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A single-blind randomized comparative study of Asafoetida vs Mefenamic acid in dysmenorrhea, associated symptoms and health-related quality of life
Abstract
Objective
To compare the efficacy and safety of asafoetida (Ferula assafoetida L. oleo-gum-resin) with mefenamic acid (NSAID) to alleviate dysmenorrhea, associated systemic symptoms and improvement in health-related quality of life.
Methods
Patients (n = 60) were randomly allocated to receive asafetida (n = 30) or mefenamic acid (n = 30) in this single-blind, randomized, standard controlled trial. Test and control drug, 250 mg was administered and given orally twice daily for 5 days; 2 days prior to and first three days of menstruation for two consecutive cycles. The primary outcomes included the severity of pain assessed with visual analogue scale, verbal multidimensional scale and safety assessment. Secondary outcomes included health-related quality of life (HRQoL) determined using SF-36 health survey questionnaire, pain duration, associated systemic symptoms and PBLAC (Pictorial Blood Loss Assessment Chart) score for menstrual blood loss. The data was statistically interpreted with 5% level of significance.
Results
Between the groups, at baseline, pain severity did not differ significantly (P > 0.05) however, after the intervention, a significant decrease in pain severity was noted in both groups (P < 0.001). At third menstrual cycle, asafetida showed a significant decrease in pain severity compared to mefenamic acid on day one (P < 0.0004) however no significant difference was observed on day two and day three (P > 0.05). At post-intervention improvement in HRQoL and decrease in pain duration was significantly higher in the test group compared with control group. Systemic symptoms decreased significantly in both groups after intervention. No side effects were reported.
Conclusion
Asafoetida was effective and safe to relieve menstrual cramps and to improve HRQoL. Further, its effect was comparable with mefenamic acid.
... In present study 30(71.4%) of the patients were nulliparous (26 of these were unmarried and 4 were married), 8 (19%) of the participants had a history of 2 live births and 4 (9.5%) had more than 2 live births ( 34 with treadmill exercise, Azima S et al. 21 with massage therapy and exercise, Harada et al. 35 using low dose oral contraceptives, Molins Cubero et al. 23 evaluating pain perception after pelvis manipulation, Mingxio et al. 13 with moxibustion, Molouk et al. 20 with cinnamon, Yasemin et al. 36 with the intervention of diet, Rehman et al. 29 using Rheum emodi, Asma et al. 22 with Ferula asafoetida showed similar outcome with p=<0.001. 33 Rehman et al. 29 and Asma et al. 22 with significant improvement in each study with p<0.01. ...
... 21 with massage therapy and exercise, Harada et al. 35 using low dose oral contraceptives, Molins Cubero et al. 23 evaluating pain perception after pelvis manipulation, Mingxio et al. 13 with moxibustion, Molouk et al. 20 with cinnamon, Yasemin et al. 36 with the intervention of diet, Rehman et al. 29 using Rheum emodi, Asma et al. 22 with Ferula asafoetida showed similar outcome with p=<0.001. 33 Rehman et al. 29 and Asma et al. 22 with significant improvement in each study with p<0.01. Limitations of this study are small sample size, validated scales for assessment of subjective parameters not used, differentiation of patients having primary or secondary dysmenorrhea was not done because of lack of basic investigations like USG. ...
... 17 Asma et al. conducted a single-blind randomized comparative study of asafoetida vs mefenamic acid in dysmenorrhea and reported that the mean percentage of pain reduction in the asafoetida group was 78.88% whereas in the mefenamic acid group was 86% after the three-cycle intervention. 20 Vahedi et al. conducted an RCT of auriculotherapy and mefenamic acid on the severity and systemic symptoms of primary dysmenorrhea. The calculated mean percentage reduction of VAS after two cycles was 48.22% in the auriculotherapy group and 25.23% in the mefenamic acid group. ...
... The average age of participants in our study was 25 years, which aligns with previous studies by Mukhtar et al and Rehman et al. 17,18 The average BMI of participants was 22.87 kg/m², with most having a normal BMI, followed by overweight, underweight, and obese. This is consistent with the findings of Vahedi et al, and Suhail et al. 13,19 We found a higher incidence of unmarried participants, which is similar to the findings of Suhail et al and Asma et al. 19,20 The majority of our participants had a mixed diet, which is in line with previous studies by Mukhtar et al and Rehman et al. 17,18 In Unani medicine, temperament (Mizāj) is a key factor in assessing one's health and identifying drugs to correct any imbalances. Our study found that most participants had a Balghamī (phlegmatic) temperament, which is supported by the writings of Unani physicians like Ibn Sina, Jurjani, and Hakim Ajmal Khan. ...
Background: The use of plant medications in Unani medicine has been suggested to alleviate pain and related symptoms associated with primary dysmenorrhea, thus enhancing the overall quality of life. The purpose of the current study was to evaluate and compare the efficacy of Zarawand Mudaharaj (Aristolochia rotunda L.) and Qust (Saussurea lappa C.B. Clarke) in treating primary dysmenorrhea.
Methods: This single-blind, randomized comparative study was conducted on patients with primary dysmenorrhea aged 18-35 years. The study participants were randomly allocated into Group A and Group B. Group A received Zarawand Mudaharaj 2 g twice daily with 5 mL honey while Group B received Qust 1.5 g twice daily with 5 mL honey from the 1st to the 5th day of their menstrual cycles for three consecutive cycles. The primary outcome measures were changes in pain severity measured on a 10 cm Visual Analog Scale (VAS) and changes in Verbal Multidimensional Scoring System (VMSS) grades. The secondary outcome measures included changes in Health-Related Quality of Life (HRQoL) measured on short form health survey-12 (SF-12) and changes in the symptoms such as pain during menstruation, low-backache, nausea, vomiting, diarrhoea, giddiness, and headache.
Results: Both groups showed a significant improvement in VMSS grade at all follow-ups compared to baseline (P < .0001). Group B showed better performance than Group A in changing the VMSS grade at the third cycle (P = .02) and the final follow-up (P = .002). Group B also had a more significant reduction in mean ± SD VAS score from baseline (6.43 ± 1.57) to the final follow-up (2.67 ± 1.69) (P < .0001) compared to Group A.
Conclusion: The preliminary findings of the study support the use of Zarawand Mudaharaj and Qust in the treatment of primary dysmenorrhea, which is consistent with the traditional knowledge of Unani scholars.
... Higher scores indicate increased levels of pain [18]. The test-retest reliability of VAS was 0.89 [19]. ...
... Items were scored, using a four-point Likert scale ranging from no symptoms to severe symptoms (i.e., none, mild, moderate, and severe) [18]. The reliability of VMS was examined using the test-retest method, and the correlation coefficient was 0.80 [19]. The PBLAC was used to measure the amount of menstrual bleeding [20]. ...
Abstract Background Primary dysmenorrhea is considered as one of the women’s main problems during reproductive age. The present study aimed to investigate the effect of vitamin D on the severity of dysmenorrhea and menstrual blood loss. Methods This double-blind, randomized, placebo-controlled trial, was performed on 84 single female college students between 18 and 25 years old who living in dormitories. Students with primary dysmenorrhea and vitamin D deficiency were divided into experimental (n = 42) and control (n = 42) groups. Five days before the putative beginning of their next menstrual cycle, the experimental group received 300,000 IU vitamin D (50,000 IU, two tablets every 8 h), and the control group received a placebo (oral paraffin). The effects of the supplement on the severity of dysmenorrhea and menstrual blood loss were evaluated one cycle before and during two successive cycles. Using the visual analog scale (VAS), verbal multidimensional scoring system (VMS), and pictorial blood assessment chart (PBLAC) questionnaires. Fisher’s exact, Chi-square, independent sample t-test and repeated measurements were used. Results In total, 78 of the 84 students completed the study (39 students per group). The intervention resulted in a significant reduction in the mean scores of both the VAS and VMS in the experimental group, in the first and second menstrual cycles (p
... In present study 30(71.4%) of the patients were nulliparous (26 of these were unmarried and 4 were married), 8 (19%) of the participants had a history of 2 live births and 4 (9.5%) had more than 2 live births ( 34 with treadmill exercise, Azima S et al. 21 with massage therapy and exercise, Harada et al. 35 using low dose oral contraceptives, Molins Cubero et al. 23 evaluating pain perception after pelvis manipulation, Mingxio et al. 13 with moxibustion, Molouk et al. 20 with cinnamon, Yasemin et al. 36 with the intervention of diet, Rehman et al. 29 using Rheum emodi, Asma et al. 22 with Ferula asafoetida showed similar outcome with p=<0.001. 33 Rehman et al. 29 and Asma et al. 22 with significant improvement in each study with p<0.01. ...
... 21 with massage therapy and exercise, Harada et al. 35 using low dose oral contraceptives, Molins Cubero et al. 23 evaluating pain perception after pelvis manipulation, Mingxio et al. 13 with moxibustion, Molouk et al. 20 with cinnamon, Yasemin et al. 36 with the intervention of diet, Rehman et al. 29 using Rheum emodi, Asma et al. 22 with Ferula asafoetida showed similar outcome with p=<0.001. 33 Rehman et al. 29 and Asma et al. 22 with significant improvement in each study with p<0.01. Limitations of this study are small sample size, validated scales for assessment of subjective parameters not used, differentiation of patients having primary or secondary dysmenorrhea was not done because of lack of basic investigations like USG. ...
... In present study 30(71.4%) of the patients were nulliparous (26 of these were unmarried and 4 were married), 8 (19%) of the participants had a history of 2 live births and 4 (9.5%) had more than 2 live births ( 34 with treadmill exercise, Azima S et al. 21 with massage therapy and exercise, Harada et al. 35 using low dose oral contraceptives, Molins Cubero et al. 23 evaluating pain perception after pelvis manipulation, Mingxio et al. 13 with moxibustion, Molouk et al. 20 with cinnamon, Yasemin et al. 36 with the intervention of diet, Rehman et al. 29 using Rheum emodi, Asma et al. 22 with Ferula asafoetida showed similar outcome with p=<0.001. 33 Rehman et al. 29 and Asma et al. 22 with significant improvement in each study with p<0.01. ...
... 21 with massage therapy and exercise, Harada et al. 35 using low dose oral contraceptives, Molins Cubero et al. 23 evaluating pain perception after pelvis manipulation, Mingxio et al. 13 with moxibustion, Molouk et al. 20 with cinnamon, Yasemin et al. 36 with the intervention of diet, Rehman et al. 29 using Rheum emodi, Asma et al. 22 with Ferula asafoetida showed similar outcome with p=<0.001. 33 Rehman et al. 29 and Asma et al. 22 with significant improvement in each study with p<0.01. Limitations of this study are small sample size, validated scales for assessment of subjective parameters not used, differentiation of patients having primary or secondary dysmenorrhea was not done because of lack of basic investigations like USG. ...
... The participant identification form was prepared according to literature (Arafa et al., 2018;Chiu et al., 2013;Daşıkan & Saruhan, 2014;Asma et al., 2017). To ensure content validity, four experts (two nurse academics in the field of obstetrics, one in the field of public health, and one physiotherapist in the field of physical therapy and rehabilitation) were consulted using Davis technique. ...
... Dysmenorrhea is often a cause of absenteeism at school and at work and is a problem that increases economic loss (Arafa et al., 2018;Asma et al., 2017;Chiu et al., 2013). In this study, 9.7% of the nurses suffering from dysmenorrhea stated that they used leave of absence/medical leave for dysmenorrhea, and this was associated with the severity of the condition. ...
This descriptive and cross-sectional study was conducted to investigate the prevalence of factors affecting dysmenorrhea and its effects on work life among nurses in Turkey. In total, 574 nurses were included. The prevalence of dysmenorrhea was 69.9%, and 86.0% of the nurses suffered from moderate and severe dysmenorrhea. According to the severity of dysmenorrhea, work satisfaction, work performance, quality of service, communication problems with teammates and patients/patient relatives, official leave of absence and requests for sick leave significantly differed. Therefore, prevalence and severity of dysmenorrhea are high in nurses, and problems experienced in the workplace differ according to its severity.
... However, these were randomised controlled trials. [31] Group A (decoction of C. fistula, F. Vulgare, M. Piperita and powder of C. melo, T. foenum graecum, D. bifloris and M. azadirach) was found effective in relieving the severity of dysmenorrhea. ...
... A number of clinical trials have been conducted to study the effect of spices belonging to the Apiaceae family in several diseases such as diabetes [113,114], obesity [115][116][117], hyperlipidemia [118,119], metabolic syndrome [120,121], functional dyspepsia [122], neuropathic pain [123], arthritis [124], skin diseases [125], gynecological problems [126][127][128][129][130], and dental diseases [131]. All these studies ruled out any safety concerns with these spices. ...
Alzheimer’s disease (AD) is one of the most prevalent neurodegenerative diseases worldwide. In an effort to search for new strategies for treating AD, natural products have become candidates of choice. Plants are a rich source of bioactive and effective compounds used in treating numerous diseases. Various plant extracts are known to display neuroprotective activities by targeting different pathophysiological pathways in association with the diseases, such as inhibiting enzymes responsible for degrading neurotransmitters, reducing oxidative stress, neuroprotection, inhibiting amyloid plaque formation, and replenishing mitochondrial function. This review presented a comprehensive evaluation of the available scientific literature (in vivo, in vitro, and in silico) on the neuroprotective mechanisms displayed by the extracts/bioactive compounds from spices belonging to the Apiaceae family in ameliorating AD.
... Traditionally, asafoetida has been used to treat dyspepsia, earache, insect repellent, wound healing, intestinal parasites, spasmodic and nervous disorders, asthma, epilepsy and microbial infections [3][4][5][6][7]. Pharmacological and biological effects of asafoetida including cytotoxic activity against different cancer cell lines such as osteosarcoma cell line (HOS CRL), cervical cancer (HeLa) and colorectal cancer (SW620) [8][9][10], inhibitory effect of acetyl deacylasadisulfide realising on metastatic melanoma [11], pungent TRPA1 ion channel activator [12], relaxant effect on smooth muscles [13,14], hepatoprotective effect [15], anti-diabetic [16], antibacterial effects [17], pain relief [18], increase expression of antioxidant gene [19] and neuroprotective properties [20,21] have been studied. A large number of compounds have been reported from asafoetida, of which 31 compounds belong to the main class of natural compounds, sesquiterpene coumarins [22][23][24], and another major class of asafetida constituents are sulfides compounds [11,12,25]. ...
... [22] A randomized standard controlled study proved that asafetida is useful in dysmenorrhoea. [23] Rosa damascena (Gule surkh): The hydroalcoholic extract of showed significant anti inflammatory and analgesic effect in the carrageenan induced rat paw oedema. ...
Introduction: Kashtartava (Dysmenorrhea) is a commonly reported menstrual disorder which affects the working ability and quality of life of the woman. Due to in discreet diet and lifestyle, young women are more liable to get afflicted with this disorder in present era. This trial was planned to evaluate the effect of Vishwadi Kwatha which is an unexplored formulation in the management of dysmenorrhoea. Materials and Methods: 18 patients fulfilling the inclusion criteria were selected from the OPD of Prasutitantra & Streeroga, of the institution (3 drop outs). Oral administration of Vishwadi Kwatha in a dose of 40ml, twice a day, before meals was given for 1 month. The effect of therapy was assessed by change in the scores of assessment criteria including Visual Analogue Scale. Follow up was done for 1 month. Result: Statistically highly significant (p<0.001) results were obtained in both the duration (75.60 %) and severity (73.68% relief) of menstrual pain and also in associated symptoms like Aruchi(93.75% relief), and Bala-Bhramsha (91.17% relief).The mean VAS score of 7.467±1.407 before treatment was reduced to 2.333±0.9 after treatment. Discussion: Vishwadi Kwatha was mentioned in Shoola Prakarana of Bhaishajyaratnavali as Sadya Shoolahara. The formulation is having Vatanulomana, Dipana-Pachana, Artavajanana, Kaphahara, and Shrotoshodhana properties which will help the easy expulsion of properly formed Artava through the unobstructed channels by correcting the Vimarga Gati of Vayu. Conclusion: Oral administration of Vishwadi Kwatha was found to be effective in the management of Kashtartava and recommended for further research.
Dysmenorrhea (menstrual or periodic pain) is a discomfort that occurs during painful periods. It is the first and most prominent reason for female lower abdominal pain. Most adolescent girls consider it a curse due to the periodic occurrence of painful cramps and bleeding. The pathogenesis of painful periods is most likely because of increased prostanoids, notably prostaglandins, produced by the cyclooxygenase pathway (PGs). Misuse of synthetic medications leads to the development of medication resistance and deposits toxic residues in the body; thus, there is a critical need for safe and effective alternatives. In recent decades, herbal treatment approaches have found extensive applications in the treatment of various ailments. Herbal therapies are an alternate source, which include several bioactive chemicals, and recent improvements in our understanding of the value of herbal therapy methods have caused a sharp rise in their production. The main focus of this review was to study herbal treatment options; the recent studies conducted on herbal therapies and various experimental investigations on dysmenorrhea and herbal therapy methods have been studied, and randomized controlled trials and animal models have been discussed describing the anti-inflammatory properties of some potential herbal medicines that can be used as treatment options for dysmenorrhoea. This review aimed to present herbal treatments that can be used as alternative traditional synthetic medications and oral hormonal contraceptives in the treatment of painful menstruation.
Oleoresin is a mixture of volatile and nonvolatile components available in whole extract of natural herb or spice. It principally comprises essential oils and resin. Lemongrass oleoresins come from the Cymbopogon species, which grow in the tropical and subtropical regions of the world. Oleoresin of lemongrass is a dark green-colored viscous liquid having a characteristic lemon aroma and flavor and is mostly used as a flavoring ingredient. The lemon prefix in the lemongrass specifies the characteristic lemon-like odor, which is due to the availability of citral content (mixture of two isomeric aldehydes, geranial and neral). It has been utilized in synthesizing flavors, perfumes, cosmetics, detergents, and in the food and pharmaceutical industries. Different methods are used to extract the lemongrass essential oil, but steam distillation is the most suitable method as it doesn’t alter the quality of the obtained oil. The chemical composition of lemongrass oil varies depending on its extraction methods, genetic differences, harvest period, photoperiod, plant age, farming practices, and geographical origin. Lemongrass essential oil has shown several biological activities, including antimicrobial, antifungal, antiprotozoan, antioxidant, antidiarrheal, antimutagenic, antiinflammatory, antimalarial, antinociceptive, antihepatotoxic activities, etc. Lemongrass oil is a potent food preservative because of its extraordinary antifungal and antibacterial activities.
Molecularly imprinted polymers (MIPs) are tailor-made functional composites which selectively recognize and bind the target molecule of interest. MIP composites are products of the massively cross-linked polymer matrices, generated via polymerization, with bio-inspired recognition cavities that are morphologically similar in size, shape and spatial patterns to the target conformation. These features have enabled researchers to expand the field of molecular recognition, more specifically for target with peculiar requirements. Nevertheless, MIPs alone are characterized with weak sensitivity. Besides, nanoparticles (NPs) are remarkably sensitive but also suffer from poor selectivity. Intriguingly, the combination of the two results in a highly sensitive and selective MIP composite. For instance, the conjugation of different functional NPs with MIPs can generate new flexible target capture tools, either a dynamic sensor or a novel drug delivery system. In this regard, although the technology is considered an established and feasible approach, it is still perceived as a burgeoning technology for various fields, which makes it unceasingly worthy reviewing. Therefore, in this review, we attempt to give an update on various custom-made biosensors based on MIPs in combination with various NPs for the detection of mycotoxins, the toxic secondary metabolites of fungi. We first summarize the classification, prevalence, and toxicological characteristics of common mycotoxins. Next, we provide an overview of MIP composites and their characterization, and then segment the role of NPs with respect to common types of MIP-based sensors. At last, conclusions and outlook are discussed.
Background
To compare the efficacy and safety of herbal decoction (pods of Cassia fistula Linn. and Arils of Myristica fragrans Houtt) with mefenamic acid in spasmodic dysmenorrhoea.
Methods
In this single-blind, prospective, parallel, standard controlled study, dysmenorrheic patients (n=64) were randomly allocated to receive herbal decoction (n=31) or mefenamic acid (n=33) for two consecutive menstrual cycles. Treatment group received 180 mL herbal decoction of post amaltas ( Cassia fistula L pod’s pericarp) (21 g), bisbasah ( Myristica fragrans Houtt arils ) (3 g) and qand siyah (jaggery) (30 g) which were orally administered at morning for 3 days before the expected start of menstruation. The control group received mefenamic acid 500 mg orally twice daily between day 1 and day 3 of menstruation. The primary outcomes were visual analog scale (VAS) for pain intensity, pain relief scale and the safety assessment by clinical examination and biochemical parameters. The secondary outcomes included health-related quality of life (HRQoL) determined by SF-12 health survey questionnaire, duration of pain and pictorial blood assessment chart score for menstrual blood loss. The data were statistically interpreted with 5% level of significance.
Results
At the baseline, on day 1, pain severity for VAS score between the groups [7.09 ± 1.07 vs. 6.75 ± 1.09] had no significant difference (p>0.05). However, during the second menstrual cycle, a significant reduction [0.03 + 0.17 vs. 0.42 + 1.44] in pain severity on day 1 was noted in both groups (p<0.001). During the second menstrual cycle, improvement in HRQoL health survey [SF-12 total score: 85.88 ± 5.99 vs 74.83 ± 15.9] and reduction in pain duration were significantly higher in the treatment group compared to the control group. No side effects were reported.
Conclusion
Herbal decoction was effective to relieve pain and to improve HRQoL in spasmodic dysmenorrhoea.
Natural products and dietary components have earlier been proven as potential chemoprotective agents, and continuous efforts are in progress to search for such new products. Gentamicin, an aminoglycoside antibiotic, is widely used for treating the infections caused by many gram negative bacteria. However, besides other unwanted effects, the drug causes tubular cell
necrosis in the proximal convoluted tubules of nephrons. Unavailability of any remedial
measures in the modern medicine for such ailments therefore makes it imperative to screen for natural products that are nephroprotective against such renal impairment. Here in the undertaken
study, we have tested nephroprotective effects of Hing (Ferula foetida) extracts on
gentamicin-treated rats. As expected, subcutaneous administration of rats with Gentamicin (100 mg/kg) showed significant increase in blood urea nitrogen (BUN), serum creatinine and thiobarbituric acid reacting substances (TBARS), as an indication of renal disorder. However, co-administration of methanol soluble and insoluble fractions of Ferula foetida (Hing), to the Gentamicin-treated rats almost showed a complete reversal of the above effects, indicating
nephroprotective properties of the herbal drug. This may be an important addition to the list of studies where natural products have been discovered to be chemoprotective.
Ferula assa-foetida L. is distributed throughout central Asia and Mediterranean area and grows wildly in Iran and Afghanistan. Asafoetida is an oleo-gum-resin that is the exudates of the roots of Ferula assa-foetida and some other Ferula species. In Iranian traditional medicine, asafoetida is considered to be sedative, analgesic, carminative, antispasmodic, diuretic, antihelmintic, emmenagogue and expectorant. The aim of this study was to evaluate the antinociceptive effect of asafoetida in mice. The analgesic activity of asafoetida (25, 50 and 100 mg/kg) was compared with that of sodium diclofenac (30 mg/kg) or morphine sulfate (8 mg/kg) by using hot plate and acetic acid induced writhing tests. In hot plate test, the percentage of maximum possible effect (%MPE) against the thermal stimulus at 15 min post treatment time point for all doses of asafoetida was significantly greater than the control group. The number of writhes in all three doses of asafoetida was significantly less than the control group. GraphPad Prism 5 software was used to analyze the behavioral responses. Data were analyzed using repeated measure one-way ANOVA and P<0.05 was considered as the significant level. According to our findings, asafoetida exhibited a significant antinociceptive effect on chronic and acute pain in mice. These effects probably involve central opioid pathways and peripheral anti-inflammatory action.
Background:
Dysmenorrhea has negative effects on women's life. Due to side-effects of chemical drugs, there is growing trend toward herbal medicine. The aim of this study was to assess the effect of Dill compared to mefenamic acid on primary dysmenorrhea.
Materials and Methods:
This double-blind, randomized, clinical trial study was conducted on 75 single female students between 18 and 28 years old educating in Nursing and Midwifery School and Paramedical Faculty of Qom University of Medical Sciences of Iran in 2011. They were allocated randomly into one of the three groups: In Dill group, they took 1000 mg of Dill powder q12h for 5 days from 2 days before the beginning of menstruation for two cycles. Other groups received 250 mg mefenamic acid or 500 mg starch capsule as placebo, respectively. Dysmenorrhea severity was determined by a verbal multidimensional scoring system and a visual analog scale (VAS). Students with mild dysmenorrhea were excluded. Data were analyzed by SPSS using the descriptive statistic, paired-samples t-test, Wilcoxon signed-rank test, Mann-Whitney test, and Kruskal-Wallis test.
Results:
There were no significant differences between three groups for demographic or descriptive variables. Comprising the VAS showed that the participants of Dill and mefenamic acid groups had lower significant pain in the 1st and the 2nd months after treatment, whereas in the placebo group this was only significant in the 2nd month (P < 0.05).
Conclusion:
Dill was as effective as mefenamic acid in reducing the pain severity in primary dysmenorrhea. Further studies regarding side-effects of Dill and its interactivity are recommended.
Primary dysmenorrhea is a prevalent disorder and its unfavorable effects deteriorates the quality of life in many people across the world. Based on some evidence on the characteristics of fenugreek as a medical plant with anti-inflammato-ry and analgesic properties, this double-blind, randomized, placebo controlled trial was conducted. The main purpose of the study was to evaluate the effects of fenugreek seeds on the severity of primary dysmenorrhea among students.
Unmarried Students were randomly assigned to two groups who received fenugreek (n = 51) or placebo (n = 50). For the first 3 days of menstruation, 2-3 capsules containing fenugreek seed powder (900 mg) were given to the subjects three times daily for two consecutive menstrual cycles. Pain severity was evaluated using a visual analog scale and systemic symptoms were assessed using a multidimensional verbal scale.
Pain severity at baseline did not differ significantly between the two groups. Pain severity was significantly reduced in both groups after the intervention; however, the fenugreek group experienced significantly larger pain reduction (p < 0.001). With respect to the duration of pain, there was no meaningful difference between the two cycles in the placebo group (p = 0.07) but in the fenugreek group, the duration of pain decreased between the two cycles (p < 0.001). Systemic symptoms of dysmenorrhea (fatigue, headache, nausea, vomiting, lack of energy, syncope) decreased in the fenugreek seed group (p < 0.05). No side effects were reported in the fenugreek group.
These data suggest that prescription of fenugreek seed powder during menstruation can reduce the severity of dysmenorrhea.
Dysmenorrhea is a common gynecologic disorder affecting as many as 60% of menstruating women. In the United States, work absenteeism due to dysmenorrhea is estimated to be 600 million work hours per year, and the economic consequences are estimated at $2 billion per year; therefore, it is a public problem nowadays.
The purpose of this study was to compare the effects of combination of fennel extract/vitamin E with ibuprofen on the intensity of pain in primary dysmenorrhea among the students of Tabriz city in 2007-2009.
This study was done by using double-blinded quasi-experimental research method. After taking the required licenses from ethics committee, 68 students from Medical and Tabriz universities, who were living in the dormitory, suffering from primary dysmenorrhea, and were eligible for the study, were randomly divided into two groups of 34 students each (the two groups used combination of fennel extract/vitamin E and ibuprofen cross-over form in the 2 months). We used Visual Analogue Scale (VAS) tool for ranking the intensity of the pain. Data analysis was done by using SPSS Ver. 14.
The mean of peak pain intensity in the first, second, third, sixth, and forty-eighth hours in the group that had used combination of fennel extract/vitamin E was lower than the group that had used ibuprofen, and statistical differences were observed between the two groups in the first and second hours; combination of fennel extract/vitamin E was more effective than ibuprofen in the first hour (P < 0.03) and second hour (P < 0.04).
Combination of fennel extract/vitamin E is effective on decreasing the intensity of pain of primary dysmenorrhea, and it is advised to those who cannot use chemical drugs.
Dysmenorrhea is a common menstrual complaint with a major impact on women's quality of life, work productivity, and health-care utilization. A comprehensive review was performed on longitudinal or case-control or cross-sectional studies with large community-based samples to accurately determine the prevalence and/or incidence and risk factors of dysmenorrhea. Fifteen primary studies, published between 2002 and 2011, met the inclusion criteria. The prevalence of dysmenorrhea varies between 16% and 91% in women of reproductive age, with severe pain in 2%-29% of the women studied. Women's age, parity, and use of oral contraceptives were inversely associated with dysmenorrhea, and high stress increased the risk of dysmenorrhea. The effect sizes were generally modest to moderate, with odds ratios varying between 1 and 4. Family history of dysmenorrhea strongly increased its risk, with odds ratios between 3.8 and 20.7. Inconclusive evidence was found for modifiable factors such as cigarette smoking, diet, obesity, depression, and abuse. Dysmenorrhea is a significant symptom for a large proportion of women of reproductive age; however, severe pain limiting daily activities is less common. This review confirms that dysmenorrhea improves with increased age, parity, and use of oral contraceptives and is positively associated with stress and family history of dysmenorrhea.
The aim of this study was to determine the clinical effect of Foeniculum vulgare on primary dysmenorrhoea. Sixty virgin girls with complaints of dysmenorrhoea were enrolled in this study, out of which 50 cases were completed the course of treatment and were divided in two groups (study and placebo) and were under treatment for two cycles. In study group a capsule of 30 mg fennel extract, four times a day for three days from start of their menstrual period and in placebo a capsule containing wheat flour in same dose was administered. Intensity of pain was reported by using a 10 - point linear analogue technique. In study group the mean age of menarche was 13.1 ± 0.1 and onset age of dysmenorrhoea was 14.5 ± 0.1 years. Both groups were relieved but there was significant difference between study and placebo group. Study group shown more effective results than placebo in pain relief (P`0.05). Based on the observations, it can be concluded that, fennel is an effective herbal drug for menstrual pain.
In folk medicines, Chaturbeeja(combination of seeds of four plants i.e Trigonella Foenum-graecum, Lepidium sativum , Nigella sativa, Trachyspermum ammi in equal quantity) has been traditionally used for variety of applications including treatment of Dysmenorrhoea, the most common gynaecological symptom reported by women. To promote the proper use of such medicines and to determine their potential as sources for new drugs, it is essential to study medicinal plants, which have folklore reputation in a more intensified way. A Single blind, prospective observational clinical study was conducted to evaluate the efficacy of Chaturbeeja powder in Primary Dysmenorrhoea (Kashtartava). 25 patients were administered Chaturbeeja powder in a single dose of 3g with hot water at night, 7 days before starting of menstruation till 3rd day of the menstruation cycle. After assessing the results it was observed that12 patients were markedly improved, 8 moderately improved and 5 were improved.
Ferula asafoetida is herbaceous plant of the umbelliferae family. It is oleo gum resin obtained from the rhizome and root of plant. This spice is used as a digestive aid, in food as a condiment and in pickles. It is used in modern herbalism in the treatment of hysteria, some nervous conditions, bronchitis, asthma and whooping cough. It was at one time employed in the treatment of infantile pneumonia and flatulent colic. The gum resin is antispasmodic, carminative, expectorant, laxative, and sedative. The volatile oil in the gum is eliminated through the lungs, making this an excellent treatment for asthma. The odor of asafoetida is imparted to the breath, secretions, flatus, and gastric eructations. Its properties are antispasmodic, expectorant, stimulant, emmenagogue and vermifuge. Asafoetida has also been used as a sedative. It also thins the blood and lowers blood pressure. It is widely used in India in food and as a medicine in Indian systems of medicine like ayurveda. Asafoetida has been held in great esteem among indigenous medicines, particularly in Unani system from the earliest times.
Based on knowledge from traditional Arabic and Islamic herbal medicine, this study aims to examine the ef-fects of extracts from Ferula assa-foetida L on male fertility and sexual functioning in rats and in man. Therefore, ethanol extract from seeds and 50% water-ethanol extracts from roots were prepared into so-called "Masculine" tablets and as-sessed for their safety and efficacy in enhancing male libido. Results obtained show that Masculine exhibit high levels of safety in both cultured human fibroblasts and in experimental studies on rats with a LD 50 of 5 g/kg. Antioxidant properties were substantial both in rat liver cells and in human sperm cells at a concentration of 50μg/ml. Experiments with rat arte-rial rings with and without their endothelial tissue revealed, that Masculine is a potent vasodilator due to an endothelia-mediated effect rather than a direct effect on smooth muscle cells. Episodes of penile erection were studied in two groups of rats and were significantly augmented in the Masculine treated group. Furthermore, two groups of healthy young men were studied and followed for 3 months while consuming one Masculine tablet daily. Masculine was well tolerated by all men and no side effects were reported. Both groups were recruited from fertility clinics, the first group (n = 60) was re-cruited due to incomplete azospermia that was medically untreatable, and the second group (n = 25) was recruited due to erectile dysfunction and impotence of no treatable cause. Quantitative and qualitative improvements of sperm counts were reported after two months of treatment in 17% and 60%, in the first and second group, respectively. In addition, 60% of the second group reported remarkable improvements in both their libido and erectile function. Taken collectively, our re-sults indicate that Masculine is a safe sexual tonic enhancing male sexual functioning in animals and in man.
Waje rehm (Dysmenorrhoea) means painful menstruation. Since ancient times, hijamat bila shurt (Dry cupping) is a method of treatment of for this disease. Therefore, objective of this preliminary study was to evaluate the efficacy of hijamat bila shurt on intensity of pain in waje rehm by using Visual Analogue Scale for pain. It was conducted from May 2009 to July 2010 on 25 patients in National Institute of Unani Medicine, Bangalore. Patients suffering from primary and secondary dysmenorrhoea with regular cycles, age group 12-37years were selected. For dry cupping, two glass cup of medium size were applied below the umbilicus for 15 minutes on day land/or day 2 of the menstrual phase for one cycle and pain intensity was assessed by Visual Analogue Scale score for pain before and after the treatment. The Mean and Standard Error Mean for pain intensity before and after the treatment was 6.48 (0.32) and 2.12 (0.32) respectively with P<0.001, considered significant. Thus, hijamat bila shurt was effective in reducing pain intensity in dysmenorrhoea.
Kashtartava is a broad term which covers all the problems and ailments that a woman may suffer from during or around menstruation. It includes both primary and secondary types of dysmenorrhea. For this study, however, we considered only primary dysmenorrhea under the term Kashtartava to cover a larger population and to make a pin-pointed assessment criteria. Thus, 40 patients in the age-group of 15-25 years suffering from primary dysmenorrhea were registered for the study. Of these patients, 35 completed the course of treatment. The selected patients were randomly allotted into two groups. Group A received Dashamoola Taila Matra Basti and group B received Tila Taila Matra Basti. These treatments were selected for the Vatashamaka, Yonishula Prashaman, and Shothahara properties of the drugs. The dose was 60 ml per day and the duration of treatment was for 7 days each cycle for two consecutive cycles. Results were assessed according to a specially prepared grading system for pain, Alpartava, Yatochitkaladarshana, Praseka, Chhardi, Vibandha, Shrama, Atisara, Vankshana, Kati, Janu Shula, Shiroshula, Swedadhikya, and Tamodarshana. Significant improvement was seen in symptoms in both groups, and on comparing the results in the two groups we found that the results were almost equivalent. There was complete remission of symptoms in 38.89% in group A and in 35.39% in group B, while there was marked improvement in 50% in group A and 47.65% in group B. However, there was a marked difference between the two groups with regard to recurrence of symptoms during the follow-up period of 2 months, with recurrence being significantly more in group B. The study suggests that Matra Basti can be a reliable treatment for relieving the symptoms of primary dysmenorrhea. We recommend that more research be done to confirm the findings of this study.
The objective was to evaluate the prevalence of dysmenorrhea and determine its effect on health-related quality of life (HRQoL) among a group of female university students. This cross-sectional study was conducted between 15 March and 15 April 2009 at Dumlupinar University, Kutahya, Health High School, Western Turkey. The study group included 623 female students. The severity of dysmenorrhea was determined with a 10-point visual analog scale. The Short Form-36 (SF-36) form was used to determinate HRQoL. Chi-square test, Student's t test, and logistic regression and variance analyses (ANOVA) were used for statistical analyses. The average age of the study group was 20.8 +/- 1.8 years (range 17-30). Prevalence of dysmenorrhea was found to be 72.7% and was significantly higher in coffee consumers, females with menstrual bleeding duration > or =7 days, and those who had a positive family history of dysmenorrhea when compared to the others (P < 0.05, for each one). By multivariate analysis, coffee consumption (OR 2.084), menstrual bleeding duration > or =7 days (OR 1.590), and positive family history of dysmenorrhea (OR 3.043) were important risk factors for dysmenorrhea. Except for social functioning, role-emotional, and mental health domains, the SF-36 points received from the other domains were higher in females with dysmenorrhea (for each one P < 0.05). With the exception of the scores received from physical functioning and role-emotional domains, the scores received from the other domains of the SF-36 scale showed a decrease with increasing severity of dysmenorrhea (P < 0.05, for each one). Dysmenorrhea is a common health problem, having negative effects on the HRQoL among university female students.
Our objective was to examine the effect of an Iranian herbal drug in the treatment of primary dysmenorrhea. A randomized, double-blind, placebo-controlled pilot trial among 180 female students at Isfahan University dormitory aged 18 to 27 who suffered from primary dysmenorrhea was undertaken. The participants were randomly divided into three groups: herbal drug, mefenamic acid, and placebo. The herbal drug group was given 500 mg of highly purified saffron, celery seed, and anise (SCA) extracts three times a day for three days, starting from the onset of bleeding or pain. Participants were followed for two to three cycles from the beginning of menstruation through the three days of bleeding. Main outcome measures were the severity and duration of pain at 2 and 3 months. A visual analogue scale was used to record pain. There were statistically significant reductions in pain scores and pain duration scores in the groups that took SCA (P < . 001) and mefenamic acid (P < . 01). The decrease in pain score was reflected by a significant reduction in other drug use among the treatment groups compared with the women in the placebo group. The magnitude of the reduction was significantly greater in the SCA group than in the mefenamic acid and placebo groups. Both drugs effectively relieved menstrual pain as compared with the placebo. More clinical trials are needed to establish the efficacy of this herbal drug.
To study the effect of vitamin E in the treatment of primary dysmenorrhoea.
A randomised, double-blind, placebo-controlled trial.
A secondary school in Tehran, Iran.
Two hundred and seventy-eight girls aged 15-17 years who suffered from primary dysmenorrhoea.
Participants were given 200 units of vitamin E or placebo twice a day, beginning two days before the expected start of menstruation and continued through the first three days of bleeding. Treatment was continued over four consecutive menstrual periods.
The severity and duration of pain, and the amount of menstrual blood loss, at two and four months. A visual analogue scale (VAS) was used to record pain, and a validated Pictorial Blood Loss Assessment Chart (PBLAC) to measure menstrual loss.
In the vitamin E group, pain severity was lower with vitamin E at two months (median VAS score 3 vs 5, P > 0.001) and four months (0.5 vs 6, P > 0.001), pain duration was shorter at two months (mean 4.2 [7.1] hours vs 15 [17], P > 0.001) and at four months (1.6 [4.0] hours vs 17 [18] hours, P > 0.0001), and blood loss assessed by PBLAC score was lower at two months (54 [31] vs 70 [40], P > 0.0001) and at four months (46 [28] vs 70 [37], P > 0.0001).
Vitamin E relieves the pain of primary dysmenorrhoea and reduces blood loss.
Herbal drugs consist of a number active phytoconstituents which has furnished mankind with a number of herbal remedies for wide range of diseases for centuries. The herbal drugs still constitutes a major share of healthcare remedies in developing countries. The officially recognized systems of health in India such as Ayurveda, Unani and Homeopathic are still been used by about 70% of India's population. Ferula foetidacommonly known as " Hing" have shown promising therapeutic value due to the prescence of various therapeutic phytoconstituents such as Terpenoids, Sulfide derivatives, Volatile Oil, Phenols, Minerals. The various pharmacological actions such as the antioxidant, antimicrobial, antifungal, anticancer, antidiabetic and various other activity have been studied.This review highlights the available information on Ferula foetida by giving due consideration to the ethno botany, pharmacognostic characteristics, traditional uses, phytoconstituents and summary of various pharmacological activities. Various other aspects has also been discussed in the review. This study can be useful increating aninterest towards hing and can be useful in developing new formulations with better and improved therapeutic value.
Primary dysmenorrhoea is chronic cyclical pelvic pain associated with menstruation in the absence of an identifiable pathological condition. While medical treatments are available for primary dysmenorrhoea, exercise is accepted as an effective intervention. This study aimed to investigate the impact of home-based exercise on pain intensity and quality of life in women with primary dysmenorrhoea. Of 45 women with primary dysmenorrhoea included in the study, 40 completed it. At the beginning of the study baseline physical activity was determined using the International Physical Activity Questionnaire (IPAQ). Pain intensity was measured on the visual analogue scale (VAS), and health-related quality of life (HRQoL) was assessed with the SF-36 health survey. A standard home-based exercise intervention was recommended for all the patients, and the outcome measures were re-assessed at the first, second and third menstrual cycles. At each menstrual cycle VAS showed a significant decrease (p<0.001). When the eight domains of the SF-36 health survey and the physical and mental component summary scores were compared between the first and fourth visits, all domains showed significant improvement (p<0.012). In our study, home-based exercise intervention seemed to provide a significant improvement in HRQoL and pain in patients with primary dysmenorrhoea.
Ferula assafoetida 'asafoetida' solution (FAS) has been used in Arab traditional medicine as an intestinal antiseptic, carminative and variety of gastric ailments. It has also been used as a neuroprotective agent for the treatment of epilepsy and hysteria. However, the neuro-pharmacological studies on their gum-resin have not received due attention. The present study was undertaken to study the anxiolytic, analgesic and sedative properties of asafoetida in rodents, using elevated plus maze, hole-board test, hot plate and motor activity meter. Diazepam was used as a reference anxiolytic agent in this study. The results of this study showed a dose-dependent anxiolytic and analgesic activity of asafoetida, with a mild sedative effect in high doses. Compared to diazepam, the asafoetida seems to be a better alternative for the treatment of anxiety disorders. However, further experimental and clinical studies are warranted to accurately assess its safety and efficacy for treatment of chronic anxiety.
Background and objective: Umbelliprenin, the natural prenylated coumarin distributed in the plants of apiaceae family, has shown various biological activities, especially as a cancer chemopreventive agent. In the present study, umbelliprenin, was examined for in vitro antioxidant activity, in vitro inhibitory activity against lipoxygenase, and in vivo antiinflammatory activity. Methods: The applied tests were interaction with 1,1-diphenyl-2-picryl-hydrazyl (DPPH) stable free radical, inhibition of lipid peroxidation, inhibition of soybean lipoxygenase and in vivo inhibition of the carrageenin-induced rat paw edema. Results: Umbelliprenin did not show any significant antioxidant activity but exhibited a remarkable and potent inhibition against soybean lipoxygenase (IC50 = 0.0725 μM). This compound, in the in vivo anti-inflammatory test, could also inhibit the carrageenin induced paw edema significantly (39 %). Conclusion: The observed inhibition of lipoxygenase may be a plausible mechanism for the potent cancer chemopreventive activity of umbelliprenin and may pose this compound as a valuable agent for the treatment of inflammatory diseases.
To assess the effectiveness of ginger in providing relief to patients of primary dysmenorrhoea.
The clinical trial was conducted at Toyserkan Azad University in western Iran from July 10 to September 5, 2010. It comprised of 70 female students of the university with primary dysmenorrhoea.The subjects were randomly divided in to two equal groups and were given either placebo or ginger in capsule form for 3 days in first menstruation cycles. They graded the severity of their pain using a visual analogue scale. A 5-point Likert scale was used to assess response to treatment. Wilcoxor's rank-sum test was used to compare the severity of pain in the two groups.
Compared with the baseline, the decrease in the visual analogue scores of post-therapy pain in the ginger group was significantly greater than that for placebo group. In the ginger group, 29 (82.85%) subjects reported an improvement in nausea symptoms, compared with 16 (47.05%) in the placebo group.
Ginger is effective in minimising the pain severity in primary dysmenorrhoea.
Background: A common gynecological problem encountered among female medical students is dysmenorrhea, which also appears to be a leading cause of absenteeism from college. Hence arises a need to evaluate the menstrual characteristics, prevalence of dysmenorrhoea and its effect on daily routine activities and quality of life of medical students. Aims: This is a cross sectional descriptive study, conducted on 560 female medical students with the objectives to evaluate the menstrual characteristics, prevalence and severity of dysmenorrhoea and its effects on the quality of life, particularly absenteeism from college. Methods: Three medical colleges in Mangalore (Karnataka, India) provided the setting of our study. These were representative of a cosmopolitan nature of the study population. A total of 560 students were interviewed by the investigators. All participants were given a preformed questionnaire to complete. Besides menstrual characteristics the questionnaire included gradation of pain and quality of life based on the American Chronic Pain Association (ACPA) which was modified according to needs of our study. Chi-square test and logistic regression were used for statistical analyses. Results: The average age of the participants was 20.57 years +/- 1.208 years (ranging from 17-24 years). The mean BMI of the participants was 21.69 +/-3.27 kg/m 2 (ranging from 14.7 kg/m 2 to 33.54kg/m 2). The average age of menarche was 12.67+/-1.10years, (9 to 16 years). The average menstrual cycle duration of the participants in the study group was 29.52+/-3.37days. 97.2%(533), family history of dysmenorrhea was present in 40% participants (n=560). Of the total, 86.96% (487) participants reported to have physical premenstrual symptoms and 55.71% (312) reported to have psychological premenstrual symptom. There is a significant association between Quality of Life and severity of dysmenorrhea. Conclusion: Our study shows a significant association of dysmenorrhoea with the age of menarche, family history and both physical and psychological premenstrual symptoms. Although there was an association of dysmenorrhoea with chronological age, BMI and cycle length, these associations were not found to be statistically significant. The most significant conclusion of our study was found to be high prevalence of dysmenorrhoea, having a significant effect on the routine activities and a detrimental effect on the quality of life. The alarming prevalence of self-medication in the form of NSAID's, easily available over the counter was also highlighted in our study.
This study assessed the effectiveness of blended essential oils on menstrual cramps for outpatients with primary dysmenorrhea and explored the analgesic ingredients in the essential oils.
A randomized, double-blind clinical trial was conducted. Forty-eight outpatients were diagnosed with primary dysmenorrhea by a gynecologist and had 10-point numeric rating scales that were more than 5. The patients were randomly assigned to an essential oil group (n = 24) and a synthetic fragrance group (n = 24). Essential oils blended with lavender (Lavandula officinalis), clary sage (Salvia sclarea) and marjoram (Origanum majorana) in a 2:1:1 ratio was diluted in unscented cream at 3% concentration for the essential oil group. All outpatients used the cream daily to massage their lower abdomen from the end of the last menstruation continuing to the beginning of the next menstruation.
Both the numeric rating scale and the verbal rating scale significantly decreased (P < 0.001) after one menstrual cycle intervention in the two groups. The duration of pain was significantly reduced from 2.4 to 1.8 days after aromatherapy intervention in the essential oil group.
Aromatic oil massage provided relief for outpatients with primary dysmenorrhea and reduced the duration of menstrual pain in the essential oil group. The blended essential oils contain four key analgesic components that amount to as much as 79.29%; these analgesic constitutes are linalyl acetate, linalool, eucalyptol, and β-caryophyllene. This study suggests that this blended formula can serve as a reference for alternative and complementary medicine on primary dysmenorrhea.
The old traditional phytomedicine asafoetida, an oleo-gum-resin obtained from the roots of different Ferula assa-foetida, is used in different countries for various purposes. Asafoetida is not only used as a culinary spice but also traditionally used to treat various diseases, including asthma, gastrointestinal disorders, intestinal parasites, etc. This oleo-gum-resin has been known to possess antifungal, anti-diabetic, anti-inflammatory, anti-mutagenic and antiviral activities. A wide range of chemical compounds including sugars, sesquiterpene coumarins and polysulfides have been isolated from this plant. Recent studies have shown new promising antiviral sesquiterpene coumarins from this old phytomedicine. The present review summarizes the information concerning the traditional uses, phytochemistry and biological activities of asafoetida.
Primary dysmenorrhea and related issues are discussed as they influence the gynecological and social health of females during adolescence, adulthood, and senior maturity. Health practitioners are exposed to multiple approaches towards the management of menstrual pain. Clinical and social viewpoints target the causation, development, diagnosis, manifestation and management of primary dysmenorrhea. This narrative review includes the topic of the doctor-patient relationship in efforts of cultivating effectively communicative health practitioners. Controversial topics related to primary dysmenorrhea and the quality of life for women are addressed.
A search for literature reviews, case studies, laboratory research, and clinical trials from 1985-2004 was performed using the MEDLINE database. Sources of additional information included textbooks, national organizational literature and contemporary articles.
Menstrual pain is a prevalent experience yet it is socially taboo for conversation; as such, it poses a hindrance to its management. The communication between the doctor and patient is a critical barrier point between establishing a diagnosis and determining an appropriate treatment plan. A multi-disciple treatment plan varies as much as patients themselves vary in personal experiences, needs, and preferences.
Medicinal prophylactics, physical therapeutics, non-acidic diets, herbal supplements, eastern therapies and the chiropractic manual adjustments of the spine are effective methods for the management of primary dysmenorrhea. The non-invasive management of primary dysmenorrhea includes the chiropractic adjustment with complimentary modalities, and other alternative health care practices. Medicinal prophylactics are invasive and pose a higher risk to long-term chemical exposure, side effects or irreversible conditions.
To compare the effects of ginger, mefenamic acid, and ibuprofen on pain in women with primary dysmenorrhea.
This was a double-blind comparative clinical trial conducted from September 2006 to February 2007. Participants were 150 students (18 years old and over) with primary dysmenorrhea from the dormitories of two medical universities who were alternately divided into three equal groups. Students in the ginger group took 250 mg capsules of ginger rhizome powder four times a day for three days from the start of their menstrual period. Members of the other groups received 250 mg mefenamic acid or 400 mg ibuprofen capsules, respectively, on the same protocol. A verbal multidimensional scoring system was used for assessing the severity of primary dysmenorrhea. Severity of disease, pain relief, and satisfaction with the treatment were compared between the groups after one menstruation.
There were not significant differences between groups in baseline characteristics, p > 0.05. At the end of treatment, severity of dysmenorrhea decreased in all groups and no differences were found between the groups in severity of dysmenorrhea, pain relief, or satisfaction with the treatment, p > 0.05. No severe side effects occurred.
Ginger was as effective as mefenamic acid and ibuprofen in relieving pain in women with primary dysmenorrhea. Further studies regarding the effects of ginger on other symptoms associated with dysmenorrhea and efficacy and safety of various doses and treatment durations of ginger are warranted.
Objective menstrual blood loss measurements (in ml) were compared with the score obtained from a pictorial blood loss assessment chart (PBAC) which took into account the degree to which each item of sanitary protection was soiled with blood as well as the total number of pads or tampons used. Twenty eight women used the chart during 55 menstrual cycles and a single observer assessed 122 cycle collections in a similar manner. A pictorial chart score of 100 or more, when used as a diagnostic test for menorrhagia, was found to have a specificity and sensitivity of greater than 80%. Demonstration of the relation between self assessed pictorial chart scores and the objective measurement of blood loss enables us to provide a simple, cheap and reasonably accurate method of assessing blood loss before embarking upon treatment.
The use of toxins as novel molecular probes to study the structure-function relationship of ion-channels and receptors as well as potential therapeutics in the treatment of wide variety of diseases is well documented. The high specificity and selectivity of these toxins have attracted a great deal of interest as candidates for drug development. This review highlights the involvement of the proteins and peptide toxins as well as non-proteinaceous compounds derived from both venomous and non-venomous animals, in anti-nociception and anti-inflammation. The possible mechanisms of these potential therapeutic agents and possible clinical applications in the treatment of pain and inflammation are also summarized.