated as high risk (27,47), and the remaining studies were assessed as medium risk (15-18, 24, 25, 31-46). Concerning the integrity of the outcome data, all studies were classified as minimal risk, as none exhibited significant attrition during the intervention, which would have led to a high-risk assessment. ...
Objective
A growing number of research papers have looked at the influence of exercise on pain severity in people with primary dysmenorrhea, but the findings have been inconsistent. The purpose of this research was to thoroughly evaluate the impact of exercise on pain severity in individuals with primary dysmenorrhea and to find the best exercise regimen for these patients.
Methods
All randomized controlled trials (RCTs) of exercise for patients with primary dysmenorrhea were searched in the Embase, PubMed, Cochrane, Web of Science, EBSCO, and CINAHL databases. The search time limit was set from the establishment of each database to 28 January 2025. Control groups included those receiving usual care, only providing health education, or no intervention at all. The outcome measure was pain intensity. The effect size was aggregated using the mean difference (MD) and 95% confidence interval (CI). The methodological quality of the included studies was evaluated using the Cochrane risk-of-bias tool. Stata 15 software was used for meta-analysis, sensitivity analysis, and assessment of potential publication bias. R 4.4.1 software was used for network meta-analysis, area under curve ranking (SUCRA), league plot, and meta-regression.
Results
The analysis included a total of 29 studies that satisfied the criteria. Exercise decreased the visual analog scale (VAS, WMD = −2.62, 95% CI [−3.29, −1.95], p < 0.001) score in individuals with primary dysmenorrhea. Strength training (WMD = −1.76, 95% CI [−2.03, −1.48], p < 0.001), exercise duration of ≥8 weeks (WMD = −1.77, 95% CI [−1.87, −1.66], p < 0.001), frequency of >3 times per week (WMD = −1.60, 95% CI [−1.75, −1.45], p < 0.001), session length of >30 min (WMD = −2.20, 95% CI [−2.38, −2.02], p < 0.001), and a total of ≥90 min per week (WMD = −2.04, 95% CI [−2.19, −1.89], p < 0.001) showed superior efficacy in enhancing VAS (subgroup analyses).
Conclusion
Engaging in physical activity may reduce the intensity of discomfort encountered by individuals afflicted with primary dysmenorrhea, with strength training potentially emerging as the most efficacious alternative. The meta-analysis presents evidence that supports clinicians’ advice to patients with primary dysmenorrhea, recommending that they exercise for a minimum of 8 weeks, with sessions occurring more than three times weekly and lasting longer than 30 min each. The goal is to achieve a minimum weekly total of 90 min by increasing the frequency of workouts.
Systematic review registration
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024581879, CRD42024581879.
... PD is primarily treated to relieve pain and other related symptoms (such as back and leg pain, anxiety, stress, and other symptoms that affect quality of life). 61,62 At present, pain VAS as a subjective way of assessing pain has been widely used to evaluate various pain disorders. Woodforde and Merskey first reported use of the VAS pain scale in patients presenting with a range of pain conditions. ...
Background
This network meta-analysis (NMA) aimed to explore the impact of Non-pharmacological therapies (NPT) on alleviating primary dysmenorrhea (PD) symptoms and assess the effectiveness differences among various NPT.
Methods
We searched seven databases and summarized clinical trials of PD treated with NPT from inception to September 6, 2023. Randomized controlled clinical trials (RCTs) of PD treated with NPT. The outcomes were the Visual Analog Scale (VAS), the Cox menstrual symptom scale (CMSS), and response rate. Quality was assessed using the Cochrane risk of bias assessment tool. Pairwise meta-analysis and network meta-analysis (NMA) was performed by RevMan (5.4), Stata (15.0), and WinBUGS (1.4.3). The ranking probabilities for all treatment interventions were performed using the Surface Under the Cumulative Ranking curve (SUCRA).
Results
A total of 16 RCTs were finally included, involving 8 kinds of NPT. Results of pairwise meta-analyses: For the VAS score results, moxibustion (SMD: −0.591,95% CI: −0.916, −0.266) was more effective than acupuncture, acupuncture (SMD: −0.948,95% CI: −1.853, −0.044) was more effective than placebo, and yoga (SMD: 2.634,95% CI: −4.28, −0.988) was more effective than the blank control. NMA results: Compared to the blank control, acupuncture (SMD: −4.81; 95% CI: −6.63, −3.00), auricular point therapy (SMD: −4.36; 95% CI: −7.18, −1.60), yoga (SMD: −2.12; 95% CI: −3.13, −1.09), moxibustion (SMD:5.54; 95% CI: 3.33, 7.68), and placebo (SMD: 3.10; 95% CI: 1.03, 5.27) proved to be a superior reduction in VAS. The use of acupressure (SMD: 2.49; 95% CI: 0.03, 5.03), moxibustion (SMD: −2.45; 95% CI: −4.06, −0.71), and acupuncture (SMD: −1.72; 95% CI: −2.75, −0.56) demonstrated a greater decrease in VAS efficacy than placebo. The consolidated ranking outcomes indicate that moxibustion, acupuncture, and auricular acupoint therapy occupy high SUCRA positions across various outcome metrics.
Conclusion
Acupuncture, moxibustion and auricular point may be the best treatment for PD. In the future, more trials are needed to obtain higher-quality evidence and the best protocols.
... In the United States, many are unprepared for menstruation, lack the resources to comfortably and confidently manage menstrual health, and are not adequately educated to provide self-care for normal pain and other menstrual issues [22]. Studies have shown that various self-care measurements, such as exercise [23], yoga [24], and herbal teas such as chamomile [25], can improve premenstrual and/or menstrual symptoms. Interestingly, a cross-sectional study explored the impact of living alone on menstrual symptoms and found that the intensity of menstruation-related symptoms was greater for students living alone [26]. ...
Background/Objectives: an estimated 1.8 billion people worldwide menstruate, and many face difficulties managing. Young adults often encounter stigma, exclusion, and a lack of resources to manage menstruation comfortably. A review of studies on college students revealed that menstrual symptoms and stigma lead to absenteeism, poorer performance at work and school, and decreased quality of life. This study examines the multifaceted perceptions of a diverse group of young adults aged 18–25 to gain a deeper understanding of the menstrual experience, including cultural stigma, to advocate for personalized care and policy change. Methods: we used snowball sampling and employed a qualitative research methodology integrating a Qualtrics survey (n = 620) and focus groups (n = 50). We used an interpretive phenomenological approach to thematically code participants’ lived experiences by assigning codes to text segments and grouping them by broader themes using the Nvivo 14.23.3 software to understand the underlying meaning and significance of the data. Results: a diverse group of young adults completed the study. Key themes include difficulties attending work/school/social activities related to the physical and mental health challenges associated with menstruation, a cultural stigma, and a lack of access to healthcare and care products during menstruation. Quality of life could be improved with decreased stigma and improved self-care strategies. Limitations include the small sample size and the qualitative study design. Conclusions: this study highlights the need for a holistic approach to supporting menstruation. Recommendations include increasing access to menstrual healthcare, an understanding of cultural differences, and consideration of policy accommodations such as paid time off by workplaces and educational institutions related to menstruation.
... Regular yoga practice has been shown to alleviate menstrual cramps and reduce the duration and intensity of menstrual cycles. Moreover, it regulates hormonal imbalances that help to reduce the excessive white vaginal discharge [13]. By strengthening the pelvic floor muscles, yoga can also aid in preventing and treating urinary incontinence, a common issue for many women. ...
Introduction: Leucorrhoea is natural vaginal discharge caused by hormonal changes, pregnancy, or sexual stimulation. This study protocol describes the methodology for a 12-week yoga program on the symptoms of leucorrhoea disorder among adult females.
Methods and analysis: The present study is a two-armed, randomized parallel-group, active-control trial for patients with blinded outcome assessors and multiple primary and secondary outcomes. The appropriate sample size will be determined based on the findings of the feasibility study. The participants will be recruited from a hospital and research centre in Madhya Pradesh, India. Individuals who meet the inclusion criteria for leucorrhoea disorder will be chosen following laboratory examinations. Randomization will be used to assign the chosen individuals to either the intervention or control groups (1:1). For adult females with leucorrhoea disorders, the intervention will consist of a yoga-based program that will run for one hour, five days a week, for 12 weeks. Data will be collected at baseline and post-intervention, in the 12th week. The outcome measures will include various primary (colour, odour, amount, vaginal culture, vaginal smear, and imbalance of various gonad hormones) and secondary (lower abdominal pain and quality of life) outcomes. The analysis will involve intention-to-treat and per-protocol approaches that will evaluate the impact of yoga on various outcome measures and will be assessed using statistical tests.
Ethics and dissemination: The study has been approved by the Institution Ethics Committee of Lakshmibai National Institute of Physical Education. Written informed consent will be obtained from each participant before inclusion. Results will be available through research articles and conferences. The summary of key results in layman's language will be made publicly available through newspaper articles.
... Similarly, a 12-week, 3 times per week regimen of aquatic exercise has been found to significantly reduce the severity and duration of PD pain in female college students [10]. Additionally, mind-body exercise like yoga and Pilates have gained popularity for their perceived benefits in managing menstrual symptoms [11,12]. However, Shafaie et al. reported no significant difference between athletes and non-athlete female college students with regard to menstrual pain, premenstrual syndrome prevalence and symptoms [13], indicating the scholarly discourse remains divided on the efficacy of exercise for alleviating PD pain and relevant symptoms. ...
Background
Exercise is increasingly being promoted as an effective treatment for primary dysmenorrhea (PD). This study aims to conduct a comprehensive network meta-analysis (NMA) of randomized controlled trials to identify the optimal types and dosages of exercise for managing PD in women.
Methods
Adhering to PRISMA-NMA guidelines, we systematically reviewed RCTs from the Cochrane Library, Web of Science, PubMed, and Embase databases up to May 23, 2024. Data analysis was performed using ‘GEMTC’ and ‘BUGSnet’ packages within a Bayesian framework in R and a hierarchy of exercise treatments was also calculated using surface under the cumulative ranking curve (SUCRA) values. Subgroup analyses were conducted to identify the most effective exercise regimens, including duration, frequency, and volume of the exercise interventions.
Results
Forty-nine studies representing 3,129 participants (1,640 exercises and 1,489 controls) were included. The results showed that all exercise interventions significantly reduced menstrual pain of the PD patients. Of six exercise intervention modalities based on the study ranked effectiveness, statistically significant reductions in pain intensity were found for resistance exercise and multi-component exercise. Multi-component exercise and stretching exercise were ranked best for menstrual symptoms, while core-strengthening exercise and multi-component exercise had the greatest impact on reducing pain duration. Significant and clinically important reductions or reliefs in pain occurred with 4 to 8 weeks of exercise training from all exercises, with resistance exercise showing the best efficacy when the duration exceeded 8 weeks, followed by multi-component exercise and mind-body exercise. Multi-component exercise and aerobic exercise with 1 to 3 sessions per week induced greater benefit in performance improvements, while resistance exercise with increased frequency showed the enhanced performance. Resistance exercise could elicit better efficacy within` 30-minute training duration, and multi-component exercise was ranked the best if such a training over 30 min.
Conclusion
This study provided quantitative insight into efficacy and effectiveness of exercise interventions on PD treatments. All six different exercises are associated with positive influence on PD management. Our study indicates that this exercise training induced adaptation may have therapeutic benefits for PD patients; however, such alterations and improvements are affected by exercise regiments.
... The results of this study also agree with previous findings, which indicate that yoga exercises are beneficial for improving body and right shoulder joint flexibility, promoting health-related physical fitness, and enhancing various aspects of physical fitness. Specifically, yoga can elicit improvements in muscle strength and endurance, overall physical fitness, and health-related fitness status (42), and enhance various aspects of physical fitness (43), Specifically, yoga can elicit improvements in muscle strength and endurance (44), overall physical fitness (45), and health-related fitness status (46). ...
... As anticipated, physical activity is associated with lower dysmenorrhea symptoms, mainly when females practice it during menstruation with a short duration. These results match prior reports describing that physical activity during menstruation reduces the incidence of dysmenorrhea [12] and increases the quality of life when the woman practices pilates [39] or relaxation exercises, such as yoga [14][15][16][17][18]40]. Other studies explain that physical activity decreases C-reactive protein (HsCRP), PGE2, and PGF2α levels, ameliorating uterine contraction and inflammation [12,13]. ...
Background: Dysmenorrhea and premenstrual syndrome (PMS) are common disorders in the Mexican population, but these are usually underdiagnosed and under-treated, impacting women’s quality of life. Adequate health habits have been reported as precursors of decreasing dysmenorrhea symptoms. However, few studies assess their impact on PMS. Aim: This study aims to evaluate dysmenorrhea and premenstrual syndrome in association with health habits in the Mexican population. Methods: To assess the impact of health habits on menstruation symptoms a validated survey was conducted in 1679 adult females aged ≥18 years. The survey collected data on participants’ dysmenorrhea, PMS, and their health habits. Results: The analysis showed that physical activity duration, changes in eating habits (increases in salty or sugary foods) during menstruation, and oversleeping habits predict increases in dysmenorrhea and PMS. In contrast, an active sexual life, relaxing physical activity, and adequate sleep hours during menstruation seem to decrease the symptoms. Conclusions: We conclude that adequate health habits and addressing early gynecological conditions might regulate dysmenorrhea and PMS.
... Among the non-pharmacological methods, warming techniques such as hot packs, hot water or clothes have been identified as the most used to reduce menstrual pain [19]. It was found that practicing yoga for 30 min twice a week for 12 weeks can relieve menstrual pain [20]. ...
Background: Dysmenorrhea is a common condition that may have negative effects on social life, couples’ relationships and professional activities. The objectives of this study were to evaluate the prevalence, risk factors and characteristics of dysmenorrhea and its impact on patients’ quality of life using a specific self-questionnaire named “DysmenQoL questionnaire”. We also checked the validity and reliability of this questionnaire in our population. Methods: We conducted a cross-sectional study that included 504 participants of reproductive age between 18 and 45 years of age. The data were collected with an original form divided into three sections. The last section (DysmenQoL questionnaire) included 20 statements scored from 1 (“never”) to 5 (“every time”) that evaluates the effects of menstrual pain on health and feelings, daily activities, relationships and professional activity. We calculated the sum of the scores for each statement and we called it the “DysmenQoL score”. Results: The prevalence of dysmenorrhea was 83.7%. The presence of dysmenorrhea was statistically significant associated with the degree of menstrual bleeding (p = 0.017), the presence of infertility (p = 0.034) and dyspareunia (p = 0.002), but also with the presence of premenstrual syndrome and a family history of dysmenorrhea (p < 0.001). Among the participants with dysmenorrhea, 73.9% considered that this symptom affected their quality of life, and this was correlated with pain intensity and the DysmenQoL score (p < 0.001). A significant difference regarding the DysmenQoL score depending on the pain intensity, frequency and duration of dysmenorrhea and the methods used to reduce the pain was observed. Conclusions: Dysmenorrhea had a high prevalence among the participants included in the study, and its presence was associated with a series of risk factors. Most women considered that dysmenorrhea affected their quality of life. The DysmenQoL questionnaire proved to be a reliable and valid method for evaluating the impact of dysmenorrhea on quality of life.
... Increased b-endorphin is associated with decreased pain, improved memory, improved appetite, sexual ability, blood pressure, and breathing. (Kuswardani, 2021;Wardani & Suryanti, 2020;Yonglitthipagon et al., 2017). ...
Background: Dysmenorrhea is a menstrual pain that is often experienced by young women, with a global prevalence of 16.8-81%. In Indonesia, the prevalence reaches 54.89%, with adolescent girls being the largest group. Treatment generally uses analgesics, but it has side effects. Yoga as a non-pharmacological therapy can reduce pain through muscle relaxation. Purpose: Analyzing the effect of yoga therapy on the intensity of the degree of dysmenorrhea in female students of the Class of 2018 Undergraduate Medical Education Study Program, Faculty of Medicine, Andalas University. Methods: This research uses a pure experimental design with a pre-test, post-test, and only group design, with a sample size of 32 people. The research instrument used in the study was a pre-test and post-test questionnaire, which contained VAS scores and guidelines regarding yoga movements. The questionnaire contains a Visual Analog Scale (VAS), which consists of a vertical scale from 0 to 10 cm. Results: The results showed there were no differences related to age. As many as 18% of respondents usually took analgesics, while 81.3% did not take analgesics to treat dysmenorrhea before yoga therapy. Meanwhile, after yoga therapy, 5 out of 6 respondents who usually consumed analgesics in previous menstrual cycles no longer consumed analgesics, and one respondent still consumed analgesics. Bivariate analysis showed a value of p=0.00 (p<0.05), which means there is a relationship between the provision of yoga therapy and the degree of dysmenorrhea. Where providing yoga therapy can reduce the intensity of pain in respondents who experience dysmenorrhea. Conclusion: This research concludes that there is a significant relationship between the provision of yoga therapy and the degree of dysmenorrhea.
... At the end, menstrual pain wes evaluated together with physical fitness outcomes (flexibility and muscle strength). The regular practice of yoga showed a positive effect on menstrual pain and also on physical fitness and quality of life, confirming yoga among the effective non-pharmacological remedies for dysmenorrhea [76,77]. ...
Objectives
This narrative review analyzes current knowledge on the pathophysiology of dysmenorrhea and the different therapeutic options currently available for adolescents and young women.
Mechanism
Dysmenorrhea is the most common gynecological disorder among adolescents and young adult women. This condition can have a strong negative impact on the quality of life involving both physical and mental health. Although physiopathological mechanisms have been hypothesised there is still a poor understanding of this condition.
Findings in Brief
The prevalence of dysmenorhea is quite variable depending on different studies but overall high. Nonsteroidal anti-inflammatory drugs are the preferred initial treatment; hormonal therapy, alone or in combination with non-hormonal treatments, is generally the next treatment option. There are evidences of the efficacy of non-pharmacological treatment, thus, these must be considered. Grading the intensity of pain would be of importance to address therapeutic choices and treatment options.
Conclusions
To date there are yet many gaps in the understanding of dysmenorrhea that to do not allow any real personalized treatment. These gaps need to be filled in order to improve and target future treatment.
... Osteopathy methods applied in primary dysmenorrhea are effective in reducing pain and increasing quality of life (Schwerla et al., 2014). ---New Technologies and Techniques in Gynecology and Obstetrics---Yoga practiced in primary dysmenorrhea is effective in reducing pain and relieving discomfort (Yonglitthipagon et al., 2017). Cobra, cat, and fish poses practiced in yoga reduce the severity and duration of primary dysmenorrhea, and yoga is a safe and simple treatment for primary dysmenorrhea (Rakhshaee, 2011). ...
... Different studies concluded that low body mass index, food habits, junk food, early menarche, disturbed sleep patterns, consumption of caffeine and alcohol, etc. are responsible factors for the risk of premenstrual symptoms among younger girls [2,4,5,8,[12][13][14]. However, this study suggested there might be a correlation between BMI and premenstrual symptoms. ...
Objectives: The ojective is to study menstrual patterns. To study the prevalence of pre-menstrual symptoms among high school girls. Methods: It is a cross-sectional, observational, and prospective study. A total of 384 adolescent girls were randomly enrolled in the study as per inclusion and exclusion criteria. Girls were belonging to higher secondary standards. Confidentiality was assured, and written informed consent was obtained. A data collection form was formed to conduct the survey. Ethical approval was obtained. The data were analyzed in MS Excel 2019. A descriptive analysis was done. Results: A total of 384 high school girls with an age of 15.65±1.16 years were enrolled in the study. The calculated mean body mass index (BMI) was 18.82±2.93. 40.4% had an underweight BMI. The majority of the adolescent girls had regular menstrual cycles, and a few had irregular menstrual cycles every month. More than half (60.41%) did not know about premenstrual syndrome. Physical premenstrual symptoms were a downward dragging sensation (58.78%), lower back pain (55.53%), acne flare-ups (44.63%), diffuse headaches (37.72%), and painful periods (33.88%). Psychological symptoms in hierarchy are anger or irritability (52.16%), less interest in usual activities (44.03%), pelvic cramping (45%), cravings for sweets (42.88%), and mood swings (41.53%). Conclusion: The prevalence of premenstrual symptoms was higher for physical and psychological symptoms. Physical symptoms can affect routine activities, and psychological symptoms affect girls’ behavior and mental status.
... Despite the close association between sleep disturbances and menstrual disturbances, addressing and treatment of sleep disturbances was not considered as a therapeutic target for menstrual disturbances. The current interventions to reduce menstrual disturbances mainly focus on lifestyle modifications (e.g., dietary modification, exercise, stress reduction, yoga, acupuncture) [73][74][75][76][77][78]. In a recent randomized controlled trial, as both PMS symptoms and sleep duration were improved by lifestyle modifications in women with irregular menstrual cycle [75]. ...
Background
Menstrual disturbances harm women’s health, and general well-being. As growing evidence highlights the relationship between sleep and menstrual disturbances, it is imperative to comprehensively examine the association between sleep and menstrual disturbance considering the multiple dimensions of sleep. This systematic review aims to identify the association between sleep and menstrual disturbances by evaluating using Buysse’s sleep health framework.
Methods
A comprehensive search of the literature was conducted in PubMed, EMBASE, psychINFO, and CINAHL to identify publications describing any types of menstrual disturbances, and their associations with sleep published between January 1, 1988 to June 2, 2022. Quality assessment was conducted using the Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross-Sectional Studies. The findings were iteratively evaluated menstrual disturbances and their association with sleep using Buysse’s sleep health framework. This framework understands sleep as multidimensional concept and provides a holistic framing of sleep including Satisfaction, Alertness during waking hours, Timing of sleep, Efficiency, and Sleep duration. Menstrual disturbances were grouped into three categories: premenstrual syndrome, dysmenorrhea, and abnormal menstrual cycle/heavy bleeding during periods.
Results
Thirty-five studies were reviewed to examine the association between sleep and menstrual disturbances. Premenstrual syndrome and dysmenorrhea were associated with sleep disturbances in sleep health domains of Satisfaction (e.g., poor sleep quality), Alertness during waking hours (e.g., daytime sleepiness), Efficiency (e.g., difficulty initiating/maintaining sleep), and Duration (e.g., short sleep duration). Abnormal menstrual cycle and heavy bleeding during the period were related to Satisfaction, Efficiency, and Duration. There were no studies which investigated the timing of sleep.
Conclusions/Implications
Sleep disturbances within most dimensions of the sleep health framework negatively impact on menstrual disturbances. Future research should longitudinally examine the effects of sleep disturbances in all dimensions of sleep health with the additional objective sleep measure on menstrual disturbances. This review gives insight in that it can be recommended to provide interventions for improving sleep disturbances in women with menstrual disturbance.
... [6][7][8] Studies that have focused on young adults found menstrual symptoms can be disabling, causing discomfort, missed activities including work, and time spent looking for Exploring impact of menstrual symptoms on young adults and implications for nurse practitioners symptom relief and provider assistance. 2,6,9,10 Research also suggests many individuals who menstruate have limited knowledge about menstrual symptoms and encounter stigma related to menstruation being known as a taboo topic. 11,12 This cross-sectional, mixed methods study investigated how a sample of young adults age 18 to 25 years at a midwestern university experience menstruation, including impacts on various aspects of their life and perceived health. ...
This original research study investigated how a sample of young adults experience menstruation, including its influence on various aspects of their life and perceived health, with study findings providing useful implications for nurse practitioners caring for young people who menstruate.
... An analysis of the results showed that the level and duration of women's menstrual pain significantly decreased after the exercise [43]. The same conclusions were reached by Yonglitthipagon et al. and Yang et al., who conducted similar studies [44,45]. Yoga has a positive effect on the human body [46]. ...
(1) Background: Studies indicate that 45 to 95% of women suffer from painful periods. Despite frequent incidence, the problem is still underestimated. Menstruation-related ailments often correlate with high absenteeism at school and work, as well as limitation of social and scientific activity. The aim of this study was to assess the relationship between the size of the curvature, the mobility of the spine in the sagittal plane, and menstrual pain in young women. (2) Methods: The analysis included 224 women aged 18–26, mean of 21.56 ± 1.95, studying at the College of Medical Sciences of the University of Rzeszów. For this purpose, the measurement of the anterior–posterior curvature of the spine with a gravitational inclinometer, the Schober test and the authors’ questionnaire related to menstruation were used. (3) Results: The data analysis demonstrated a significant difference between the group with menstrual pain (MP) and the control group without pain (CG), where the angle of the lumbar sacral transition (p = 0.034), thoracolumbar transition (p = 0.044) and lumbar lordosis (p = 0.006) were statistically significantly lower in MP compared to CG. There were no significant differences in the measurement of the so-called smartphone hump and between the mobility of the lumbar spine and menstrual pain in any of the groups. (4) Conclusions: Women with menstrual pain are characterized by reduced lumbar lordosis and thoracic kyphosis, while sagittal mobility of the spine does not affect pain.
... Latihan yoga dapat dilakukan dengan beberapa pose sederhana yang dapat dilakukan dirumah sebagai latihan rutin untuk mengurangi nyeri menstruasi. Pada penelitian (Yonglitthipagon et al., 2017) merancang booklet khusus "Yoga for Primary Dysmenorrhea" yang berisi paduan penjelasan langkah-langkah dan gerak tubuh. Dalam latihan yoga dapat mengaktifkan sistem modulasi rasa sakit di otak dan memproyeksikan ke sumsum tulang belakang sehingga mengeluarkan sekresi beta-endorfin yang berguna untuk obat Pereda rasa sakit alami dalam tubuh. ...
Peningkatan kejadian dismenore pada remaja meningkat tiap tahunnya, namun penanganan masalah tersebut masih berfokus pada penanganan farmakologis yang menimbulkan dampak ketergantungan. sehingga perlu adanya informasi yang komprehensif terkait penanganan non-farmakologis. Tujuan dari penelitian ini untuk mengetahui intervensi non-farmakologi yang dapat dilakukan perawat untuk mengurangi nyeri haid pada remaja. Studi ini menggunakan narattive review pada 4 database yaitu PubMed, ScienceDirect, Ebsco dan Garuda, dengan kriteria inklusi termasuk full-text, publikasi studi 2017 hingga 2022. Keywords yang digunakan dalam pencarian artikel diantaranya Adolescent, Non-pharmacological, Reduce pain, Menstruation, Dysmenorrhea didapatkan 6 artikel dari total 2.135 artikel. Berdasarkan hasil bahwa intervensi manajemen nyeri non farmakologi seperti varash oil, zumba exercise, yoga, terapi relaksasi progresif, kompres hangat dan minuman kedelai kombinasi asam jawa dengan kunyit efektif dalam penurunan skala nyeri haid pada remaja.
... Yoga is an increasingly popular alternative medicine. A previous study reported that specially designed poses of yoga effectively improved pain and quality of life in non-athlete women aged 18-22 with PD (10). Hatha yoga, with s o m e p o s e s s u c h a s b h u j a n g s a n a , shavasana, and vajrasana, was also claimed to improve pain due to dysmenorrhea (11). ...
p> Background : Yoga has been known as an alternative therapeutic modality for reducing pain. The benefits of yoga for reducing pain have been proven. Women often suffer pain due to dysmenorrhea. The effect of Yoga on dysmenorrhea pain has not been widely studied
Objectives : This study aimed to investigate the effect of hatha yoga on pain in primary dysmenorrhea (PD).
Methods : This was a randomized controlled study (RCT) involving 50 female students, 25 each in control (C) and yoga group (Y). PD was diagnosed by Working ability, Location, Intensity (Wong-Baker scale), and Days of the Pain of Dysmenorrhea (WaLIDD) questionnaire. Pain intensity was assessed by the Numeric Rating Scale (NRS). Hatha yoga training was conducted for 12 weeks. The unpaired t-test, ANOVA and Tukey post hoc, and Pearson correlation test was applied. Significance was set at p<0.05 .
Results : The characteristics between groups were not different. ANOVA indicated the NRS score in control was not changed, while yoga was diminished (p=0.02). Tukey post hoc showed that the second and third NRS were lower than basal NRS (p=0.038 and 0.01, respectively). The third was also lower than the second NRS (p=0.039). The second and the third NRS in yoga were lower than in control (p=0.027 and <0.01, respectively). The second magnitude of change of NRS was significantly different from the first in yoga ( 1.92 ±2.4 vs. 3.09 ± 2.8, p=0.018). The magnitude of NRS changes in the first (0.06±1.1 vs. 1.92±2.4, p=0.013) and second (0.02 ± 1.6 vs. 3.09 ± 2.8, p= 0.004) in yoga was significantly greater than the control. NRS score was not correlated with age, BMI, and age of menarche.
Conclusions : Hatha yoga exercise ameliorate pain intensity in primary dysmenorrhea among female university students. </p
... Yoga is a non-pharmacological technique that teaches about a combination of relaxation techniques, breathing, and body position to increase strength, and balance, and reduces pain [14]- [16]. Several studies mentioned that yoga is useful for reducing the intensity of primary dysmenorrheal pain [17], [18]. In yoga, there are several movements such as yoga Nidra, solar namaskar, yoga asanas, and yoga solar na-mascara [17]. ...
Background: Dysmenorrhea is pain, often very severe pain, felt in the lower abdomen during menstruation. Menstrual pain often lasts till the conclusion of the menstrual cycle and can be disruptive to daily activities. There are both pharmaceutical and non-pharmacological ways to treat dysmenorrhea pain. Yoga asanas are one non-pharmacological method of pain management. This study sought to ascertain how yoga asanas affected the pain associated with dysmenorrhea. This study used an incidental sampling technique along with a one-group pre-and post-test design and a quasi-experimental sampling strategy. The population of this study consisted of all dysmenorrheic grade 11 pupils. This study was conducted using a quasi-experimental methodology using a one-group pre-test and post-test design. The study's sample size was 19 samples, including 8 samples from the control group and 11 samples from the intervention group, as determined by the Mann-Whitney U and Wilcoxon t-Independent Sample tests. It can be concluded that yoga asanas do not affect dysmenorrhea in 11th-grade students based on the findings of this study, which revealed no difference in dysmenorrhea pain between the p values for the intervention and control groups of (0.373) and (0.915), as well as no difference between the two groups pre- and post-test dysmenorrhea pain with p values of (0.102) and (0.317).
... Based on the results of statistical analysis using the Wilcoxon test for dysmenorrhea pain, before and after the intervention was given to each group, the results obtained p value = 0.00 (p <0.05) which means that there is a difference in dysmenorrhea pain before and after being given Pranayama yoga and Surya Namaskar yoga in each -each group. This is in line with the results of research conducted by (Shakeela & Sugumar, 2020;Yonglitthipagon et al., 2017), that yoga can reduce dysmenorrhea pain, and improve health and quality of life, other than that according to (Estevao, 2022), yoga is beneficial for mental and physical health, such as balancing hormones, reducing stress levels, reducing inflammation. The analysis test used Mann-Whitney to compare the intervention in the two groups. ...
... In addition to effective pain management, physical therapy has also been shown to minimize the emotional stress that often accompanies physical symptoms (Azim et al., 2022). Yoga has also shown promise for alleviating menstrual pain due to its relaxation techniques coupled with physical exercises and stretching (Sutar et al., 2016;Yonglitthipagon et al., 2017). It is possible that females are unaware that physical therapy may be an option for them to explore to relieve their menstrual pain. ...
... Results of recent research have supported the use of complementary methods for relieving menstrual pain and its consequences. Some experimental studies have shown that non-pharmacological ways of coping with menstrual pain, like acupuncture (Abaraogu & Tabansi-Ochuogu, 2015), acupressure (Abaraogu & Tabansi-Ochuogu, 2015;Mejías-Gil et al., 2021), transcutaneous electrical nerve stimulation (Arik et al., 2022;Elboim-Gabyzon & Kalichman, 2020;Wang et al., 2009), thermotherapy (Choi, 2017), therapeutic exercise (Carroquino-Garcia et al., 2019), yoga (Kamalifard et al., 2017;Kim, 2019;Yonglitthipagon et al., 2017), physical activity (Matthewman et al., 2018), manual therapy (Barcikowska et al., 2021;Trybulec & Wyżycka, 2016), massage therapy (Azima et al., 2015), aromatherapy (Apay et al., 2012;Sadeghi Aval Shahr et al., 2015) and Kinesio Taping (Boguszewski et al., 2020;Choi, 2017;Doğan et al., 2020;Forozeshfard et al., 2016;Lim et al., 2013;Mejías-Gil et al., 2021;Tomás-Rodríguez et al., 2015;Toprak Celenay et al., 2020) proved to be very efficient. ...
Current research promotes complementary methods of coping with menstrual pain (MP). Our objective was to examine the effectiveness of the Kinesio Taping (KT) intervention on MP and determine whether KT has therapeutic impact or whether there is presence of placebo. We used crossover design, dividing 30 female participants into KT and placebo KT groups. Every phase included one menstrual cycle. The average age of participants was 23.5 years (ranging from 18 to 39 years). In the assessment, we used VAS, Brief Pain Inventory Scale, and some SF-36 subscales. In KT phase all types of pain (the average MP, the worst experienced MP, the mildest one, and the current MP) were significantly less intense. KT has beneficial effect in reducing MP and its consequences and it is significantly superior to placebo. The order of intervention showed no statistical significance, which also confirms the therapeutic effect of KT.
Latar Belakang: Setiap bulan perempuan berusia 12–49 tahun (WUS), tidak sedang hamil dan belum menopause mengalami menstruasi. Pada saat menstruasi masalah yang dialami banyak wanita adalah rasa tidak nyaman atau rasa nyeri. Perubahan fungsi sistem syaraf otonom selama fase luteal menstruasi berhubungan dengan gejala psikosomatik pada fase menstruasi. Alternatif preventif untuk meningkatkan kesehatan perempuan adalah dengan melakukan yoga. Yoga memberikan manfaat pada kesehatan fisik dan mental melalui pengaturan sumbu HPA (Hipothalamus Pitutari Adrenal) dan System Syaraf Simpatis, meningkatkan aktifitas parasimpatis, menurunkan tekanan darah menurunkan stress dan tingkat kecemasan. Gerakan-gerakan fisik dari yoga merangsang, menguatkan tubuh serta meningkatkan sirkulasi darah. Organ-organ panggul, otot-otot perineal dan panggul menjadi lebih sehat, mendapatkan asupan oksigen, sehingga vaskularisasi menuju organ reproduksi menjadi optimal.Tujuan: Mengetahui pengaruh Yoga terhadap penurunan tingkat kecemasan pada siklus menstruasi remaja putri.Metode: Desain penelitian ini menggunakan systematic literature review yang bersumber dari EBSCO, ProQuest, Science Direct and PubMed dengan jangka waktu terbit 10 tahun..Hasil: penelitian ini menemukan bahwa yoga dapat menurunkan tingkat kecemasan pada siklus menstruasi remaja putri.Kesimpulan: Yoga mempunyai pengaruh yang efektif terhadap penurunan tingkat kecemasan pada siklus menstruasi remaja putri.Saran: Pemberian treatment yoga dapat direkomendasikan sebagai tindakan non farmakologi dan terapi komplementer untuk menurunkan tingkat kecemasan dengan biaya yang murah, resiko sedikit, manfaatnya lebih besar dan efektif serta sangat sesuai untuk remaja perempuan yang menginginkan aktivitas ringan dan mudah. Kata Kunci : Menstruasi; Remaja Putri; Tingkat Kecemasan; Yoga ABSTRACT Background: Every month women aged 12–49 years (WUS), not pregnant and not yet menopausal experience menstruation. During menstruation, the problem experienced by many women is discomfort or pain. Changes in the function of the autonomic nervous system during the luteal phase of menstruation are related to psychosomatic symptoms during the menstrual phase. A preventive alternative to improve women's health is to do yoga. Yoga provides benefits to physical and mental health through regulation of the HPA axis (Hypothalamus Pituitary Adrenal) and the Sympathetic Nervous System, increasing parasympathetic activity, lowering blood pressure, reducing stress and anxiety levels. The physical movements of yoga stimulate, strengthen the body and improve blood circulation. The pelvic organs, perineal and pelvic muscles become healthier, get oxygen intake, so that vascularization to the reproductive organs becomes optimal.Purpose: To determine the effect of Yoga on reducing anxiety levels in the menstrual cycle of adolescent girls .Methods: This research design uses a systematic literature review sourced from EBSCO, ProQuest, Science Direct and PubMed with a publication period of 10 years.Results: This study found that yoga can reduce anxiety levels in the menstrual cycle of adolescent girls .Conclusion: Yoga has an effective influence on reducing anxiety levels in the menstrual cycle of adolescent girls.Suggestions: Yoga treatment can be recommended as a non-pharmacological action and complementary therapy to reduce anxiety levels at a low cost, with minimal risk, greater benefits and effectiveness and is very suitable for adolescent girls who want light and easy activities . Keywords: : Adolescent Girls; Anxiety Level; Menstruation; Yoga
Dysmenorrhea is a common problem in adolescent girls and women; with moderate to severe pain, often refrain from their daily activity and also affect their profession and quality of life. In this study effect of vitamin C and vitamin C in combination with exercise on the pain of dysmenorrhea was examined on twenty girl students of age range 18-22 years suffering from the symptoms of mild to moderate primary dysmenorrhea. Pain was measured as Pain Rating Index (PRI) using McGill pain Questionnaire. Duration of the intervention was for consecutive 8 weeks and pain score was measured three times; before intervention, after 1st menstrual cycle and after second menstrual cycle. Results showed that pain score decreased after both the treatments. It was also observed that vitamin C in combination with exercise showed a better effect than vitamin C alone (P < 0.05).
Background: Primary dysmenorrhea is the most common complaint related to menstrual disorders among women and young girls. The goal of this research was to examine the effect of yoga exercises on menstrual pain and distress in female students aged 20 - 35 years with primary dysmenorrhea, both with and without lumbar hyperlordosis. Despite the research and studies conducted in the field of primary dysmenorrhea, many aspects of the condition remain unknown. This study aims to provide new insights for the audience. Objectives: The aim of this study was to evaluate the effect of a course of yoga exercises on menstrual pain and distress in women with primary dysmenorrhea, both with and without lumbar hyperlordosis. Methods: The statistical population of the present study included 60 eligible female patients aged 20 to 35 years, selected through available and targeted sampling. Participants were divided into an experimental group (15 individuals with hyperlordosis and 15 individuals without hyperlordosis) and a control group (15 individuals). Those with hyperlordosis had a lumbar lordosis angle above 30 degrees. Patients in the experimental group participated in yoga exercises for eight weeks, with three sessions per week, each lasting one hour. Variables were evaluated before and after the eight-week intervention. Menstrual pain, menstrual distress, and lumbar lordosis were measured using the Visual Analog Scale (VAS), the Menstrual Distress Questionnaire (MMDQ), and a flexible ruler, respectively. Data analysis was conducted using the Shapiro-Wilk test, covariance analysis, and paired t-tests to compare the variables. The final results were confirmed using covariance analysis. Results: The findings demonstrated that yoga exercises in the experimental group led to a significant reduction in menstrual pain, menstrual distress, and the lumbar lordosis angle after the intervention (P ≤ 0.05). Conclusions: Based on the findings of the current research, yoga exercises, as a non-invasive method, significantly improved menstrual pain, menstrual distress, and the lumbar lordosis angle in the experimental group.
A BSTRACT
Dysmenorrhea, commonly known as menstrual pain, is characterized by painful uterine cramps during menstruation and significantly impacts a woman’s physical, mental, and emotional health. Elevated prostaglandin levels cause dysrhythmic uterine contractions, reducing blood flow, leading to uterine hypoxia, and producing anaerobic metabolites that activate pain receptors. This study aims to review the effectiveness of yoga as an alternative treatment for primary dysmenorrhea. A search of English-language literature published from 2010 to 2023 was conducted across Scopus, PubMed, and Google Scholar using keywords “Yoga” AND “Menstrual Pain” OR “Dysmenorrhea.” The inclusion criteria were limited to randomized controlled trials examining the impact of yoga on dysmenorrhea symptoms. From 111 identified studies, 6 met the selection criteria and were included in the review. The review investigates yoga’s potential to alleviate primary dysmenorrhea’s physical and mental health effects. The literature indicates that yoga, including asanas, pranayama, and Yoga Nidra, is effective in reducing dysmenorrhea symptoms. Findings suggest that various yoga practices can significantly reduce menstrual pain and discomfort, improving overall health outcomes. However, the reviewed studies have limitations, such as small sample sizes and variations in study design. To establish yoga as an evidence-based solution for menstrual health issues, further research with rigorous scientific methods and larger sample sizes is needed. More high-quality trials focusing on a yogic approach are necessary to confirm yoga’s effectiveness as a primary management option for women with primary dysmenorrhea.
The aim of this study was to investigate the effect of Pilates exercise versus yoga on primary dysmenorrhea in adolescent girls. The study was designed as a randomized controlled trial and was conducted with adolescent girls at an experimental school in Cairo. Sixty adolescent girls, aged 12 to 16 years, who were all diagnosed with primary dysmenorrhea, participated in this study. They were randomly assigned to one of two groups: Group (A) (Pilates exercise) with 30 participants, and Group (B) (Yoga exercise) with 30 participants. Participants were assessed before and after the treatment period. Group (A) performed Pilates exercises for 30 minutes, three days per week, for three months, while Group (B) engaged in yoga exercises for 30 minutes, three days per week, for three months. The Visual Analog Scale (VAS) was used to rate the intensity of pain, and the Verbal Multidimensional Scoring System (VMS) was used to assess the severity of menstrual symptoms. Data analysis was conducted using the Statistical Package for the Social Sciences (SPSS). The study revealed a statistically significant improvement in VAS and VMS measures following Pilates exercise in Group A (p < 0.05). Similarly, a statistically significant improvement in VAS and VMS measures was observed following yoga exercise in Group B (p < 0.05). Both Pilates and yoga exercises demonstrated a significant impact on managing primary dysmenorrhea. The findings indicate that these mind-body interventions are effective in alleviating the severity of menstrual pain and related symptoms.
Purpose: It was aimed to investigate the effects of telerehabilitation method and online yoga-based exercise program on pain, menstrual attitude, body awareness and quality of life in women with primary dysmenorrhea (PD). Methods: This study is an experimental randomized controlled single-blind study. Fifty women (25 in the intervention group, and 25 in the control group) between the ages of 18-35 were included in the study. Information training on PD was given to both groups. In addition to the intervention group, a total of 16 sessions of online specific yoga poses were applied twice a week for 8 weeks, individually. Visual analog scale (VAS), menstrual attitude scale (MAS), body awareness questionnaire (BAQ), short form-36 (SF-36), and satisfaction questionnaire were used for data collection. Results: The VAS score of the intervention group decreased from 6.76 to 3.76 points. VAS (p
The study aims to evaluate the effect of yoga on the premenstrual syndrome, perceived stress level and the quality of life. The study was conducted as a randomized controlled trial at a university in Turkey. A yoga group = 39, a control group = 41, total of n = 80 female students participated in the study. In the study, firstly, the preview was made, then the yoga group was applied two days a week for eight weeks, the second follow-up was made after the application, and lastly, the last follow-up was made in the 24th week. Four questionnaire surveys were applied on students. When the yoga group compared with the control group in terms of premenstrual syndrome, the quality of life and perceived stress level in the 2nd follow-up, a statistically significant decrease was found in the mean between the menstrual and premenstrual period, and the quality of life increases in the yoga group compared to the control group students. Practicing yoga in university students with premenstrual syndrome reduced premenstrual symptoms and raised quality of life. Yoga can be recommended to girls with premenstrual syndrome (PMS) to reduce PMS and improve quality of life.
This study aims to prove the effectiveness of aerobic exercise and yoga in lowering blood pressure in mothers. The study was conducted using experimental methods and involved 28 participants selected by purposive sampling from Nogosari village, Boyolali regency, Indonesia, during 12 sessions. Blood pressure data were collected from participants with hypertension before and after aerobic exercise and yoga. Measurements were taken on participants for 12 sessions in one month using a blood pressure monitor. The device used in this study was a sphygmomanometer ambulatory blood pressure monitoring (ABPM). Statistical tests were performed using independent samples t-tests with a significance level of p
Background
Studies have demonstrated that exercise can mitigate the intensity of menstrual pain in primary dysmenorrhea, but the most effective type of exercise remains unclear. The objective of this systematic review and network meta-analysis was to evaluate the effectiveness of different exercise regimens in reducing pain associated with primary dysmenorrhoea.
Methods
Randomized controlled trials investigating the relationship between menstrual pain and exercise were selected from major electronic databases until February 2, 2024. The primary outcome was the effect of exercise on pain intensity measured by the mean difference on a 10-cm visual analogue scale at 4 and 8 weeks after intervention. The secondary outcome was the difference in risk of dropout at 8 weeks. The study protocol was registered as INPLASY202330050.
Results
This systematic review and network meta-analysis included 29 randomized controlled trials, which involved 1808 participants with primary dysmenorrhea. Exercise interventions included relaxation exercise, strength training, aerobic activity, yoga, mixed exercise, and the Kegel maneuver. Relaxation exercise was the most effective in reducing menstrual pain in 4 weeks (− 3.56; 95% confidence interval: − 5.03 to − 2.08). All exercise interventions were effective in reducing menstrual pain at 8 weeks, with reductions ranging from − 3.87 (95% CI − 5.51 to − 2.22) for relaxation exercise to − 2.75 (95% CI − 4.00 to − 1.51) for yoga, compared to the control group. Relaxation exercises were found to have a significantly lower dropout risk (− 0.11; 95% CI − 0.20 to 0.02), while none of the exercise types was associated with a higher dropout risk than the control group.
Conclusion
All exercise interventions were effective in reducing menstrual pain in primary dysmenorrhea after 8 weeks of intervention. However, relaxation exercise was found to be the most effective intervention at 4 and 8 weeks and had the lowest risk of dropout.
Graphical Abstract
A jógázást, mint elme-test módszert, számtalan kutatás vizsgálja a mentális és testi egészség területén normál és klinikai mintát figyelembe véve. A jógázók körében végzett vizsgálatok eredményei szerint a jógázás pozitív összefüggéseket mutat a mentális egészség több mutatójával, továbbá a mentális egészséggel szoros kapcsolatban álló szomatizációval is a felnőtt lakosság körében. A nemzetközi szakirodalomban hiányként jelölik meg a kutatók a spiritualitással és szomatizációval kapcsolatos felmérések területét, továbbá rámutatnak a COVID-19 pandémia időszakában olyan módszerek feltárásának szükségességére, amelyek segíthetik a népegészségügyet a járvány idején.
Kutatásaink fő céljai e hiányterületekhez kapcsolódtak, amelyhez szerettünk volna olyan felméréseket is végezni, amelyekre korábban nem került sor Magyarországon. A kutatásainkban vizsgáltuk a mentális egészség és a testi tünetek összefüggéseit a jógázó nők jógázási paramétereivel összefüggésben. Vizsgáltuk továbbá azt is, hogy a jógázók mennyire tartják hasznosnak a jógázás módszerét az általános jóllét fenntartására és a COVID-19 esetekkel kapcsolatban és ezek a változók milyen összefüggést mutatnak a jógázás heti gyakoriságával. Emellett kettős célként tűztük ki, hogy adaptáljuk a Spirituális Egészség- és Életorientáció Kérdőív magyar változatát és elvégezzük annak pszichometriai elemzését, továbbá vizsgáljuk a jóga lehetséges hatásait a spiritualitásra, a mentális jóllétre és a szomatizációra egyetemi hallgatói mintán, aktív kontroll csoporttal is összehasonlítva.
Eredményeink igazolják azon korábbi kutatásokat, amelyek pozitív kapcsolatot tártak fel a jógázás heti gyakorisága és a mentális egészség mutatói, mint a csökkent depresszió, szorongás, stressz, a hatékonyabb stresszel való megküzdés / affektivitás, továbbá a jobb szubjektív egészség és csökkent testi tünetek területén. A mért változók ehhez hasonló pozitív összefüggéseket mutattak a jógázással töltött évek számával is. A mentális jóllét szintje pozitív összefüggést mutatott a jógázás heti gyakoriságával. Továbbá hasonló pozitív összefüggés volt kimutatható azzal kapcsolatban is, hogy mennyire tartják a jógázók hasznosnak a jógagyakorlást a COVID-19 nyomán kialakult egészségproblémák megelőzésére, a tüntetek enyhítésére és orvosi kezelés kiegészítésére. A Spirituális Egészség- és Életorientáció Kérdőív (SHALOM) megbízható eszköznek bizonyult a spiritualitás négy területének kimutatására: Személyes, Társas, Környezeti, és Transzcendens dimenziók. A legjobb illeszkedést a bifaktoros modell mutatta, amely a négy elsődleges dimenzió mellett az általános faktort, amit spiritualitásnak hívunk, is hivatott mérni. Találtunk olyan tételeket is, amelyek további pontosításra szorulnak. Az egyetemi testnevelési órákon felmért jógázás azt mutatta, hogy a spiritualitás terén a jógázás hatása jelentősebb a sportágakat végzőkkel összehasonlítva, akik ugyanakkor a testi tünetek enyhítésében bizonyultak hatékonyabbnak. A jógázás és sportok végzése összességében nem mutatott jelentős különbségeket. Az elemzéseink során több olyan változót is vizsgáltunk, amelyek a nemzetközi kutatásokkal ellentétben nem mutattak pozitív változást, mint az általános és pszichológiai jóllét és az élettel való elégedettség.
Összességében azt tapasztaltuk, hogy minél nagyobb heti gyakorisággal vagy minél hosszabb ideje jógázik valaki, annál több egészséghasznot várhat a jógázástól. A jógázás hatékonynak bizonyul a mentális egészség fenntartásában még a fokozottan stresszel teljes környezetben is, mint a jelenlegi COVID-19 járvány, és hatásos eszköze lehet elsősorban a megelőzésnek. A jógázás otthoni környezetben is könnyen gyakorolható módszer, amely ajánlott az egészség fenntartásához akár a világjárvány időszakában is. A jóga gyakorlásának megismertetése ajánlható az egyetemi testnevelés órai keretben.
Objective: Despite the historical marginalisation of women and the progress made in securing their legal rights, primary dysmenorrhea continues to present difficulties that impact women's physical and emotional health. This meta-analysis investigates yoga's effectiveness as a non-pharmacological treatment for primary dysmenorrhea. Method: A systematic review utilising Shodhganga, Research Gate, and PubMed was carried out in accordance with PRISMA standards on studies published from 2010 to 2023. Primary dysmenorrhea and effective yoga therapies were the main inclusion criteria. Studies that were not experimental or that dealt with other forms of dysmenorrhea were not included. Results: Twenty studies are included in the meta-analysis, which highlights yoga's effectiveness in easing the symptoms of primary dysmenorrhea. Across a wide range of demographics, asanas, pranayamas, and meditation dramatically reduce menstruation discomfort and enhance general wellbeing. Discussion: Yoga has been shown to have a persistent good impact on general development, stress levels, and pain reduction. As a non-pharmacological intervention, it is a safe and effective choice for managing primary dysmenorrhea. The utilisation of an Android app for yoga relaxation and the possibility of increasing beta-endorphin levels through a yoga-murottal intervention are noteworthy findings. Conclusion: Yoga is a valuable, all-encompassing, and reasonably priced treatment for primary dysmenorrhea since it treats the mental and physical components of the condition. The evidence base has to be strengthened by larger, more diversified populations and more research using standardised procedures. For the reduction of menstruation discomfort, yoga provides a specialised and scientifically supported approach.
Introduction: Menstrual colic, or dysmenorrhea, is a common gynecological complaint characterized by pelvic cramp-like pain before or during menstruation. Medicinal Biomagnetism (BM) is a complementary and integrative method that may help in the treatment and prevention of dysmenorrhea symptoms. It aims to restore the energetic balance and ideal pH of the area impacted by medium-intensity therapeutic magnets. Objective: To investigate the effect of the Double BM Magnet on acute menstrual colic pain. Methodology: A case study involving two participants where the Double BM Magnet protocol was applied to address dysmenorrhea, assessed using the Visual Analog Scale. Results: It was observed that the Double BM Magnet tool generated an analgesic effect on menstrual colic pain, providing a significant result within 60 minutes of its application. Conclusion: This study suggests that the application of the Double BM Magnet in the pelvic region for the relief of menstrual pain can have a significant analgesic effect. It proves to be relevant due to its ease of application, non- invasiveness, low cost, and the possibility of self-application. Furthermore, it has minimal contraindications and rare side effects.
Introduction: Dysmenorrhea is a common, painful, and debilitating problem of personal activity with psychological symptoms of anxiety and distress. The present study was performed with aim to investigate the effect of Mandela therapy on anxiety, pain intensity, and distress in primary dysmenorrhea.
Methods: This randomized clinical trial study was conducted in 2022 on 80 university students in Arak city who had a pain intensity score of 4 to 8. People were placed in the intervention and control groups. The intervention group painted the mandala for five days in two menstrual cycles. The questionnaires of Spielberger's anxiety, Moos menstrual distress, and numerical pain measure were completed by two groups before and after two intervention periods. Data were analyzed using SPSS statistical software (version 28) and Fisher's exact, independent t and paired t, and Mann-Whitney and Wilcoxon tests. P<0.05 was considered statistically significant.
Results: Although the mean score of dysmenorrhea distress after the intervention had a significant decrease in the intervention group (35.76±8.18) compared to the control group (40±7.93) (d=0.645, p=0.01), but the reduction in mean pain intensity in the intervention group (5.82±2.08) was not significantly different compared to the control group (6.45±1.96) (p>0.05). Also, there was no significant difference between the mean of trait and state anxiety in the two groups after the intervention (p>0.05).
Conclusion: Mandala therapy can be effective in reducing the distress caused by primary dysmenorrhea.
The effect of mandala therapy on anxiety, pain severity and distress of primary dysmenorrhea: A randomized clinical trial
Mahsa Hosseini 1 Zahra Borzabadi Farahani 2 Azam Moslemi 3 Fatemeh Bodaghi 1 Fereshteh Farzan Azar 4
1 B.Sc. of Nursing, Student Research Committee Center, School of Nursing, Arak University of Medical Sciences, Arak, Iran.
2 Instructor, Department of Psychiatric Nursing, School of Nursing, Arak University of Medical Sciences, Arak, Iran.
3 Assistant Professor, Department of Biostatistics, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran.
4 Assistant Professor, Department of Midwifery, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran.
Introduction: Dysmenorrhea is a common, painful, and debilitating problem of personal activity with psychological symptoms of anxiety and distress. The present study was performed to investigate the effect of Mandela therapy on anxiety, pain intensity, and distress in primary dysmenorrhea.
Methods: This randomized clinical trial study was conducted in 2022 on 80 university students in Arak City who had a pain intensity score of 4 to 8. People were placed in the intervention and control groups. The intervention group painted the mandala for five days in two menstrual cycles. The questionnaires of Spielberger's anxiety, Moos menstrual distress, and numerical pain measure were completed by two groups before and after two intervention periods. Data were analyzed using SPSS statistical software (version 28) and Fisher's exact, independent t and paired t, and Mann-Whitney and Wilcoxon tests. P<0.05 was considered statistically significant.
Results: Although the mean score of dysmenorrhea distress after the intervention had a significant decrease in the intervention group (35.76±8.18) compared to the control group (40±7.93) (d=0.645, p=0.01), the reduction in mean pain intensity in the intervention group (5.82±2.08) was not significantly different compared to the control group (6.45±1.96) (p>0.05). Also, there was no significant difference between the mean of trait and state anxiety in the two groups after the intervention (p>0.05).
Conclusion: Mandala therapy can be effective in reducing the distress caused by primary dysmenorrhea.
keyword
Art therapy Clinical trial Dysmenorrhea Mandala coloring Primary dysmenorrhea
Dysmenorrhea is a menstrual disorder characterized by painful uterine cramps that occur during menstruation. There are two types of dysmenorrhea, primary and secondary. It affects 45-95% of all menstruating women worldwide. The prevalence in India is approximately 75%. Primary dysmenorrhea diagnosis is based on the patient's medical history and physical examination. If the history of start and duration of lower abdominal discomfort suggests secondary dysmenorrhoea or if the dysmenorrhoea does not respond to medical treatment, a pelvic examination is necessary to evaluate dysmenorrhoea. Because of the increasingly large number of women who are impacted by primary dysmenorrhea, it should be a public health concern that authorities must address. Abdominal stretching is a very simple, efficient, and risk-free workout. Some of the benefits of stretching exercises for dysmenorrhea include increased elasticity and strength of the spine and pelvic muscles and reduction in pain. The knee-to-chest exercise in combination with hydrocollator packs has a significant effect in improving the pain and the monthly irregularities in primary menstrual pain. Massage of connective tissue is a form of cutaneous stimulation that tries to stimulate the connective tissue's mechanical receptors. Connective tissue massage studies for treating a range of dysfunctions usually indicate that patients treated with this modality get pain alleviation and even complete remission.
The author discusses the health risks associated with early menopause and the benefits of hormone replacement therapy to mitigate these risks and alleviate hypoestrogenic symptoms as appropriate for individual patients.
Beérkezett: 2021. december 2.; elfogadva: 2022. május 31. ABSZTRAKT Elméleti háttér: Számos nemzetközi kutatás eredményei szerint a jógagyakorlás megfelelő iránymuta-tás mellett pozitív hatással van az egészséges emberek testi és lelki állapotára, valamint szerepet játsz-hat egyes betegségek kiegészítő kezelésében is. A jógázókat felmérő kutatások pozitív irányú összefüg-géseket tártak fel több egészségi mutató és a jóga végzésének gyakorisága, részben pedig a jógázással töltött idő között. A női egészség tekintetében a jógázás pozitív hatásúnak bizonyult a depresszió, a szorongás, a stressz és több szomatikus tünet enyhítésében. Célkitűzés: Vizsgálatunk célja a magyar jógázó nők egészsége szubjektív pszichés és testi tünet mutatóinak felmérése, valamint ezen változók összefüggéseinek vizsgálata a tapasztalat és gyakoriság szerint elkülönített csoportok között. Módsze rek: A vizsgálati mintát 457 egészséges nő alkotta, átlagéletkoruk 42,28 (SD = 11,72) év, a jógagyakor-lók aránya 72,3%, a jógaoktatóké pedig 27,7%. A vizsgálat során a Depresszió Szorongás és Stressz Kérdőívet (DASS-21), a Pozitív és Negatív Affektivitás Skálát (PANAS), egy szubjektív egészségi álla-potra vonatkozó kérdést és a Szubjektív Testi Tünet Skálát (PHQ-15) alkalmaztuk. A kialakított cso-portok közötti különbségeket Kruskal-Wallis H-és Mann-Whitney U-próbákkal elemeztük. Eredmé nyek: A jógagyakorlással töltött idő szerint kialakított három csoport (kezdő: 1-6 hónap, középhaladó: 7-35 hónap, haladó: ≥3 év) között statisztikailag szignifikáns különbséget találtunk a depresszió (χ 2 (2, n = 457) = 23,205; p < 0,001), a szorongás (χ 2 (2, n = 457) = 9,489; p = 0,009), a stressz (χ 2 (2, n = 457) = 27,224; p < 0,001), a pozitív affektivitás (χ 2 (2, n = 456) = 7,689; p = 0,021), a negatív affektivitás (χ 2 (2, n = 456) = 46,177; p < 0,001), a szubjektív egészségi állapot (χ 2 (2, n = 457) = 28,862; p < 0,001) és a Szub-jektív Testi Tünetek skálán elért (χ 2 (2, n = 455) = 26,022; p < 0,001) pontszámok között. A jógázás gyakorisága alapján kialakított két csoport (heti 1-2 vs. heti 3-7 alkalom) között szintén szignifikáns páros különbséget találtunk a depresszió (U(1) = 19 148,50; n 1 = 161; n 2 = 295; Z =-3,508; p < 0,001), a stressz (U(1) = 19 588,50; n 1 = 161; n 2 = 295; Z =-3,107; p = 0,002), a pozitív affektivitás (U(1) = 18 189,00; n 1 = 161; n 2 = 294; Z =-4,090; p < 0,001), a negatív affektivitás (U(1) = 18 456,50; n 1 = 161; n 2 = 294; Z =-3,894; p < 0,001), a szubjektív egészségi állapot (U(1) = 18 244,00; n 1 = 161; n 2 = 295; Z =-4,873; p < 0,001) és a Szubjektív Testi Tünetek skálán elért pontszám (U(1) = 19 777,50; n 1 = 160; n 2 = 294; Z =-2,817; p = 0,005) esetében. Közepes hatásnagyságú különbség volt megfigyelhető a negatív affektivi-tás esetében, és kis hatásnagyságú különbségek a többi mért változónál. Következtetések: A jógázás ajánlható a depresszió, a szorongás, a stressz és a szomatizáció tüneteinek enyhítésére, valamint egy stresszel szembeni lehetséges adaptív megküzdési stratégia az egészséges nők számára. Az eredmé-nyek azt sugallják, hogy a hosszabb ideje tartó jógagyakorlás (években), vagy a jóga fizikai gyakorla-tainak (ászana) heti többszöri ismétlése (3 vagy több alkalom) adhatja a legnagyobb egészséghasznot.
Amaç: Bu araştırma menstrüel sağlık sorunları yaşayan üniversite öğrencilerinin geleneksel ve tamamlayıcı tıp (GETAT) yöntemlerini kullanma durumlarının ve kullanılan geleneksel ve tamamlayıcı tıp yöntemlerinin belirlenmesi amacıyla yapılmıştır. Gereç ve Yöntem: Tanımlayıcı-kesitsel olan araştırma 1 Ocak - 30 Haziran 2020 tarihlerinde bir üniversite öğrencileri ile yapılmıştır. Araştırmanın örneklemini 436 öğrenci oluşturmaktadır. Verilerin değerlendirilmesinde, yüzde ve ki-kare testi kullanılmıştır. Bulgular: Katılımcıların %65.4’ü menstrüel sağlık sorunları için geleneksel ve tamamlayıcı tıp yöntemlerine başvurmaktadır. Geleneksel ve tamamlayıcı tıp yöntemlerinden aktivite/egzersiz alanında katılımcıların %70.4’ü abdomene sıcak uygulama yapmakta; kültürel/dini uygulamalar alanında katılımcıların %41.3’ü menstrüel sağlık sorunlarıyla baş etmek için dua etmekte; bitkisel tedavi alanında katılımcıların %38.1’i papatya çayı içmektedir. Katılımcıların %49.3’ü kullanmakta olduğu geleneksel ve tamamlayıcı tıp yöntemini ailesinden öğrenmiştir. En sık başvurulan geleneksel ve tamamlayıcı tıp yönteminin abdomene sıcak su uygulama olduğu görülmüştür. Katılımcıların çoğunluğu geleneksel ve tamamlayıcı tıp yöntemlerini fayda gördükten sonra bırakmıştır. Sonuç: Araştırmada katılımcıların menstrüel sağlık sorunları yaşadığı ve bu sorunlara yönelik geleneksel ve tamamlayıcı tıp yöntemlerine başvurabildikleri saptanmıştır.
Yoga classes designed for women with premenstrual syndrome are available, but their efficacy is unclear. We investigated the effects of 12 weeks' yoga exercise (yoga intervention) on premenstrual symptoms in menstruating females in Taiwan. Sixty-four subjects completed the yoga intervention, and before and after the intervention filled out a structured self-report questionnaire about their demographics, personal lifestyle, menstrual status, baseline menstrual pain scores, premenstrual symptoms, and health-related quality of life. Of 64 subjects, 90.6% reported experiencing menstrual pain during menstruation. After the yoga intervention, subjects reported decreased use of analgesics during menstruation (p = 0.0290) and decreased moderate or severe effects of menstrual pain on work (p = 0.0011). The yoga exercise intervention was associated with the improvement of the scale of physical function (p = 0.0340) and bodily pain (p = 0.0087) of the SF-36, and significantly decreased abdominal swelling (p = 0.0011), breast tenderness (p = 0.0348), abdominal cramps (p = 0.0016), and cold sweats (p = 0.0143). Menstrual pain mitigation after yoga exercise correlated with improvement in six scales of the SF-36 (physical function, bodily pain, general health perception, vitality/energy, social function, mental health). Employers can educate female employees about the benefits of regular exercise such as yoga, which may decrease premenstrual distress and improve female employee health.
The definition of functional pain syndromes is varied across literature. No effort has been made to see all functional pain disorder groups under broad nomenclature which would exclude conditions for which pathophysiology is strongly known. Since these disorders are commonly treated with alternative treatment modalities and impose significant burden on health utilization, an effort to look into studies on yoga-based interventions on 'functional pain syndromes' (FPS) was made. This study defined FPS as 'Chronic relapsing remitting pain conditions, the origin of which is difficult to trace with no definite physical pathology on clinical suspicion or available laboratory measures and are valid based on subjective pain reporting, associated distress and socio-occupational dysfunction'. Chronic headache, neck pain, back pain, fibromyalgia, pelvic pain, Irritable Bowel Syndrome, Chronic Fatigue Syndrome, and somatoform pain disorders were included for this review. The review found four meta-analyses on the selected topic both indicating modest efficacy and benefit of yoga in these disorders. Future efforts should be directed to do a large meta-analysis of functional pain syndromes.
Introduction:
Dysmenorrhea is one of the most common gynecologic disorders that affects women's quality of life and social activities. Lifestyle, eating behaviors, and general health are essential to the management of menstrual symptoms. This study was conducted to examine the relationship between lifestyle and primary dysmenorrhea in students at Sari University of Medical Sciences in 2015 in order to facilitate the performance of lifestyle-improving interventions among young women.
Methods:
This study was conducted on 250 students with and without primary dysmenorrhea at Sari University of Medical Sciences in 2015. Data were collected using personal-social and lifestyle questionnaires (addressing nutrition, physical activity, stress, social relationships, improper health behaviors, and self-care). The data were analyzed by SPSS software, version 18, using the independent-samples t-test, the chi-squared test, and logistic regression analysis.
Results:
Given the scores obtained on the lifestyle questionnaire, significant differences were observed between the groups with and without dysmenorrhea in terms of eating behavior (p=0.008), physical activity (p=0.011), stress (p=0.041), and social relationships (p=0.000). No differences were observed in terms of self-care (p=0.115) and smoking, drinking, and drug use (p=0.355). According to the logistic regression analysis, age (OR=1.208, p=0.014), physical activity (OR=1.008, p=0.040) and social relationship (OR=0.952, p=0.002) were different in the two groups, but there was no statistical differences in their eating behavior, self-care, and stress.
Conclusion:
To prevent and reduce the incidence of primary dysmenorrhea, knowledge and awareness should be raised in young women through proper lifestyle education and health promotion measures.
Background:
Despite yoga's popularity, few clinical trials have employed rigorous methodology to systematically explore its functional benefits compared with more established forms of exercise. The objective of this study was to compare the functional benefits of yoga with the conventional stretching-strengthening exercises recommended for adults.
Methods:
Sedentary healthy adults (N = 118; M age = 62.0) participated in an 8-week (three times a week for 1 hour) randomized controlled trial, which consisted of a Hatha yoga group (n = 61) and a stretching-strengthening exercise group (n = 57). Standardized functional fitness tests assessing balance, strength, flexibility, and mobility were administered at baseline and postintervention.
Results:
A repeated measures multivariate analysis of variance showed a significant time effect for measures of balance [F(3,18) = 4.88, p < .01, partial η(2) = .45], strength [F(2,19) = 15.37, p < .001, partial η(2) = .62], flexibility [F(4,17) = 8.86, p < .001, partial η(2) = .68], and mobility [F(2,19) = 8.54, p < .002, partial η(2) = .47]. Both groups showed significant improvements on measures of balance (left-right leg and four square step); strength (chair stands and arm curls); flexibility (back scratch and sit-and-reach); and mobility (gait speed and 8-feet up and go), with partial η(2) ranging from .05 to .47.
Conclusions:
These data suggest that regular yoga practice is just as effective as stretching-strengthening exercises in improving functional fitness. To our knowledge, this is the first study to examine functional benefits of yoga in comparison with stretching-strengthening exercises in sedentary, healthy, community-dwelling older adults. These findings have clinical implications as yoga is a more amenable form of exercise than strengthening exercises as it requires minimal equipment and can be adapted for individuals with lower levels of functioning or disabilities.
Physiological benefits of yoga on volunteers of a particular age group are available. However, reports on efficacy of a specific yoga package on the populace of different age groups from similar occupational background is still very limited. Therefore, the present study was conducted to appraise the effect of a specific Hatha yoga package on anthropometric characteristics, flexibility and muscular strength of healthy individuals of different age groups from similar occupational trade.
A total of 71 participants (Group All) from Indian Air Force ground personnel volunteered and age wise divided into 3 groups - (i) Group I (Gr. - I) (n1 = 27, 20-29 years), (ii) Group II (Gr. - II) (n2 = 21, 30-39 years) and (iii) Group III (Gr. - III) (n3 = 23, 40-49 years). All the participants undergone selected Hatha yoga training for 1 h daily for a period of 12 weeks. Parameters were recorded before and after the training. Pre and post training differences were assessed by Student's t-test.
Body weight (All, Gr. - II and Gr. - III [all P < 0.05]), body mass index (Gr. - II and Gr. - III [both P < 0.01]) and fat% (Gr. - II and III [both P < 0.05]) were decreased significantly. Neck circumference was increased significantly in Gr. - I (P < 0.05) but decreased significantly in Gr. - III (P < 0.05). Chest circumference (All (P < 0.001), in Gr. - I and II [both P < 0.05]), grip strength (All [left: P < 0.01 and right: P < 0.05], in Gr. - I [left: P < 0.05 and right: P < 0.01], in Gr. - II [right: P < 0.05] and in Gr. - III [left: P < 0.05 and right: P < 0.01]), back leg strength (group wise P < 0.001, P < 0.05, P < 0.01 and P < 0.05 respectively) and flexibility (all P < 0.001) were increased significantly.
Hatha yoga can improve anthropometric characteristics, muscular strength and flexibility among volunteers of different age group and can also be helpful in preventing and attenuating age related deterioration of these parameters.
OBJETIVO: Avaliar a amplitude de movimento (ADM) e o torque flexor e extensor do joelho após a realização de um programa de alongamento ativo excêntrico dos músculos flexores do joelho. MATERIAIS E MÉTODOS: Trinta e quatro voluntários (23 mulheres e 11 homens), 34,42±9,3 anos, realizaram um programa de alongamento ativo excêntrico dos músculos flexores do joelho na postura em pé, que consistiu de sete repetições de um minuto com 30 segundos de descanso entre as repetições. O programa de alongamento foi realizado duas vezes por semana, durante quatro semanas. A ADM de extensão e o torque flexor e extensor do joelho foram avaliados no dinamômetro isocinético pré e pós-programa de alongamento. O torque foi avaliado nos modos isométrico e isocinético concêntrico e excêntrico a 30°/s e 60°/s. RESULTADOS: Houve aumento na ADM de 53,7±13° para 30,1±16° (p=0,0001), no torque isométrico flexor de 89±32Nm para 93±33Nm (p=0,01) e extensor de 178±67Nm para 187±73Nm (p=0,006). O torque flexor concêntrico e excêntrico a 30°/s aumentou de 90±31Nm para 96±31Nm (p=0,001) e de 100±34Nm para 105±35Nm (p=0,01), respectivamente. O torque extensor concêntrico a 60°/s aumentou de 144±51Nm para 151±58Nm (p=0,02) e o excêntrico a 30°/s de 175±71Nm para 189±73Nm (p=0,01). CONCLUSÕES: O programa de alongamento proposto foi efetivo para aumentar a flexibilidade dos músculos alongados e torque dos grupos musculares agonistas (alongados) e seus antagonistas.
PURPOSE: The purpose of the present study was to evaluate effects of regular practice of sun salutation on muscle strength, general body endurance and body composition.
METHODS: Subjects (49 male and 30 female) performed 24 cycles of sun salutation, 6 days a week for 24 weeks. Upper body muscle strength was determined by 1 repetition maximum (1RM) for bench press and shoulder press technique. Back and leg dynamometry was used to assess strength of back and leg muscles. General body endurance was evaluated by push-up and sit-up tests. Body composition was assessed by noting% body fat by using bioelectric impedance analysis. Perceived intensity of exercise by subjects was noted by Borg scale.
RESULTS: Muscle strength by bench press showed significant increase in male (29.49±9.70 to 36.12±9.09 Kg, P<0.001) and female (10.5±4.42 to 13.16±4.44 Kg, P<0.001) subjects. Strength by shoulder press also increased (males; 22.96±9.57 Kg to 26.53±11.05 Kg, P<0.001, females; 6.83±2.78 to 8.83±3.87, P<0.001). Endurance by push-ups & sit-ups showed similar findings in male (19.0±9.58 to 21.98±8.98, P<0.001 and 24.92±10.41 to 29.84±12.64, P<0.001 respectively) and female (14.66±6.80 to 18.56±6.97 and 13.16±7.75 to 19.23±8.25, P<0.001 respectively) subjects. A significant decrease in body fat percent was observed only in female (27.68±5.46 to 25.76±4.72, P<0.001) but not in male subjects. BMI significantly decreased in both the groups (z=4.37, P<001 and t=5.41, P<0.001 respectively).
CONCLUSION: From our observations we conclude that sun salutation can be an ideal exercise to keep oneself in optimum level of fitness.
When comparing active treatments, a non-inferiority (or one-sided equivalence) study design is often used. This design requires the definition of a non-inferiority margin, the threshold value of clinical relevance. In recent studies, a non-inferiority margin of 15 mm has been used for the change in endometriosis-associated pelvic pain (EAPP) on a visual analog scale (VAS). However, this value was derived from other chronic painful conditions and its validation in EAPP was lacking.
Data were analyzed from two placebo-controlled studies of active treatments in endometriosis, including 281 patients with laparoscopically-confirmed endometriosis and moderate-to-severe EAPP. Patients recorded EAPP on a VAS at baseline and the end of treatment. Patients also assessed their satisfaction with treatment on a modified Clinical Global Impression scale. Changes in VAS score were compared with patients' self-assessments to derive an empirically validated non-inferiority margin. This anchor-based value was compared to a non-inferiority margin derived using the conventional half standard deviation rule for minimal clinically important difference (MCID) in patient-reported outcomes.
Anchor-based and distribution-based MCIDs were-7.8 mm and-8.6 mm, respectively.
An empirically validated non-inferiority margin of 10 mm for EAPP measured on a VAS is appropriate to compare treatments in endometriosis.
Chronic pain is multi-dimensional. At the physical level itself, beyond the nociceptive pathway, there is hyper arousal state of the components of the nervous system, which negatively influences tension component of the muscles, patterns of breathing, energy levels and mindset, all of which exacerbate the distress and affect the quality of life of the individual and family. Beginning with the physical body, Yoga eventually influences all aspects of the person: vital, mental, emotional, intellectual and spiritual. It offers various levels and approaches to relax, energize, remodel and strengthen body and psyche. The asanas and pranayama harmonize the physiological system and initiate a "relaxation response" in the neuro endocrinal system. This consists of decreased metabolism, quieter breathing, stable blood pressure, reduced muscle tension, lower heart rate and slow brain wave pattern. As the neural discharge pattern gets modulated, hyper arousal of the nervous system and the static load on postural muscle come down. The function of viscera improves with the sense of relaxation and sleep gets deeper and sustained; fatigue diminishes. Several subtle level notional corrections can happen in case the subject meditates and that changes the context of the disease, pain and the meaning of life. Meditation and pranayama, along with relaxing asanas, can help individuals deal with the emotional aspects of chronic pain, reduce anxiety and depression effectively and improve the quality of life perceived.
beta-Endorphin, a 31-amino-acid peptide, is primarily synthesised in the anterior pituitary gland and cleaved from pro-opiomelanocortin, its larger precursor molecule. beta-Endorphin can be released into the circulation from the pituitary gland or can project into areas of the brain through nerve fibres. Exercise of sufficient intensity and duration has been demonstrated to increase circulating beta-endorphin levels. Previous reviews have presented the background of opioids and exercise and discussed the changes in beta-endorphin levels in response to aerobic and anaerobic exercise. The present review is to update the response of beta-endorphin to exercise. This review suggests that exercise-induced beta-endorphin alterations are related to type of exercise and special populations tested, and may differ in individuals with health problems. Additionally, some of the possible mechanisms which may induce beta-endorphin changes in the circulation include analgesia, lactate or base excess, and metabolic factors. Based on the type of exercise, different mechanisms may be involved in the regulation of beta-endorphin release during exercise.
Sahaja Yoga is a traditional system of meditation based on yogic principles which may be used for therapeutic purposes. A study was undertaken to assess the effectiveness of this therapy as an adjunctive tool in the management of asthma in adult patients who remained symptomatic on moderate to high doses of inhaled steroids.
A parallel group, double blind, randomised controlled trial was conducted. Subjects were randomly allocated to Sahaja yoga and control intervention groups. Both the yoga and the control interventions required the subjects to attend a 2 hour session once a week for 4 months. Asthma related quality of life (AQLQ, range 0-4), Profile of Mood States (POMS), level of airway hyperresponsiveness to methacholine (AHR), and a diary card based combined asthma score (CAS, range 0-12) reflecting symptoms, bronchodilator usage, and peak expiratory flow rates were measured at the end of the treatment period and again 2 months later.
Twenty one of 30 subjects randomised to the yoga intervention and 26 of 29 subjects randomised to the control group were available for assessment at the end of treatment. The improvement in AHR at the end of treatment was 1.5 doubling doses (95% confidence interval (CI) 0.0 to 2.9, p=0.047) greater in the yoga intervention group than in the control group. Differences in AQLQ score (0.41, 95% CI -0.04 to 0.86) and CAS (0.9, 95% CI -0.9 to 2.7) were not significant (p>0.05). The AQLQ mood subscale did improve more in the yoga group than in the control group (difference 0.63, 95% CI 0.06 to 1.20), as did the summary POMS score (difference 18.4, 95% CI 0.2 to 36.5, p=0.05). There were no significant differences between the two groups at the 2 month follow up assessment.
This randomised controlled trial has shown that the practice of Sahaja yoga does have limited beneficial effects on some objective and subjective measures of the impact of asthma. Further work is required to understand the mechanism underlying the observed effects and to establish whether elements of this intervention may be clinically valuable in patients with severe asthma.
Women commonly use soy products, herbs, and other complementary and alternative medicine (CAM) therapies for menopausal symptoms. Randomized, controlled trials have evaluated the efficacy and short-term safety of these therapies.
To review randomized, controlled trials of CAM therapies for menopausal symptoms in order to better inform practice and guide future research.
Searches of MEDLINE for articles published from January 1966 through March 2002, of the Alternative and Complementary Database (AMED) of the British Library for articles published from January 1985 through December 2000, and of the authors' own extensive files. Search terms were hot flash/flush, menopause, and climacteric, combined with phytoestrogens, alternative medicine, herbal medicine, traditional medicine, Traditional Chinese Medicine (TCM ), Ayurveda, naturopathy, chiropractic, osteopathy, massage, yoga, relaxation therapy, homeopathy, aromatherapy, and therapeutic touch.
29 randomized, controlled clinical trials of CAM therapies for hot flashes and other menopausal symptoms were identified; of these, 12 dealt with soy or soy extracts, 10 with herbs, and 7 with other CAM therapies.
Each author extracted information from half of the studies on the number of patients, study design, outcome measures, and results; the other author then checked these results.
Soy seems to have modest benefit for hot flashes, but studies are not conclusive. Isoflavone preparations seem to be less effective than soy foods. Black cohosh may be effective for menopausal symptoms, especially hot flashes, but the lack of adequate long-term safety data (mainly on estrogenic stimulation of the breast or endometrium) precludes recommending long-term use. Single clinical trials have found that dong quai, evening primrose oil, a Chinese herb mixture, vitamin E, and acupuncture do not affect hot flashes; two trials have shown that red clover has no benefit for treating hot flashes.
Black cohosh and foods that contain phytoestrogens show promise for the treatment of menopausal symptoms. Clinical trials do not support the use of other herbs or CAM therapies. Long-term safety data on individual isoflavones or isoflavone concentrates are not available.
To evaluate factors predisposing women to chronic and recurrent pelvic pain. DESIGN, DATA SOURCES, AND METHODS: Systematic review of relevant studies without language restrictions identified through Medline, Embase, PsycINFO, Cochrane Library. SCISEARCH, conference papers, and bibliographies of retrieved primary and review articles. Two reviewers independently extracted data on study characteristics, quality, and results. Exposure to risk factors was compared between women with and without pelvic pain. Results were pooled within subgroups defined by type of pain and risk factors.
There were 122 studies (in 111 articles) of which 63 (in 64,286 women) evaluated 54 risk factors for dysmenorrhoea, 19 (in 18,601 women) evaluated 14 risk factors for dyspareunia, and 40 (in 12,040 women) evaluated 48 factors for non-cyclical pelvic pain. Age < 30 years, low body mass index, smoking, earlier menarche (< 12 years), longer cycles, heavy menstrual flow, nulliparity, premenstrual syndrome, sterilisation, clinically suspected pelvic inflammatory disease, sexual abuse, and psychological symptoms were associated with dysmenorrhoea. Younger age at first childbirth, exercise, and oral contraceptives were negatively associated with dysmenorrhoea. Menopause, pelvic inflammatory disease, sexual abuse, anxiety, and depression were associated with dyspareunia. Drug or alcohol abuse, miscarriage, heavy menstrual flow, pelvic inflammatory disease, previous caesarean section, pelvic pathology, abuse, and psychological comorbidity were associated with an increased risk of non-cyclical pelvic pain.
Several gynaecological and psychosocial factors are strongly associated with chronic pelvic pain. Randomised controlled trials of interventions targeting these potentially modifiable factors are needed to assess their clinical relevance in chronic pelvic pain.
Health care planning for chronic pelvic pain (CPP), an important cause of morbidity amongst women is hampered due to lack of clear collated summaries of its basic epidemiological data. We systematically reviewed worldwide literature on the prevalence of different types of CPP to assess the geographical distribution of data, and to explore sources of variation in its estimates.
We identified data available from Medline (1966 to 2004), Embase (1980 to 2004), PsycINFO (1887 to 2003), LILACS (1982 to 2004), Science Citation index, CINAHL (January 1980 to 2004) and hand searching of reference lists. Two reviewers extracted data independently, using a piloted form, on participants' characteristics, study quality and rates of CPP. We considered a study to be of high quality (valid) if had at least three of the following features: prospective design, validated measurement tool, adequate sampling method, sample size estimation and response rate >80%. We performed both univariate and multivariate meta-regression analysis to explore heterogeneity of results across studies.
There were 178 studies (459975 participants) in 148 articles. Of these, 106 studies were (124259 participants) on dysmenorrhoea, 54 (35973 participants) on dyspareunia and 18 (301756 participants) on noncyclical pain. There were only 19/95 (20%) less developed and 1/45 (2.2%) least developed countries with relevant data in contrast to 22/43 (51.2%) developed countries. Meta-regression analysis showed that rates of pain varied according to study quality features. There were 40 (22.5%) high quality studies with representative samples. Amongst them, the rate of dysmenorrhoea was 16.8 to 81%, that of dyspareunia was 8 to 21.8%, and that for noncyclical pain was 2.1 to 24%.
There were few valid population based estimates of disease burden due to CPP from less developed countries. The variation in rates of CPP worldwide was due to variable study quality. Where valid data were available, a high disease burden of all types of pelvic pain was found.
Objective:
Some evidence suggests that Hatha yoga might be an effective practice to reduce anxiety. To examine the effect of Hatha yoga on anxiety, we conducted a meta-analysis of relevant studies extracted from PubMed, PsycINFO, the Cochrane Library, and manual searches.
Methods:
The search identified 17 studies (11 waitlist controlled trials) totaling 501 participants who received Hatha yoga and who reported their levels of anxiety before and after the practice. We estimated the controlled and within-group random effects of the practice on anxiety.
Results:
The pre-post within-group and controlled effect sizes were, Hedges' g = 0.44 and Hedges' g = 0.61, respectively. Treatment efficacy was positively associated with the total number of hours practiced. People with elevated levels of anxiety benefitted the most. Effect sizes were not moderated by study year, gender, presence of a medical disorder, or age. Although the quality of the studies was relatively low, the risk of study bias did not moderate the effect.
Conclusions:
Hatha yoga is a promising method for treating anxiety. However, more well-controlled studies are needed to compare the efficacy of Hatha yoga with other more established treatments and to understand its mechanism. This article is protected by copyright. All rights reserved.
BACKGROUND: Dysmenorrhoea is the occurrence of painful menstrual cramps of the uterus. Medical therapy for dysmenorrhoea commonly consists of nonsteroidal anti-inflammatory drugs or the oral contraceptive pill both of which work by reducing myometrial (uterine muscle) activity. However, these treatments are accompanied by a number of side effects, making an effective non-pharmacological method of treating dysmenorrhoea of potential value. Transcutaneous electrical nerve stimulation (TENS) is a treatment that has been shown to be effective for pain relief in a variety of conditions. Electrodes are placed on the skin and electric current applied at different pulse rates (frequencies) and intensities is used to stimulate these areas so as to provide pain relief. In dysmenorrhoea. TENS is thought to work by alteration of the body's ability to receive or perceive pain signals rather than by having a direct effect on the uterine contractions. Acupuncture may also be indicated as a useful, non-pharmacological method for treating dysmenorrhoea. Acupuncture is thought to excite receptors or nerve fibres which, through a complicated interaction with mediators such as serotonin and endorphins, blocks pain impulses. Acupuncture typically involves penetration of the skin by fine, solid metallic needles, which are manipulated manually or by electrical stimulation. OBJECTIVES: To determine the effectiveness of high and low frequency transcutaneous electrical nerve stimulation and acupuncture when compared to each other, placebo, no treatment, or medical treatment for primary dysmenorrhoea. SEARCH STRATEGY: Electronic searches of the Cochrane Menstrual Disorders and Subfertility Group Register of controlled trials, CCTR (Cochrane Library Issue 3, 2001), MEDLINE, EMBASE, CINAHL, Bio extracts, PsycLIT and SPORTDiscus were performed in August 2001 to identify relevant randomised controlled trials (RCTs). The Cochrane Complementary Medicine Field's Register of controlled trials (CISCOM) was also searched. Attempts were also made to identify trials from the UK National Research Register, the Clinical Trial Register and the citation lists of review articles and included trials. In most cases, the first or corresponding author of each included trial was contacted for additional information. SELECTION CRITERIA: The inclusion criteria were randomised controlled trials of transcutaneous electrical nerve stimulation and acupuncture that compared these treatments to each other, placebo, no treatment, or medical treatment for primary dysmenorrhoea. Exclusion criteria were: mild, infrequent or secondary dysmenorrhoea and dysmenorrhoea associated with an IUD. DATA COLLECTION AND ANALYSIS: Nine RCTs were identified that fulfilled the inclusion criteria for this review, seven involving TENS, one acupuncture, and one both treatments. Quality assessment and data extraction were performed independently by two reviewers. Meta analysis was performed using odds ratios for dichotomous outcomes and weighted mean differences for continuous outcomes. Data unsuitable for meta-analysis was reported as descriptive data and was also included for discussion. The outcome measures were pain relief (dichotomous, visual analogue scales, descriptive), adverse effects, use of analgesics additional to treatment and absence from work or school. MAIN RESULTS: Overall high frequency TENS was shown to be more effective for pain relief than placebo TENS. Low frequency TENS was found to be no more effective in reducing pain than placebo TENS. There were conflicting results regarding whether high frequency TENS is more effective than low frequency TENS. One small trial showed acupuncture to be significantly more effective for pain relief than both placebo acupuncture and two no treatment control groups. REVIEWER'S CONCLUSIONS: High frequency TENS was found to be effective for the treatment of dysmenorrhoea by a number of small trials. The minor adverse effects reported in one trial requires further investigation. There is insufficient evidence to determine the effectiveness of low frequency TENS in reducing dysmenorrhoea. There is also insufficient evidence to determine the effectiveness of acupuncture in reducing dysmenorrhoea, however a single small but methodologically sound trial of acupuncture suggests benefit for this modality.
Background:
Dysmenorrhoea refers to the occurrence of painful menstrual cramps of uterine origin and is a common gynaecological condition. One possible treatment is spinal manipulation therapy. One hypothesis is that mechanical dysfunction in certain vertebrae causes decreased spinal mobility. This could affect the sympathetic nerve supply to the blood vessels supplying the pelvic viscera, leading to dysmenorrhoea as a result of vasoconstriction. Manipulation of these vertebrae increases spinal mobility and may improve pelvic blood supply. Another hypothesis is that dysmenorrhoea is referred pain arising from musculoskeletal structures that share the same pelvic nerve pathways. The character of pain from musculoskeletal dysfunction can be very similar to gynaecological pain and can present as cyclic pain as it can also be altered by hormonal influences associated with menstruation.
Objectives:
To determine the safety and efficacy of spinal manipulative interventions for the treatment of primary or secondary dysmenorrhoea when compared to each other, placebo, no treatment, or other medical treatment.
Search strategy:
We searched the Cochrane Menstrual Disorders and Subfertility Group trials register (searched 18 March 2004), CENTRAL (The Cochrane Library Issue 1, 2004), MEDLINE (1966 to March 2004), EMBASE (1980 to March 2004), CINAHL (1982 to March 2004), AMED (1985 to March 2004), Biological Abstracts (1969 to Dec 2003), PsycINFO (1872 to March 2004) and SPORTDiscus (1830 to March 2004). The Cochrane Complementary Medicine Field's Register of controlled trials (CISCOM) was also searched. Attempts were also made to identify trials from the metaRegister of Controlled Trials and the citation lists of review articles and included trials. In most cases, the first or corresponding author of each included trial was contacted for additional information.
Selection criteria:
Any randomised controlled trials (RCTs) including spinal manipulative interventions (e.g. chiropractic, osteopathy or manipulative physiotherapy) vs each other, placebo, no treatment, or other medical treatment were considered. Exclusion criteria were: mild or infrequent dysmenorrhoea or dysmenorrhoea from an IUD.
Data collection and analysis:
Four trials of high velocity, low amplitude manipulation (HVLA), and one of the Toftness manipulation technique were included. Quality assessment and data extraction were performed independently by two reviewers. Meta analysis was performed using odds ratios for dichotomous outcomes and weighted mean differences for continuous outcomes. Data unsuitable for meta-analysis were reported as descriptive data and were also included for discussion. The outcome measures were pain relief or pain intensity (dichotomous, visual analogue scales, descriptive) and adverse effects.
Main results:
Results from the four trials of high velocity, low amplitude manipulation suggest that the technique was no more effective than sham manipulation for the treatment of dysmenorrhoea, although it was possibly more effective than no treatment. Three of the smaller trials indicated a difference in favour of HVLA, however the one trial with an adequate sample size found no difference between HVLA and sham treatment. There was no difference in adverse effects experienced by participants in the HVLA or sham treatment. The Toftness technique was shown to be more effective than sham treatment by one small trial, but no strong conclusions could be made due to the small size of the trial and other methodological considerations.
Reviewers' conclusions:
Overall there is no evidence to suggest that spinal manipulation is effective in the treatment of primary and secondary dysmenorrhoea. There is no greater risk of adverse effects with spinal manipulation than there is with sham manipulation.
β-Endorphin, a 31-amino-acid peptide, is primarily synthesised in the anterior pituitary gland and cleaved from pro-opiomelanocortin, its larger precursor molecule. β-Endorphin can be released into the circulation from the pituitary gland or can project into areas of the brain through nerve fibres. Exercise of sufficient intensity and duration has been demonstrated to increase circulating β-endorphin levels. Previous reviews have presented the background of opioids and exercise and discussed the changes in β-endorphin levels in response to aerobic and anaerobic exercise. The present review is to update the response of β-endorphin to exercise. This review suggests that exercise-induced β-endorphin alterations are related to type of exercise and special populations tested, and may differ in individuals with health problems. Additionally, some of the possible mechanisms which may induce β-endorphin changes in the circulation include analgesia, lactate or base excess, and metabolic factors. Based on the type of exercise, different mechanisms may be involved in the regulation of β-endorphin release during exercise.
We have evaluated the clinical efficacy of yoga for primary dysmenorrhea. Primary dysmenorrhea occurs in 50% of female adolescents and is a common problem in women of reproductive age. We have assessed whether three yoga poses (Cobra, Cat, and Fish Poses) are able to reduce severity and duration of primary dysmenorrhea.
To determine the effectiveness of yoga in adolescents with primary dysmenorrhea, 92 girl students,18-22 years old, were randomly assigned to an experimental group (n = 50) and a control group (n = 42). The Visual Analog Scale for Pain was used to assess intensity of pain and the pain duration was calculated in terms of hours. Each group was evaluated for three menstrual cycles. At first cycle no method was presented; the participants only were asked to complete the questionnaire of menstrual characteristics during their menstrual. Then the participants were asked by the experimental group to do yoga poses at luteal phase, and also to complete the menstrual characteristics questionnaire in during of menstruation. The control group did not receive any intervention except to complete menstrual characteristics questionnaire in during of menstruation.
There was a significant difference in the pain intensity and pain duration in the post-tests compared with the pretest in yoga group (P < 0.05). The results showed that compared with the Control group, there was a significant difference in the pain intensity and pain duration in the experimental group (P < 0.05).
Yoga reduced the severity and duration of primary dysmenorrhea. The findings suggest that yoga poses are safe and simple treatment for primary dysmenorrhea.
Background:
Dysmenorrhoea is a common gynaecological problem consisting of painful cramps accompanying menstruation, which in the absence of any underlying abnormality is known as primary dysmenorrhoea. Research has shown that women with dysmenorrhoea have high levels of prostaglandins, hormones known to cause cramping abdominal pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) are drugs that act by blocking prostaglandin production. They inhibit the action of cyclooxygenase (COX), an enzyme responsible for the formation of prostaglandins. The COX enzyme exists in two forms, COX-1 and COX-2. Traditional NSAIDs are considered 'non-selective' because they inhibit both COX-1 and COX-2 enzymes. More selective NSAIDs that solely target COX-2 enzymes (COX-2-specific inhibitors) were launched in 1999 with the aim of reducing side effects commonly reported in association with NSAIDs, such as indigestion, headaches and drowsiness.
Objectives:
To determine the effectiveness and safety of NSAIDs in the treatment of primary dysmenorrhoea.
Search methods:
We searched the following databases in January 2015: Cochrane Menstrual Disorders and Subfertility Group Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL, November 2014 issue), MEDLINE, EMBASE and Web of Science. We also searched clinical trials registers (ClinicalTrials.gov and ICTRP). We checked the abstracts of major scientific meetings and the reference lists of relevant articles.
Selection criteria:
All randomised controlled trial (RCT) comparisons of NSAIDs versus placebo, other NSAIDs or paracetamol, when used to treat primary dysmenorrhoea.
Data collection and analysis:
Two review authors independently selected the studies, assessed their risk of bias and extracted data, calculating odds ratios (ORs) for dichotomous outcomes and mean differences for continuous outcomes, with 95% confidence intervals (CIs). We used inverse variance methods to combine data. We assessed the overall quality of the evidence using GRADE methods.
Main results:
We included 80 randomised controlled trials (5820 women). They compared 20 different NSAIDs (18 non-selective and two COX-2-specific) versus placebo, paracetamol or each other. NSAIDs versus placeboAmong women with primary dysmenorrhoea, NSAIDs were more effective for pain relief than placebo (OR 4.37, 95% CI 3.76 to 5.09; 35 RCTs, I(2) = 53%, low quality evidence). This suggests that if 18% of women taking placebo achieve moderate or excellent pain relief, between 45% and 53% taking NSAIDs will do so.However, NSAIDs were associated with more adverse effects (overall adverse effects: OR 1.29, 95% CI 1.11 to 1.51, 25 RCTs, I(2) = 0%, low quality evidence; gastrointestinal adverse effects: OR 1.58, 95% CI 1.12 to 2.23, 14 RCTs, I(2) = 30%; neurological adverse effects: OR 2.74, 95% CI 1.66 to 4.53, seven RCTs, I(2) = 0%, low quality evidence). The evidence suggests that if 10% of women taking placebo experience side effects, between 11% and 14% of women taking NSAIDs will do so. NSAIDs versus other NSAIDsWhen NSAIDs were compared with each other there was little evidence of the superiority of any individual NSAID for either pain relief or safety. However, the available evidence had little power to detect such differences, as most individual comparisons were based on very few small trials. Non-selective NSAIDs versus COX-2-specific selectorsOnly two of the included studies utilised COX-2-specific inhibitors (etoricoxib and celecoxib). There was no evidence that COX-2-specific inhibitors were more effective or tolerable for the treatment of dysmenorrhoea than traditional NSAIDs; however data were very scanty. NSAIDs versus paracetamolNSAIDs appeared to be more effective for pain relief than paracetamol (OR 1.89, 95% CI 1.05 to 3.43, three RCTs, I(2) = 0%, low quality evidence). There was no evidence of a difference with regard to adverse effects, though data were very scanty.Most of the studies were commercially funded (59%); a further 31% failed to state their source of funding.
Authors' conclusions:
NSAIDs appear to be a very effective treatment for dysmenorrhoea, though women using them need to be aware of the substantial risk of adverse effects. There is insufficient evidence to determine which (if any) individual NSAID is the safest and most effective for the treatment of dysmenorrhoea. We rated the quality of the evidence as low for most comparisons, mainly due to poor reporting of study methods.
The effects of mechanical stimuli on preserving muscle mass while transforming them into slow, fatigue resistant muscles have been studied in the rabbit. When combined, stretching and electrical stimulation (10 Hz) induce rapid and marked growth of muscles. This procedure also more rapidly activates the transformation process(es) than when either stretching or electrical stimulation (10 Hz) are used alone. Stretch by itself is also anabolic causing useful lengthening of muscles and preventing collagen accumulation. In contrast, muscle inactivity leads to rapid atrophy, fiber shortening and reduced muscle compliance. We believe these findings have important implications to cardiomyoplasty.
Relaxation therapy was used to treat ten high school-aged girls suffering from dysmenorrhea. A self-judgment sheet was used to evaluate the results of the therapy. The treatment group improved significantly (p less than 0.01) on the symptoms "cramps" and "nausea," and on "difficult to concentrate," "unambitious" and "being irritable" (p less than 0.05).
Dysmenorrhea is the leading cause of short-term school absenteeism. It is associated with a negative impact on social, academic, and sports activities of many female adolescents. Dysmenorrhea has not previously been described among Hispanic adolescents, the fastest growing minority group in the United States.
To determine the prevalence of dysmenorrhea among Hispanic female adolescents; its impact on academic performance, school attendance, and sports and social activities; and its management.
A total of 706 Hispanic female adolescents, in grades 9 through 12, completed a 31-item questionnaire about the presence, duration, severity, treatment, and limitations of dysmenorrhea at a local urban high school.
Among participants who had had a period in the previous 3 months, 85% reported dysmenorrhea. Of these, 38% reported missing school due to dysmenorrhea during the 3 months prior to the survey and 33% reported missing individual classes. Activities affected by dysmenorrhea included class concentration (59%), sports (51%), class participation (50%), socialization (46%), homework (35%), test-taking skills (36%), and grades (29%). Treatments taken for dysmenorrhea included rest (58%), medications (52%), heating pad (26%), tea (20%), exercise (15%), and herbs (7%). Fourteen percent consulted a physician and 49% saw a school nurse for help with their symptoms. Menstrual pain was significantly associated with school absenteeism and decreased academic performance, sports participation, and socialization with peers (P<.01).
Dysmenorrhea is highly prevalent among Hispanic adolescents and is related to school absenteeism and limitations on social, academic, and sports activities. Given that most adolescents do not seek medical advice for dysmenorrhea, health care providers should screen routinely for dysmenorrhea and offer treatment. As dysmenorrhea reportedly affects school performance and attendance, school administrators may have a vested interest in providing health education on this topic to their students. Arch Pediatr Adolesc Med. 2000;154:1226-1229.
Dysmenorrhoea refers to the occurrence of painful menstrual cramps of uterine origin and is a common gynaecological complaint. Common treatment for dysmenorrhoea is medical therapy such as nonsteroidal anti-inflammatories (NSAIDs) or oral contraceptive pills (OCPs) which both work by reducing myometrial activity (contractions of the uterus). The efficacy of conventional treatments such as nonsteroidals is considerable, however the failure rate is still often 20-25%. Many consumers are now seeking alternatives to conventional medicine and research into the menstrual cycle suggests that nutritional intake and metabolism may play an important role in the cause and treatment of menstrual disorders. Herbal and dietary therapies number among the more popular complementary medicines yet there is a lack of taxonomy to assist in classifying them. In the US, herbs and other phytomedicinal products (medicine from plants) have been legally classified as dietary supplements since 1994. Included in this category are vitamins, minerals, herbs or other botanicals, amino acids and other dietary substances. For the purpose of this review we use the wider term herbal and dietary therapies to include the assorted herbal or dietary treatments that are classified in the US as supplements and also the phytomedicines that may be classified as drugs in the European Union.
To determine the efficacy and safety of herbal and dietary therapies for the treatment of primary and secondary dysmenorrhoea when compared to each other, placebo, no treatment or other conventional treatments (e.g. NSAIDS).
Electronic searches of the Cochrane Menstrual Disorders and Subfertility Group Register of controlled trials, CCTR, MEDLINE, EMBASE, CINAHL, Bio extracts, and PsycLIT were performed to identify relevant randomised controlled trials (RCTs). The Cochrane Complementary Medicine Field's Register of controlled trials (CISCOM) was also searched. Attempts were also made to identify trials from the National Research Register, the Clinical Trial Register and the citation lists of review articles and included trials. In most cases, the first or corresponding author of each included trial was contacted for additional information.
The inclusion criteria were RCTs of herbal or dietary therapies as treatment for primary or secondary dysmenorrhoea vs each other, placebo, no treatment or conventional treatment. Interventions could include, but were not limited to, the following; vitamins, essential minerals, proteins, herbs, and fatty acids. Exclusion criteria were: mild or infrequent dysmenorrhoea or dysmenorrhoea from an IUD.
Seven trials were included in the review. Quality assessment and data extraction were performed independently by two reviewers. The main outcomes were pain intensity or pain relief and the number of adverse effects. Data on absence from work and the use of additional medication was also collected if available. Data was combined for meta-analysis using Peto odds ratios for dichotomous data or weighted mean difference for continuous data. A fixed effects statistical model was used. If data suitable for meta-analysis could not be extracted, any available data from the trial was extracted and presented as descriptive data.
MAGNESIUM: Three small trials were included that compared magnesium and placebo. Overall magnesium was more effective than placebo for pain relief and the need for additional medication was less. There was no significant difference in the number of adverse effects experienced. VITAMIN B6: One small trial of vitamin B6 showed it was more effective at reducing pain than both placebo and a combination of magnesium and vitamin B6. MAGNESIUM AND VITAMIN B6: Magnesium was shown to be no different in pain outcomes from both vitamin B6 and a combination of vitamin B6 and magnesium by one small trial. The same trial also showed that a combination of magnesium and vitamin B6 was no different from placebo in reducing pain. VITAMIN B1: One large trial showed vitamin B1 to be more effective than placebo in reducing pain. VITAMIN E: One small trial comparing a combination of vitamin E (taken daily) and ibuprofen (taken during menses) versus ibuprofen (taken during menses) alone showed no difference in pain relief between the two treatments. OMEGA-3 FATTY ACIDS: One small trial showed fish oil (omega-3 fatty acids) to be more effective than placebo for pain relief. JAPANESE HERBAL COMBINATION: One small trial showed the herbal combination to be more effective for pain relief than placebo, and less additional pain medication was taken by the treatment group.
Vitamin B1 is shown to be an effective treatment for dysmenorrhoea taken at 100 mg daily, although this conclusion is tempered slightly by its basis on only one large RCT. Results suggest that magnesium is a promising treatment for dysmenorrhoea. It is unclear what dose or regime of treatment should be used for magnesium therapy, due to variations in the included trials, therefore no strong recommendation can be made until further evaluation is carried out. Overall there is insufficient evidence to recommend the use of any of the other herbal and dietary therapies considered in this review for the treatment of primary or secondary dysmenorrhoea.
Ten healthy, untrained volunteers (nine females and one male), ranging in age from 18-27 years, were studied to determine the effects of hatha yoga practice on the health-related aspects of physical fitness, including muscular strength and endurance, flexibility, cardiorespiratory fitness, body composition, and pulmonary function. Subjects were required to attend a minimum of two yoga classes per week for a total of 8 weeks. Each yoga session consisted of 10 minutes of pranayamas (breath-control exercises), 15 minutes of dynamic warm-up exercises, 50 minutes of asanas (yoga postures), and 10 minutes of supine relaxation in savasana (corpse pose). The subjects were evaluated before and after the 8-week training program. Isokinetic muscular strength for elbow extension, elbow flexion, and knee extension increased by 31%, 19%, and 28% (p<0.05), respectively, whereas isometric muscular endurance for knee flexion increased 57% (p<0.01). Ankle flexibility, shoulder elevation, trunk extension, and trunk flexion increased by 13% (p<0.01), 155% (p<0.001), 188% (p<0.001), and 14% (p<0.05), respectively. Absolute and relative maximal oxygen uptake increased by 7% and 6%, respectively (p<0.01). These findings indicate that regular hatha yoga practice can elicit improvements in the health-related aspects of physical fitness. (c)2001 CHF, Inc.
To develop and test the safety and effectiveness of an acupressure garment (the Relief Brief) in decreasing the pain and symptom distress associated with dysmenorrhea.
A randomized clinical trial applied a 2 (Relief Brief use or control group) x 3 (baseline and two treatment measurement occasions) mixed factorial design.
Sixty-one (61) women with moderately severe primary dysmenorrhea were randomly assigned to the standard treatment control group or the Relief Brief acupressure device group after one pretreatment menses, with 58 women reporting the effect on their pain during two post-treatment menstrual cycles. The acupressure garment: The Relief Brief is a cotton Lycra panty brief with a fixed number of lower abdominal and lower back latex foam acupads that provide pressure to dysmenorrhea-relieving Chinese acupressure points.
Menstrual pain severity (worst pain and symptom intensity), pain medication use, and adverse effects were analyzed using between-groups and repeated measures analyses of treatment effects. Statistical and clinical significance criteria were applied a priori.
For pain measures and pain medication use, the group main effect, time main effect and group x time interaction were statistically significant. Median pain medication use, the same for both groups at baseline (6 pills per day), dropped to 2 pills per day for the Relief Brief group but remained at 6 pills for the control group at the second treatment cycle. Predicted clinical significance criteria were surpassed: almost all (90%) women wearing the Relief Brief obtained at least a 25% reduction in menstrual pain severity (a 2-3 point drop) compared to only 8% of the control group (z = 6.07; p < 0.05). Relief Brief use was associated with at least a 50% decline in menstrual pain symptom intensity in more than two thirds of the women.
An acupressure device is an effective and safe nonpharmacologic strategy for the treatment of primary dysmenorrhea. With design modifications, it could serve as a main treatment modality for women who suffer from primary dysmenorrhea and do not wish to or cannot use the conventional pharmacologic agents. In addition, this acupressure device may serve as an adjuvant therapy to medication in more severe cases of dysmenorrhea.
Dysmenorrhea is the most frequent gynaecological problem in adolescent girls (the prevalence is 80-90%). Genetic influence, style of life (diet and physical activity) social, economical and cultural factors can affect symptoms. Prostaglandins and leucotrienes produced by endometrium, abnormal uterine smooth muscle contractility and modifications of the local blood flow are responsible for abdominal pain. Frequently daily activities are negatively affected (missing time at school) dysmenorrhoea can be primary or secondary to anatomical anomalies of internal genitalia or presence of synechie (post surgery or inflammatory pelvic diseases). Therapy may consist of traditional medicine (relaxing techniques such as yoga, agopuncture, mild analgesic drugs or more effective FANS). In case of therapeutical failure, contraceptive and/or GnRH agonists can represent the last choice. Endometriosis is less frequent, etiopatogenesis is not completely understood, but the anatomical lesions consist of an oestrogen-dependent neo-angiogenesis. Oestrogen inhibitors, oral contraceptives or GnRH agonists may be useful in treating this pathology. In case of drug failure surgery is suggested. For the effective diagnosis laparoscopy and biopsy are absolutely necessary. Premenstrual syndrome is cyclical, extremely complex, unusual in adolescent girls, sometimes associated to pre-existent psychic disorders. It can be treated with symptomatic drugs or, more recently, using drugs that alter the levels of serotonin, but their use in the adolescent patient is not yet recommended.
Complementary therapies are becoming increasingly popular in cultures dominated by biomedicine. Modalities are often extracted from various healing systems and cultural contexts and integrated into health care, expanding the focus from treatment of disease to the promotion of health. The cultural aspects of biomedicine are presented and compared and contrasted with other healing systems. Three healing systems; traditional Chinese medicine, Yoga, with roots in Ayurvedic medicine and Shamanic healing illustrate these fundamental differences in approaches to healing. A reverse example of isolating one healing intervention from biomedicine and interpreting it through other cultural lenses is presented. Implications are drawn for practice and research.
This randomized, double-blind, placebo-controlled exploratory study examined the efficacy and safety of a low-dose oral contraceptive (Mircette), desogestrel/ethinyl estradiol [DSG/EE] and ethinyl estradiol [EE]) in relieving the symptoms of dysmenorrhea. Twenty-three clinics in the United States enrolled 77 women (age < or =32 years) with primary dysmenorrhea documented for at least four consecutive cycles. Forty participants received DSG/EE&EE and 37 received placebo for four consecutive 28-day cycles. The intensity of menstrual-related distress was measured with the Menstrual Distress Questionnaire (MDQ). Patient diaries were used to assess number of school/work days missed as well as the use of rescue medication. Participants receiving DSG/EE&EE recorded reduced menstrual pain severity, lower total MDQ scores, and significantly less menstrual cramping. No significant change in bloating, anxiety, loneliness, weight gain, or acne was reported. The DSG/EE&EE formulation shows promise for the treatment of primary dysmenorrhea and was well tolerated by the participants in this study.
Many women suffer from pelvic pain, and a great many visit their family doctor for diagnosis and treatment. Two common causes are primary dysmenorrhea and endometriosis. Primary dysmenorrhea is best treated by prostaglandin inhibition from nonsteroidal anti-inflammatory drugs (NSAIDs) and cyclo-oxygenase-2 (COX-2)-specific inhibitors. Oral contraceptives can be added to improve pain control. Endometriosis can be treated with NSAIDs and COX-2-specific inhibitors as well but can also be treated with hormonal manipulation or surgery. Empiric treatment for endometriosis in selected patients is now accepted, making the disorder easier for family physicians to manage.
Yoga has become increasingly popular in Western cultures as a means of exercise and fitness training; however, it is still depicted as trendy as evidenced by an April 2001 Time magazine cover story on "The Power of Yoga." There is a need to have yoga better recognized by the health care community as a complement to conventional medical care. Over the last 10 years, a growing number of research studies have shown that the practice of Hatha Yoga can improve strength and flexibility, and may help control such physiological variables as blood pressure, respiration and heart rate, and metabolic rate to improve overall exercise capacity. This review presents a summary of medically substantiated information about the health benefits of yoga for healthy people and for people compromised by musculoskeletal and cardiopulmonary disease.
The prevalence of dysmenorrhoea (painful menstrual cramps of uterine origin) is difficult to determine because of different definitions of the condition—prevalence estimates vary from 45% to 95%. However, dysmenorrhoea seems to be the most common gynaecological condition in women regardless of age and nationality.1,2 Absenteeism from work and school as a result of dysmenorrhoea is common (13% to 51% women have been absent at least once and 5% to 14% are often absent owing to the severity of symptoms).3 Dysmenorrhoea, especially when it is severe, is associated with a restriction of activity and absence from school or work. Yet despite this substantial effect on their quality of life and general wellbeing, few women with dysmenorrhoea seek treatment as they believe it would not help.w1
Dysmenorrhea is the most common gynecologic complaint among adolescent females. Dysmenorrhea in adolescents is usually primary, and is associated with normal ovulatory cycles and with no pelvic pathology. In approximately 10% of adolescents with severe dysmenorrheic symptoms, pelvic abnormalities such as endometriosis or uterine anomalies may be found. Potent prostaglandins and leukotrienes play an important role in generating the symptoms of dysmenorrhea. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most common pharmacologic treatment for dysmenorrhea. A loading dose of NSAIDs (typically twice the regular dose) should be used as initial treatment for dysmenorrhea in adolescents, followed by a regular dose until symptoms abate. Adolescents with symptoms that do not respond to treatment with NSAIDs for three menstrual periods should be offered hormonal treatment such as combined estrogen/progestin oral contraceptive pills for three menstrual cycles. Adolescents with dysmenorrhea who do not respond to this treatment should be evaluated for secondary causes of dysmenorrhea. The adolescent care provider's role is to explain the pathophysiology of dysmenorrhea to every adolescent female, address any concern that the patient has about her menstrual period, and review effective treatment options for dysmenorrhea with the patient.
The Harvard Guide to Women's Health
- K J Carlson
- S A Eisenstat
- T Zipryn
Carlson, K.J., Eisenstat, S.A., Zipryn, T., 2004. The Harvard Guide to Women's Health.
Harvard University Press, Cambridge.
Nonsteroidal antiinflammatory drugs for dysmenorrhoea
- J Marjoribanks
- M Proctor
- C Farquhar
- R S Derks
Marjoribanks, J., Proctor, M., Farquhar, C., Derks, R.S., 2010. Nonsteroidal antiinflammatory drugs for dysmenorrhoea. Cochrane Database Syst. Rev. 20 (1),
CD001751.
ACSM's Guidelines for Exercise Testing and Prescription
The American College of Sports Medicine, 2010. ACSM's Guidelines for Exercise
Testing and Prescription, eighth ed. Lippincott Williams & Wilkins, Baltimore,
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Primary dysmenorrhea
- Coco