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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. [ABSTRACT FROM AUTHOR]

Objective To explore the pharmacological efiects and regulatory mechanisms of Carthami Flos water extract and its main constituent, hydroxysafilower yellow A ( HSYA), on primary dysmenorrhea rats with cold coagulation and blood stasis. Methods Forty-two female specific pathogen-free grade rats aged 6-8 weeks were divided into blank, model, HSYA( 0. 01 g/kg), ibuprofen( 0. 04 g/kg), and low (0.06 g/kg), medium (0.20 g/kg), and high (0.40 g/kg) Carthami Flos water extract dose groups using the random number table method, with six rats per group. A rat model was established using ice water bath stimulation combined with estradiol benzoate and oxytocin. Continuous gavage was administered for 6 days from the seventh day of modeling. After the intervention, the writhing reaction test was conducted. The rats, uteri, and ovaries were weighed to calculate the organ index. An enzyme-linked immunosorbent assay and radioimmunoassay were used to detect the prostaglandin E2 ( PGE2) and prostaglandin F2a ( PGF2a) contents in the uterus, thromboxane B2( TXB2 ) and 6 -keto-prostaglondin F1a ( 6-keto-PGF1a) in plasma, and estradiol (E2) in the serum. Hematoxylin and eosin staining were used to detect the pathological changes in uterine tissue. Immunohistochemistry was used to determine cyclooxygenase-2 ( COX - 2 ) expression in uterine tissue, whereas immunofluorescence was used to measure follicle-stimulating hormone receptor ( FSH-R) expression in ovarian tissue. Western blotting was used to detect gonadotropin-releasing hormone receptor ( GnRH-R) and FSH-R expression in uterine tissue. Results Compared with the blank group, the rats in the model group exhibited an increase in uterine and ovarian indices and increased PGE2 and PGF2a in the uterus. TXB2 in the plasma and E2 in the serum were also evaluated. Additionally, 6 -keto-PGF1a decreased, and COX - 2, GnRH-R, and FSH-R expression in the uterus and FSH-R expression in the ovaries also increased ( P <0.05). The morphology of the uterine tissue was disordered. Compared with the model group, the low Carthami Flos water extract dose group showed a decrease in uterine index ( P < 0. 05 ) . In the medium and high Carthami Flos water extract dose groups, the writhing response decreased, as did the uterine and ovarian indices and PGE2 and TXB2 contents. The 6 - keto-PGF1a content increased, whereas the GnRH-R protein expression in the uterus decreased ( P<0. 05). The high Carthami Flos water extract dose group also showed a decrease in PGF2a and FSH-R protein expression in the uterus (P<0. 05). In the HSYA group, the writhing response decreased, the uterine and ovarian indices decreased, the PGE2, PGF2a, and TXB2 contents decreased, and GnRH-R and FSH-R protein expression decreased in the uterus ( P< 0.05). The serum E2 levels of the groups that received Carthami Flos water extract at various doses and those of the HSYA group were reduced, and the uterine morphology was improved. COX-2 expression in the uterus and FSH-R protein expression in the ovaries were also reduced (P <0.05). Conclusion Carthami Flos water extract and HSYA can improve the pathological state of primary dysmenorrhea rats with cold coagulation and blood stasis. Its mechanism may be related to regulating the hypothalamic-pituitary-ovary axis. [ABSTRACT FROM AUTHOR]

Primary dysmenorrhea (PD) is a prevalent problem in gynecology affecting the quality of life for young women. This medical condition is often responsible for the absence of young women from school or work, increasing the risk of developing hyperemesis gravidarum in the future. Furthermore, PD causes pain due to the activation of the local PGF2α pathway in the endometrium, which triggers oxidative stress processes, uterine ischemia and spasmodic uterine contractions. The first-line therapies for PD, Nonsteroid anti-inflammatory drugs (NSAIDs) and oral contraceptives, can cause side effects such as headache, nausea, intestinal ulcers and platelet abnormalities. To overcome the impact of PD, cupping has been proven effective as an alternative pain therapy with minimal side effects. Therefore, this study aimed to evaluate the effects of cupping on writing latency threshold time, PGF2α levels and FP receptor expression in PD model rats. The experiment was conducted using female Sprague Dawley rats to analyze the effects of wet cupping therapy (WCT) on inflammatory repair in the uterus. The method used was a pre- and post-test control group design, with 35 female rats randomly divided into 5 groups. These consisted of normal control (NC), negative control (C-), positive control (C+) + ibuprofen 7.2 mg, as well as treatment groups, comprising dry cupping (DC) and WCT. The results showed that writhing time threshold of WCT was the same as C+ (p = 0.368), while PGF2α decreased in DC (43.43 pg/mL, p = 0.008) and WCT (189.25 pg/mL, p = 0.0154). Similar to C+, WCT significantly decreased serum PGF2α levels compared to C-. WCT also influenced the expression of PTGFR subunit similarly to NC, showing the capacity to control the inflammatory pathway. The study suggested that WCT was a promising therapeutic strategy for PD by decreasing PGF2α and PTGFR expression. [ABSTRACT FROM AUTHOR]

Menstrual disorders are very common in women, with rates as high as 75%, and dysmenorrhea is the most commonly reported menstruation-related disorder. Dysmenorrhea is defined as a painful, cramping sensation in the lower abdomen, often accompanied by headache, nausea, vomiting and sweating. Studies on primary dysmenorrhea and its severity have investigated the effects of various demographic, physical, lifestyle and psychosocial factors. However, there is a need for a study that examines these factors together and comprehensively, especially in the Turkish population. This study aimed to determine the factors associated with primary dysmenorrhea in Turkish women. The study was a cross-sectional study conducted between May 2021 and December 2021. The study included 760 literate, reproductive-age women over 18 years of age. Personal Information Form and Beck Anxiety Scale were used to collect data. When the socio-demographic and lifestyle characteristics of the participants were compared, it was found that family history of menstrual pain (p=<.001) and alcohol use (p=.027) were associated with increased menstrual pain. Duration of menstruation (p=.026), duration of pain during menstruation (p=.005) and giving birth (p=.024) were associated with pain intensity. As the duration of menstruation increased, the severity of pain increased in those who stated that they experienced pain during menstruation and in those who did not give birth. When the severity of menstrual pain and anxiety levels of the participants were compared, it was determined that the severity of menstrual pain increased as the anxiety level increased (p=.026). Family history, alcohol use, duration of menstruation, giving birth and anxiety level were determined as risk factors for pain intensity in primary dysmenorrhea. [ABSTRACT FROM AUTHOR]

(-)-Carvone, a ketone monoterpene, is the main component of essential oils from several medicinal plants and has been reported to have anti-arthriric, anticonvulsive, antidiabetic, anti-inflammatory, anticancer, and immunomodulatory effects. Therefore, this study aimed to investigate the spasmolytic activity of (-)-carvone in rodent models. The isolated virgin rat uterus was mounted in an organ bath apparatus, and the relaxing effect of (−)-carvone and its mechanism of action were evaluated in tonic contractions induced by carbachol, KCl, PGF2α, or oxytocin. The animal model of primary dysmenorrhea was replicated with the injection of estradiol benzoate in female mice for three consecutive days, followed by intraperitoneal administration of oxytocin. Non-clinical acute toxicity evaluation was also performed. (-)-Carvone potency and effectiveness were larger in carbachol (pEC50 = 5.41 ± 0.14 and Emax = 92.63 ± 1.90% at 10–3 M) or oxytocin (pEC50 = 4.29 ± 0.17 and Emax = 86.69 ± 1.56% at 10–3 M) contractions. The effect of (−)-carvone was altered in the presence of 4-aminopyridine, glibenclamide, L-NAME, or methylene blue. Mice pre-treated with (-)-carvone at a dose of 100 mg/kg showed a significant reduction in the number of writhing after oxytocin administration. No toxicity was observed after oral administration of 1 g/kg (−)-carvone. Taken together, we showed that (-)-carvone reduced writhing by a spasmolytic effect, probably through the participation of KV and KATP channels and the nitric oxide pathway. [ABSTRACT FROM AUTHOR]

The enhanced efficacy of vinegar‐processed Cyperus rotundus (VCR) in treating primary dysmenorrhea (PD) has been observed. However, the active components and potential mechanisms of synergy are still unclear. The objective of this study was to develop a method that combines bionic technology, plant metabolomics and network pharmacology to discover the active components and potential mechanisms underlying the enhanced therapeutic effects of VCR for PD. Vinegar processing alters the flavor of C. rotundus, leading to changes in its properties. The acidic nature of vinegar enhances the selectivity of the medicine toward the liver, thereby improving its ability to soothe the liver, regulate qi and provide pain relief. Through gas chromatography–mass spectrometry and multivariate statistical analysis, 30 key differential components between raw C. rotundus and VCR have been screened and identified. These differential components primarily exert their therapeutic effects in treating PD by modulating targets such as interleukin‐6, TNF, TP53 and PTGS2, as well as pathways including the estrogen signaling pathway, ovarian steroidogenesis, the TNF signaling pathway and the HIF‐1 signaling pathway. The findings of this study serve as a reference for the application of VCR in compound formulas and clinic practiceal. Furthermore, the methodology employed in this study provides research insights for the processing of other Chinese medicines. [ABSTRACT FROM AUTHOR]

Introduction: The brain's reward system (RS) reacts differently to pain and its alleviation. This study examined the correlation between RS activity and behavior during both painful and pain-free periods in individuals with primary dysmenorrhea (PDM) to elucidate their varying responses throughout the menstrual cycle. Methods: Ninety-two individuals with PDM and 90 control participants underwent resting-state functional magnetic resonance imaging (rsfMRI) scans during their menstrual and peri-ovulatory phases. Regional homogeneity (ReHo) and amplitude of low-frequency fluctuation (ALFF) analyses were used to evaluate RS responses. Psychological evaluations were conducted using the McGill Pain Questionnaire and the Pain Catastrophizing Scale. Results: ReHo analysis showed higher values in the left putamen and right amygdala of the PDM group during the peri-ovulatory phase compared to the menstrual phase. ALFF analysis revealed lower values in the putamen of the PDM group compared to controls, regardless of phase. ReHo and ALFF values in the putamen, amygdala, and nucleus accumbens were positively correlated with pain scales during menstruation, while ALFF values in the ventral tegmental area inversely correlated with pain intensity. Those with severe PDM (pain intensity ≥7) displayed distinct amygdala ALFF patterns between pain and pain-free phases. PDM participants also had lower ReHo values in the left insula during menstruation, with no direct correlation to pain compared to controls. Discussion: Our study highlights the pivotal role of the RS in dysmenorrhea management, exhibiting varied responses between menstrual discomfort and non-painful periods among individuals with PDM. During menstruation, the RS triggers mechanisms for pain avoidance and cognitive coping strategies, while it transitions to processing rewards during the peri-ovulatory phase. This demonstrates the flexibility of the RS in adapting to the recurring pain experienced by those with PDM. [ABSTRACT FROM AUTHOR]

Objective To explore the central analgesic mechanism of acupuncture at Guanyuan acupoint and Sanyinjiao acupoint in treatment of primary dysmenorrhea（PDM). Methods Twenty patients in the PDM group and 27 healthy control group were included. The resting-state functional magnetic resonance imaging（rs-fMRI） scans were performed on the 1st to 3st days of menstruation respectively. In the PDM group, acupuncture at Guanyuan acupoint and Sanyinjiao acupoint was performed continuously one week before the next menstrual period until menstruation began. Visual analogue scale（VAS） for pain, Cox menstrual symptom scale（CMSS), self-rating Anxiety Scale（SAS), and self-rating Depression Scale（SDS） were used to evaluate clinical symptoms. SPM and DPARSFA software based on Matlab platform were used for data preprocessing, regional homogeneity（ReHo） statistical parameters and brain function images, and the difference in ReHo values before and after acupuncture treatment was compared. Results The VAS, CMSS, SAS, and SDS scores decreased after acupuncture in comparison with those before treatment in patients of the PDM group（all P＜0. 01). After acupuncture, the ReHo values of left temporal pole and superior temporal gyrus, left precentral gyrus and postcentral gyrus increased significantly in PDM patients, while ReHo values decreased significantly in left middle temporal gyrus, bilateral precuneate lobe and left peri-talar fissure cortex. Compared with the healthy control group, ReHo increased in right dorsolateral superior frontal gyrus and right insular lobe after, left superior temporal gyrus and left precentral gyrus, while ReHo decreased in right thalamus, left middle temporal gyrus, bilateral anterior cingulate and lateral cingulate gyrus and medial superior frontal gyrus in PDM group. Conclusion Acupuncture at Guanyuan acupoint and Sanyinjiao acupoint in the treatment of PDM mainly locates in the pain and emotion conduction pathway and limbic system, and alleviates PDM pain by regulating the brain function of pain-related brain areas. [ABSTRACT FROM AUTHOR]

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Primary dysmenorrhea is considered one of the main causes of pelvic pain during a woman's childbearing years, resulting in poor quality of life. The objective was to evaluate the effectiveness of transcutaneous tibial nerve stimulation (TTNS) in painful symptomatology improvement and non-steroidal anti-inflammatory drug (NSAID) intake reduction in women with primary dysmenorrhea (PD) compared with a control group in the short, medium, and long terms. A single-blind, controlled clinical trial was developed. Participants were randomized to the experimental (TTNS) and control group (sham TTNS). Both groups received 12-weekly 30-min sessions with a NeuroTracTM PelviTone electrostimulation device. The intensity and severity of pain and non-steroidal anti-inflammatory drug (NSAID) intake were evaluated in the short-term (after treatment), medium-term (1–3 months), and long-term (6 months). A total of 61 participants were randomized, with a split of 31 (experimental group) and 30 (control group), but 55 participants completed the study and were analyzed. Statistically significant differences between both groups in the maximum pain intensity decrease (F = 4.88, p = 0.0043) measured with the visual analogue scale, as well as NSAID intake decrease (F = 4.68, p = 0.011) and days of their ingestion (F = 4.57, p = 0.012) occurred in the short term. Furthermore, significant decreases in the total number of NSAIDs ingested during the cycle (F = 3.82, p = 0.011) and the number of days on which patients ingested NSAIDs (F = 3.59, p = 0.015) in the medium–long term occurred. TTNS could be an effective and safe strategy to reduce pain caused by PD, which could reduce or complement the use of pharmacological techniques and other more invasive methods. [ABSTRACT FROM AUTHOR]

Abstract Primary dysmenorrhea (PD) is a common global health concern. However, limited studies explored the association between soft drinks intake and PD among female undergraduates in China. To determine the association between soft drinks (carbonated soft drinks, etc.) as well coffee intake and the incidence/severity of PD among female undergraduates in China. We performed a cross-sectional study among 1809 female undergraduates in China from September 29, 2020 to October 22, 2020. The demographic information and menstrual information of the participants were collected by a self-administrated questionnaire. Chi-square test, ANOVA test, and logistic regression test were used to investigate the association between soft drinks intake and the incidence/severity of PD. We also conducted stratification analysis among different locations (rural or urban). The prevalence of PD was 47.1% (n = 852). There were 221 (25.9%) participants suffered from severe pain. In the participants with PD, the OR of carbonated soft drinks intake was 1.244 (95% CI 1.010–1.533). Among the participants with PD from rural areas, the OR of carbonated soft drinks intake was 1.402 (95% CI 1.045–1.881), compared with the non-carbonated soft drink group. In the participants with moderate and severe PD, the OR of coffee intake was 0.451 (95% CI 0.228–0.892), compared with the non-coffee-drinking group. There was a significant association between carbonated soft drinks intake frequency and the severity of PD (P

Ri-Bo Chen,1,&ast; Mei-Yi Zhong,2,&ast; Yu-Lin Zhong3 1Department of Radiology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, 330006, People’s Republic of China; 2The First Clinical Medical College, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, 330006, People’s Republic of China; 3Department of Ophthalmology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, 330006, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yu-Lin Zhong, Department of Ophthalmology, Jiangxi Provincial People’s Hospital, No. 152, Ai Guo Road, Dong Hu District, Nanchang, Jiangxi, 330006, People’s Republic of China, Tel +86 15970475954, Email 804722489@qq.comBackground: Accumulating studies have revealed altered brain function and structure in regions linked to sensory, pain and emotion in individuals with primary dysmenorrhea (PD). However, the changes in the topological properties of the brain’s functional connectome in patients with PD experiencing chronic pain remain poorly understood.Purpose: Our study aimed to explore the mechanism of functional brain network impairment in individuals withPD through a graph-theoretic analysis.Material and Methods: This study was a randomized controlled trial that included individuals with PD and healthy controls (HC) from June 2021 to June 2022. The experiment took place in the magnetic resonance imaging facility at Jiangxi Provincial People’s Hospital. Static MRI scans were conducted on 23 female patients with PD and 23 healthy female controls. A two-sample t-test was conducted to compare the global and nodal indices between the two groups, while the Network-Based Statistics (NBS) method was utilized to explore the functional connectivity alterations between the groups.Results: In the global index, The PD group exhibited decreased Sigma (p = 0.0432) and Gamma (p = 0.0470) compared to the HC group among the small-world network properties.(p< 0.05) In the nodal index, the PD group displayed reduced betweenness centrality and increased degree centrality in the default mode network (DMN), along with decreased nodal efficiency and increased degree centrality in the visual network (VN). (P < 0.05, Bonferroni-corrected) Furthermore, in the connection analysis, PD patients showed altered functional connectivity in the basal ganglia network (BGN), VN, and DMN.(NBS corrected).Conclusion: Our results indicate that individuals with PD showed abnormal brain network efficiency and abnormal connection within DMN, VN and BGN related to pain matrix. These findings have important references for understanding the neural mechanism of pain in PD.Keywords: primary dysmenorrhea, graph theory, functional connectivity, resting-state functional magnetic resonance imaging

Dysmenorrhea is defined as “painful menstruation”. Two types of dysmenorrhea are known: primary, which occurs in the absence of any gynecological disease, and secondary, which is associated with an underlying pathology. Primary dysmenorrhea typically occurs approximately 6 months after menarche. Approximately 16% to 81% of women of childbearing age experience primary dysmenorrhea, with 2% to 29% reporting moderate to severe intensity. The treatment of primary dysmenorrhea focuses on pain relief. However, supplements such as Vitamin D3 and Zinc should be considered. Vitamin D3 inhibits prostaglandin synthesis, while zinc also inhibits its synthesis, thereby improving uterine microcirculation and reducing the intensity of uterine contractions. It is important to note that not only pharmacological treatment should be considered, but also lifestyle changes that promote maximum physical and emotional well-being to reduce the consumption of analgesics and achieve control or remission of the underlying pathology.

Objective: To observe and compare the clinical effects of different electroacupuncture waveforms on primary dysmenorrhea. Methods: This was a prospective, randomized, three-group, parallel-controlled trial. Participants with primary dysmenorrhea were randomly divided into dense-sparse wave, continuous wave, and discontinuous wave groups in a 1:1:1 ratio. Two lateral Ciliao (BL 32) points were used. All three groups started treatment 3–5 days before menstruation, once a day for six sessions per course of treatment, one course of treatment per menstrual cycle, and three menstrual cycles. The primary outcome measure was the proportion with an average visual analog scale (VAS) score reduction of ≥50% from baseline for dysmenorrhea in the third menstrual cycle during treatment. The secondary outcome measures included changes in dysmenorrhea VAS scores, Cox Menstrual Symptom Scale scores and the proportion of patients taking analgesic drugs. Results: The proportion of cases where the average VAS score for dysmenorrhea decreased by ≥50% from baseline in the third menstrual cycle was not statistically significant (P > .05). Precisely 30 min after acupuncture and regarding immediate analgesia on the most severe day of dysmenorrhea, there was a statistically significant difference in the dense-sparse wave group compared with the other two groups during the third menstrual cycle (P

Gurleen Mann,1 Sonia Shirin,2,3 Sewon Bann,2– 4 Paul J Yong,2,3,5 Dharani Kalidasan,2 Azita Goshtasebi,2,3 Jerilynn C Prior2– 4,6 1University of British Columbia, Vancouver, British Columbia, Canada; 2Centre for Menstrual Cycle and Ovulation Research, University of British Columbia, Vancouver, British Columbia, Canada; 3British Columbia Women’s Health Research Institute, Vancouver, British Columbia, Canada; 4Division of Endocrinology and Metabolism, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; 5Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada; 6School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, CanadaCorrespondence: Jerilynn C Prior, Diamond Healthcare Centre – Division of Endocrinology and Metabolism, 2775 Laurel Street, Suite 4111, Vancouver, British Columbia, V5Z 1M9, Canada, Tel +1-604 875-5927, Email jerilynn.prior@ubc.caPurpose: It is asserted that primary dysmenorrhea/menstrual cramps only occur in ovulatory menstrual cycles. Our first objective was to present detailed menstrual cramps information in normally ovulatory versus anovulatory cycles from a single-cycle cohort study during the SARS-CoV-2 Pandemic. Secondly, we reviewed the literature for cohort studies documenting both menstrual cramps and ovulation.Participants and Methods: The Menstruation and Ovulation Study 2 recruited 108 women ages 19– 35 years to a prospective, observational single-cycle study, recording cramps daily (0– 4 scale) in the Menstrual Cycle Diary© and assessing normal ovulation (luteal length ≥ 10 days) by the validated Quantitative Basal Temperature© (Mean Temperature Method). We searched databases for « primary dysmenorrhea » / » menstrual cramps »; « menstrual cycles »; « anovulation », finding four valid publications.Results: In 75 women/cycles during the Pandemic, mean age was 28.5, body mass index 23.5, and higher education (16 years); 40 normally ovulatory and 35 anovulatory cycles had similar lengths (29.5– 30.0 days), respectively (P= 0.571). However, anovulatory cycles recorded significantly worse menstrual cramps versus normally ovulatory cycles; anovulatory median intensity was 1.9 versus 1.6, and Cramp Score was 8 versus 6 in normally ovulatory cycles (P=0.017). Four publications in 273 women (991 cycles) showed cramps in both anovulatory and ovulatory cycles; three were in adolescent/young adult women, one of which documented a significantly greater percentage of cramps in ovulatory cycles. The 694 cycles in premenopausal women (20– 41 years) showed similar percentages of symptomatic cramps in cycles of both ovulatory types. Meta-analysis documented significantly higher cramp prevalence in ovulatory cycles (OR 2.10; 95% CI 1.31, 3.37; P=0.002).Conclusion: This is the first documentation of more intense and frequent cramps in anovulatory cycles. However, meta-analysis showing the presence of symptomatic cramps in both ovulatory and anovulatory cycles documented they were twice as prevalent in ovulatory menstrual cycles.Plain Language Summary: “Worse Menstrual Cramps in Anovulatory Cycles”. Medicine has long believed that menstrual cramps only occur in ovulatory menstrual cycles that release an egg and have high progesterone levels that decrease before the next period. The notion was that dropping progesterone levels triggered release of prostaglandins that cause the pain and uterus muscle contractions of menstrual cramps. This research studied 75 community women aged 19– 35 years for a single cycle during COVID-19. Forty women had normally ovulatory cycles and 35 had anovulatory cycles with a similar mean cycle length of 29.7 days. Women in both groups were similar in age, weight, education and other reproductive characteristics. Women recorded Menstrual Cycle Diary© daily experiences for cramp presence and intensity (scored 0– 4). Ovulation was documented by daily first morning temperatures analyzed by the valid Quantitative Basal Temperature© method. Results showed menstrual cramps occurred in both normally ovulatory and anovulatory cycles. Surprisingly, anovulatory compared with ovulatory cycles had cramps that lasted longer (4 rather than 3 days), were more intense (1.9 versus 1.6) and with significantly higher Cramp Scores (of 8 versus 6). We also found four other published studies showing cramps occurred in both anovulatory and ovulatory cycles. A meta-analysis of these, however, showed that cramps were twice as frequent in ovulatory cycles. These results matter because they stimulate the search for more accurate understandings of why menstrual cramps occur. They will likely stimulate more effective therapies for the rare, intense menstrual cramps that currently are not effectively treated by anti-inflammatory medicines such as ibuprofen.Keywords: primary dysmenorrhea, menstrual pain, menstrual cycles, ovulation, adolescent, premenopause

Background: Menstrual pain is commonly felt by women on the first day of menstruation. Based on the results of an initial survey conducted at STIKes Maranatha Kupang D-III Midwifery Study Program 1 (10%) people who experience mild dysmenorrhoea, 7 (70%) people experience moderate dysmenorrhoea, 2 (20%) people who experience severe dysmenorrhoea, 2 (20%) people who experience very severe dysmenorrhoea every month. Objectives : The purpose of this study was to determine the difference in effectiveness between red ginger and L14 acupressure on menstrual pain (primary dysmenorrhoea) in students at STIKes Maranatha Kupang D III Midwifery Study Program.Methods: The design used in this study was comparative analytics with an observational approach. The study population was all adolescent girls who had primary dysmenorrhoea and were not taking painkillers. A sample of 32 respondents was taken by accidental sampling. The instrument used is the NRS Bourbanis pain scale assessment sheet. This research was conducted at STIKes Maranatha Kupang Midwifery Study Program D-III. Results : The pretest results of the red ginger group showed that most respondents (56%) 9 respondents experienced mild. pain, while the post test results showed almost all respondents (81%) 13 respondents experienced mild pain. The pretest results of the L14 Acupressure group showed that most respondents (75%) 12 respondents experienced moderate pain, while the post test results showed almost all respondents (81%) 13 respondents experienced mild pain. With the statistical test Mann-Whitney Test the results show P_value = 0.030 < (α) 0.05.Conclusions: That there is a significant difference in effectiveness between after consumption of red ginger and L14 on the intensity of menstrual pain in adolescent girls at STIKes Maranatha Kupang Study Program D-III Midwifery. It is hoped that the results of this study can be used as an alternative option to overcome / reduce the intensity of menstrual pain (primary dysmenorrhoea) in adolescent girls without having to use chemical drugs.

Koray Özbay, Altu&gbreve; Semiz Department of Obstetrics and Gynecology, Memorial &Scedil;i&scedil;li Hospital, Istanbul, TurkeyCorrespondence: Koray Özbay, Department of Obstetrics and Gynecology, Gebze Yüzy&inodot;l Hospital, Ilyas Bey Cad. No:38, Gebze/Kocaeli, Turkey, Tel +90-5394737958, Email ozbaykoray@gmail.comPurpose: We aimed to assess uterine and arcuate artery Doppler indices in patients with mild primary dysmenorrhea.Patients and Methods: A total of 55 patients were included, consisting of women without dysmenorrhea (n=26, group A) and women with mild primary dysmenorrhea (n=29, group B). Doppler measurements of the uterine and arcuate arteries were performed in both groups on the 1st-2nd days and 21st-24th days (midluteal phase) of the menstrual cycle using transvaginal ultrasound and compared between the groups. The severity of dysmenorrhea was assessed using visual analog scale scores.Results: Doppler measurements of the uterine and arcuate arteries performed on the 1st-2nd days of the menstrual cycle and the midluteal phase were similar between the groups (p> 0.05). There was a significant decrease in the intragroup measurements of uterine and arcuate arteries performed on the first day of menstruation and the luteal phase in both groups (p< 0.01).Conclusion: Doppler findings of the uterine and arcuate arteries did not differ between patients with and without mild primary dysmenorrhea. The etiology of primary dysmenorrhea mainly involves ischemia and vasoconstriction, but mild primary dysmenorrhea appears to be associated with a different etiology other than decreased tissue perfusion.Keywords: color Doppler, primary dysmenorrhea, ultrasonography, blood circulation, menstruation

Background: Primary dysmenorrhea leads to significant gynecological consultations, school absenteeism, disrupted daily activities, and adversely affects overall quality of life (QOL). Purpose: This study compared the effects of aquatic exercise versus aerobic exercise on primary dysmenorrhea and QOL in adolescent females. Subjects and Methods: Sixty adolescent females suffering from primary dysmenorrhea with moderate to severe intensity were distributed randomly and equally into two groups was registered at ClinicalTrials.gov (NCT06129708) the Registration Date, November 13, 2023; group A was treated by aquatic exercise for 12 weeks, while group B was treated by aerobic exercise for 12 weeks. Assessment of both groups before and after treatment involved evaluating dysmenorrhea severity using the WaLIDD Score, measuring pain intensity with the numeric pain rating scale (NPRS), determining pressure pain threshold (PPT) with an algometry, and evaluating the QOL using EuroQol—5 Dimension—3 Level (EQ‐5D‐3L) and EuroQol‐visual analog scale (EQ‐VAS). Results: Both groups, A and B, experienced significant reductions in the WaLIDD score, NPRS, and all domains of EQ‐5D‐3L (p < 0.05), coupled with significant increases in PPT and EQ‐VAS (p < 0.05). Posttreatment comparisons between the groups showed insignificant differences in WaLIDD score, NPRS, and PPT (p > 0.05). However, there was a significant decrease in EQ‐5D‐3L and a significant increase in EQ‐VAS, favoring group A (p < 0.05). Conclusion: Both aquatic and aerobic exercises are effective methods in primary dysmenorrhea management and QOL improvement in adolescent females, with a better effect of aquatic exercise in enhancing QOL. [ABSTRACT FROM AUTHOR]

Graphene-based warm uterus acupoint paste (GWUAP) is an emerging non-drug alternative therapy for the treatment of primary dysmenorrhea (PD), but the underlying mechanism is still unclear. SD female rats were randomly divided into control group, model group and treatment group to explore the mechanism of GWUAP in the treatment of PD. Combined with 16S rDNA and fecal metabolomics, the diversity of microbiota and metabolites in each group was comprehensively evaluated. In this study, GWUAP reduced the torsion score of PD model rats, improved the pathological morphology of uterine tissue, reduced the pathological damage score of uterine tissue, and reversed the expression levels of inflammatory factors, pain factors and sex hormones. The 16 S rDNA sequencing of fecal samples showed that the abundance of Lactobacillus in the intestinal flora of the model group decreased and the abundance of Romboutsia increased, while the abundance of Lactobacillus in the intestinal flora of the treatment group increased and the abundance of Romboutsia decreased, which improved the imbalance of flora diversity in PD rats. In addition, 32 metabolites related to therapeutic effects were identified by metabolomics of fecal samples. Moreover, there is a close correlation between fecal microbiota and metabolites. Therefore, the mechanism of GWUAP in the treatment of PD remains to be further studied. [ABSTRACT FROM AUTHOR]

Dysmenorrhea is a known phenomenon and not just recently, and investigations conducted recently have shown that female adolescents are very susceptible to this condition. Our goal is to determine the prevalence of dysmenorrhea in Tunisia, its risk factors, its impact on truancy rates, and the therapeutic attitudes of girls attending high school about this illness using an epidemiological survey. This eight-month study, which spans from October 2022 to May 2023, focuses on 160 high school girls between the ages of 13 and 21. It is a transversal descriptive study. The required data is gathered through the distribution of a self-administered questionnaire. The mean age of female adolescent participants is 16.44 years and 68 % of them reported dysmenorrhea. The most common symptoms of the pain were headaches (40.0 %). There is a notable prevalence of absenteeism during the menstrual cycle. There seems to be a trend toward self-medication. In Tunisia, primary dysmenorrhea is a common cause of school absenteeism among female adolescents. Girls' attitudes toward dysmenorrhea indicate a lack of knowledge, which is why it is crucial for midwives and physicians to educate teenage girls about the condition. [ABSTRACT FROM AUTHOR]

Objective: To assess the use of evidence-based research (EBR) approach in randomized controlled trials (RCTs) of acupuncture-related therapies for primary dysmenorrhea (PD). Methods: PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, Chinese Biomedical Database, and China Science and Technology Journal Database were searched from January 2013 to December 2022 for RCTs of acupuncture on PD. The full text and references of each RCT were read to assess whether systematic reviews (SRs) or other types of studies with similar research questions and end-users' perspectives were cited to justify and design the trial. In addition, the discussion section were analyzed to evaluate whether trials placed the new result in the existing SRs to draw a conclusion. Multivariable logistic regression was used to find variables that associated with 3 aspects of EBR approach: (1) citing clinical studies for justification, (2) citing relevant studies that obtain the perspectives of end users, and (3) citing clinical studies for results discussion. Results: Of 473 RCTs included, 45.67% (216) of the trials cited relevant similar studies, 21.56% (102) referenced to the studies that collected end-users' perspectives, and 10.99% (52) placed result in the context of the previous research. Few RCTs appropriately applied EBR approach. Among all the included studies, 3.17% (15) of the trials used SRs to inform study questions but none of them used updated SRs with acceptable quality; 1.05% (5) of the trials cited SRs of end-user's perspectives in the justification and design of the study, and only 1 trial added results in existing SR to draw a conclusion. Year of publication, language, funding, registration, ethical approval and number of sites were significantly associated with 1 of the 3 aspects of EBR approach. Conclusions: Few RCTs in acupuncture-related therapies for PD used the EBR approach to minimize research redundancy. Researchers, research institutes, funding agencies, ethics committees, journals and peer reviewers in acupuncture should make efforts to use and promote the EBR approach to ensure the value of new trials. [ABSTRACT FROM AUTHOR]

Dysmenorrhea, or painful uterine contractions during menstruation in women, is a common condition. It may affect up to 90% of patients in a doctor's office. Depending on the severity of symptoms, it may cause discomfort or prevent normal functioning in everyday life. Some women do not realize that this is not a normal symptom during menstruation. Unfortunately, lack of exercise, smoking, or drinking alcohol only increases the symptoms. A medical history and physical examination of the patient are important steps in finding the cause. Primary dysmenorrhea is primarily associated with the pathogenesis of prostaglandins and leukotrienes, which generate inflammation and pain. However, it has nothing to do with pelvic pathology. It usually first appears in young women during puberty, up to 24 months after their first period. If the history and physical examination are not clear about the primary cause of pain, a secondary cause should be considered. For this purpose, a transvaginal ultrasound examination should be performed. The most common secondary pathology is endometriosis. In the treatment of primary and secondary diseases, physical exercises and warm compresses are beneficial, which women are often unaware of. First-line pharmacological treatment may include NSAIDs or combined oral estrogen-progestogen hormonal therapy. The purpose of this review is to provide knowledge about the symptoms, risk factors, diagnosis, and treatment of dysmenorrhea.

ObjectiveTo determine the comparative effects and safety of traditional Chinese medicine (TCM) interventions based on meridian theory for pain relief in patients with primary dysmenorrhea (PD).MethodsThis is a systematic review with network meta-analysis. Randomized controlled trials (RCTs) comparing meridian-based TCM interventions with waitlist, placebo, western medicine, and conventional therapies for PD pain. A SUCRA was used to estimate the probability ranking for the effects of interventions.Results57 RCTs involving 3,903 participants and 15interventions were included. Thirty-two RCTs were rated as low risk of bias. A network diagram was drawn with 105 pairs of comparisons. Compared with NSAIDs and waitlist, significantly better effects were found in acupressure [SMD = −1.51, 95%CI (−2.91, −0.12)/SMD = −2.31, 95%CI (−4.61, −0.02)], warm needling [SMD = −1.43, 95%CI (−2.68, −0.18)/SMD = −2.23, 95%CI (−4.43, −0.03)], moxibustion [SMD = −1.21, 95%CI (−1.85, −0.57)/SMD = −2.10, 95%CI (−3.95, −0.07)], and acupuncture [SMD = −1.09, 95%CI (−1.62, −0.55)/SMD = −1.89, 95%CI (−3.67, −0.11)]. No adverse events were detected.ConclusionFor PD pain, the effects of acupressure, acupuncture, warm needling, and moxibustion were superior to those of NSAIDs and waitlist. Oral contraceptive pill, electro-acupuncture, acupressure, and warm needling demonstrated higher probabilities of being better interventions. More high-quality clinical trials are needed to provide more robust evidence of this network.Systematic review registrationPROSPERO CRD42022373312.

IntroductionPrimary dysmenorrhea (PDM), characterized by cyclic pain, may involve pain modulation within the reward system (RS). The Catechol-O-methyltransferase (COMT) Val158Met polymorphism, which significantly influences dopamine activity, is linked to the regulation of both acute and chronic pain. This study examines the differential neurodynamic modulation in the RS associated with COMT Val158Met polymorphisms during menstrual pain among PDM subjects.MethodNinety-one PDM subjects underwent resting-state fMRI during menstruation and were genotyped for COMT Val158Met polymorphisms. The amplitude of low-frequency fluctuation (ALFF) and functional connectivity (FC) analyses were used to assess the RS response. Psychological evaluations included the McGill Pain Questionnaire, Pain Catastrophizing Scale, Beck Anxiety Inventory, and Beck Depression Inventory.ResultVal/Val homozygotes (n = 50) and Met carriers (n = 41) showed no significant differences in McGill Pain Questionnaire, Beck Anxiety Inventory, and Beck Depression Inventory. However, Met carriers exhibited lower scores on the Pain Catastrophizing Scale. Distinct FC patterns was observed between Val/Val homozygotes and Met carriers, specifically between the nucleus accumbens (NAc) and prefrontal cortex, NAc and inferior parietal lobe, ventral tegmental area (VTA) and prefrontal cortex, VTA and precentral gyrus, and VTA and superior parietal lobe. Only Met carriers showed significant correlations between ALFF and FC values of the NAc and VTA with pain-related metrics (McGill Pain Questionnaire and Pain Catastrophizing Scale scores). NAc ALFF and NAc-prefrontal cortex FC values positively correlated with pain-related metrics, while VTA ALFF and VTA-prefrontal cortex and VTA-superior parietal lobe FC values negatively correlated with pain-related metrics.DiscussionThis study reveals that the COMT Val158Met polymorphism results in genotype-specific functional changes in the brain’s RS during menstrual pain. In Met carriers, engagement of these regions is potentially linked to motivational reward-seeking and top-down modulation. This polymorphism likely influences the RS’s responses, significantly contributing to individual differences in pain regulation.

Xia Li,1,&ast; Yanan Sun,2,&ast; Yuhan Wang,1 Xiyou Wang,1 Changhe Yu1 1Tuina and Pain Management Department, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, People’s Republic of China; 2Traditional Chinese Medicine Department, Xuanwu Hospital Capital Medical University, Beijing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xiyou Wang; Changhe Yu, Email dzmyywxy@163.com; yakno2@163.comObjective: This research aimed to assess the effectiveness of manual therapy in alleviating pain among women undergoing primary dysmenorrhea (PD).Methods: All randomized controlled trials (RCTs) regarding manual therapy for PD were searched from online databases, spanning from their inception to July 2023. The identified literature underwent a thorough screening process, and the data were meticulously extracted and analyzed using RevMan 5.3. Subsequently, the included studies underwent Cochrane’s quality assessment and meta-analysis. The evidence obtained was then assessed using the grading of recommendations, assessment, development, and evaluation (GRADE) approach.Results: 32 RCTs, involving 2566 women were finally included for analysis. The overall quality of the concluding evidence was generally rated as low or very low. Performance bias and blind bias were found to be the main risk of bias of the included studies. In comparison to no treatment, manual therapy demonstrated a significant increase in pain relief in short-term (n=191, MD=1.30, 95% CI: 0.24~2.37). The differences in the effects of manual therapy and the placebo on pain intensity may not be statistically significant (n=255, MD=0.10, 95% CI: − 0.37~0.58). In contrast to NSAIDs, manual therapy exhibited superior pain alleviation (n=507, MD=3.01, 95% CI: 1.08~4.94) and a higher effective rate (n=1029, OR=4.87, 95% CI: 3.29~7.20). Importantly, no severe adverse events were reported across all studies, indicating a relatively safe profile for manual therapy.Conclusion: Manual therapy presented promise in effectively relieving menstrual pain with minimal adverse events in short term, outperforming both no treatment and NSAIDs. However, this conclusion is tempered by the low quality of the included RCTs, highlighting the necessity for more robust trials to validate it.Keywords: primary dysmenorrhea, manual therapy, meta-analysis, systematic review

Primary dysmenorrhea is one of the types of gynecological pathology, the frequency of which is 45-53% in girls and young women aged 13 to 45 years, which is not given enough attention in diagnosis and treatment.The pathogenesis takes into account the increased secretion of prostaglandins F2α and E2 in the period from the beginning of pregnancy to birth, which cause pelvic pain.The diagnosis is based on the patient's history, symptoms, examination, the treatment is aimed at improving the quality of life by prescribing nonsteroidal anti-inflammatory drugs, hormonal contraceptives and the use of non-medicinal means. Purpose: to specify some links in the pathogenesis of primary dysmenorrhea and, taking into account its multicomponent nature, to evaluate the effectiveness of the proposed treatment. Under observation there were 68 women who were divided into 2 groups: 34 women with primary dysme­norrhea (main group) and 34 healthy women (control group).The diagnosis of primary dysmenorrhea was established on the basis of complaints of patients about painful menstruation and accompanying symptoms during consultations with a gynecologist and endocrinologist.Treatment of patients in the main group was carried out with the drug, which includes Vitex agnus castus L, indinol-3-carbinol, 3,3-diindolyl-methane, extract of passionflower, California Eschscholzia. In women with typical symptoms, dysmenorrhea can be diagnosed on the basis of medical information without physical pelvic examination, empirical treatment should be initiated, including nonsteroidal anti-inflammatory drugs and/or oral contraceptives, because it is a functional condition resulting from an imbalance in the hormonal regulation of myometrial contraction. As a result of the proposed treatment, pain disappeared completely in 70% of patients (23/34), as well as vegetative-vascular (from 18 to 2% of patients), vegetative (from 10 to 1% of patients), metabolic and endocrine disorders (from 15 to 2% female patients), disorders of the emotional and mental sphere (from 25 to 10% of patients). Improvement in quality of life was noted by 80% (26/34) of patients, improvement in working capacity – by 70% (23/34) of patients, after 2 months – by 95% (31/34) and 85% (28/34), respectively, after 3 months all examined patients with primary dysmenorrhea noted an improvement in the quality of life and an increase in work capacity. Sexually active women with symptoms of inflammatory processes of the genital tract, severe dysmenorrhea should undergo pelvic examination. In view of safety and high therapeutic efficiency, the drug based on Vitex agnus castus can be offered for the treatment over the period lasting at least for3 months for girls and young women aged 13 to 45 years with primary dysmenorrhea.

Introduction: With the increasing use of medicinal plants in the treatment of some diseases, studying their side effects is very important. One of these herbal medicines is fennel that various results have been reported regarding its side-effects on the amount of menstrual bleeding, therefore, the present research was conducted with aim to investigate the effect of fennel on the amount and duration of menstrual bleeding. Methods: This quasi-experimental study was performed in 2016 on 50 students with primary dysmenorrhea living in the dormitories of Islamic Azad University, Ardabil. Participants were examined in three consecutive menstrual cycles. In the first cycle, participants did not take any medication; in the second and third cycles, in the first 3 days of menstruation they used fennel of 3-5 drops in water or tea three times a day. The standard Higham chart was used to determine the amount and duration of bleeding. Data was analyzed by SPSS software (version 17) and Paired-t test. P0.005). Conclusion: In the present study, fennel consumption had no effect on the amount and duration of menstrual bleeding. To determine the definitive result and the safety use of fennel, conducting more studies is recommended.

Objective: This study aims to investigate the effect of physical activity, body mass index (BMI), and levels of prostaglandins (PGF2α) urine on the occurrence of dysmenorrhea in adolescents. Methods: A total of 128 female students included in the study. The study was conducted from January to March 2023 using a cross‐sectional design. This study utilized the Menstrual Symptom Questionnaire (MSQ) and gynecological examination with ultrasonography. The urinary prostaglandin (PGF2α) was measured using the enzyme linked immuno sorbent assay (ELISA). Data were analyzed using the chi‐square test and logistic regression test. Results: The age range of the participants included in the study was 14–17, with a mean age of 15.85 ± 0.65. There was an correlation between physical activity, BMI, and urinary prostaglandin (PGF2α) levels with the incidence of dysmenorrhea in adolescents (p < 0.001). In multivariate analysis, it revealed that underweight, and had a high urinary prostaglandin significant correlated to primary dysmenorrhea with odds ratio 4.78 (95% confidence interval [CI] 1.98–11.54) and 4.88 (95% CI 1.98–12.08), respectively. High physical activity and overweight was not associated with incidence of dysmenorrhea in adolescents. Conclusion: This study provides valuable insights into the correlation between physical activity, BMI, and levels of prostaglandins (PGF2α) in urine. A high level of urinary prostaglandin was found to be the most influential factor in the incidence of primary dysmenorrhea in adolescents. By addressing factors associated with dysmenorrhea in adolescents, healthcare professionals can potentially enhance well‐being by reducing menstrual pain and encouraging a healthy lifestyle to prevent dysmenorrhea. [ABSTRACT FROM AUTHOR]

Photobiomodulation (PBM) has attracted widespread attention in suppressing various pain and inflammation. Primary dysmenorrhea (PD) primarily occurs in adolescents and adult females, and the limited effectiveness and side effects of conventional treatments have highlighted the urgent need to develop and identify new adjunct therapeutic strategies. In this work, the results of pain and PGs demonstrated that 850 nm, 630 nm, and 460 nm all exhibited pain inhibition, decreased PGF2α and upregulated PGE2, while 630 nm PBM has better effectiveness. Then to explore the underlying biological mechanisms of red light PBM on PD, we irradiated prostaglandin‐F2α induced HUSM cells and found that low‐level irradiance can restore intracellular calcium ion, ROS, ATP, and MMP levels to normal levels. And, red light enhanced cell viability and promoted cell proliferation for normal HUSM cells. Therefore, this study proposes that red light PBM may be a promising approach for the future clinical treatment of PD. [ABSTRACT FROM AUTHOR]

The effects of the menstrual cycle in women with and without primary dysmenorrhea on phase-related postural sensory organization are controversial. This study was carried out to examine postural sensory organization in three phases of the menstrual cycle in women with and without primary dysmenorrhea and to evaluate whether there is a difference between women with/without primary dysmenorrhea in this regard. Women aged 18–30 years were divided into two groups as primary dysmenorrhea group (PDG, n = 14) and control group (CG, n = 15). Computerized dynamic posturography were applied to the participants on the follicular, ovulation, and luteal phases of the menstrual cycle. Outcome measures were antero-posterior and medio-lateral Sensory Organization Test (SOT–somatosensory, vestibular and visual scores) and Limits of Stability test (LoS). The findings obtained were analyzed with the two-factor ANOVA, paired samples t test, and independent samples t test. In the PDG, follicular phase antero-posterior somatosensory scores were lower compared to luteal phase (p = 0.002). Follicular phase antero-posterior and medio-lateral vestibular scores were lower than ovulation (p = 0.003, p = 0.004, respectively) and luteal (p = 0.005, p = 0.001, respectively) phases. Follicular phase LoS scores were lower than ovulation (p = 0.001) and luteal (p = 0.002) phases. In the CG, ovulation phase antero-posterior somatosensory scores were lower than follicular phase (p = 0.003). Follicular phase LoS scores were lower than ovulation phase (p = 0.002). The PDG had lower follicular phase antero-posterior somatosensory (p = 0.019), vestibular (p = 0.031), and medio-lateral somatosensory (p = 0.019) scores than those of the CG. The PDG had lower luteal phase antero-posterior somatosensory scores than those of the CG (p = 0.029). The PDG showed lower follicular phase LoS scores than those of the CG (p = 0.009). This study revealed that primary dysmenorrhea impairs postural sensory organization. Decreased sensory organization may predispose women to injury. The risk of injury should be investigated and necessary precautions should be taken. • Primary dysmenorrhea may impair sensory organization. • Limits of stability were lower in those with primary dysmenorrhea. • Sensory organization may be affected in all phases of menstruation in dysmenorrhea. • Decreased sensory organization and postural control may predispose women to injury. [ABSTRACT FROM AUTHOR]

Introduction: With the increasing use of medicinal plants in the treatment of some diseases, studying their side effects is very important. One of these herbal medicines is fennel that various results have been reported regarding its side-effects on the amount of menstrual bleeding, therefore, the present research was conducted with aim to investigate the effect of fennel on the amount and duration of menstrual bleeding. Methods: This quasi-experimental study was performed in 2016 on 50 students with primary dysmenorrhea living in the dormitories of Islamic Azad University, Ardabil. Participants were examined in three consecutive menstrual cycles. In the first cycle, participants did not take any medication; in the second and third cycles, in the first 3 days of menstruation they used fennel of 3-5 drops in water or tea three times a day. The standard Higham chart was used to determine the amount and duration of bleeding. Data was analyzed by SPSS software (version 17) and Paired-t test. P<0.05 was considered statistically significant. Results: The mean amount of bleeding before consuming fennel was 46.7±24.8 and in two consecutive cycles after consuming fennel were 48.4±26.2 and 49.5±24.3, respectively, which was not statistically significant. Moreover, no significant difference was observed in the duration of menstrual bleeding before the treatment (6.13±1.33) compared to two consecutive cycles after fennel consuming (6.82±1.45 and 6.26±1.02) (P>0.005). Conclusion: In the present study, fennel consumption had no effect on the amount and duration of menstrual bleeding. To determine the definitive result and the safety use of fennel, conducting more studies is recommended. [ABSTRACT FROM AUTHOR]

Background: Every one in six people in the world is an adolescent, and as many as 85% of adolescents live in developed countries, which often experience menstrual disorders such as primary dysmenorrhea. Primary dysmenorrhea is menstrual pain in the absence of pathological conditions in the pelvis that often occurs at a young/adolescent age triggered by various factors such as nutritional status, diet, exercise habits, and stress. Objectives: To analyze the association between nutritional status (BMI-for-age), junk food consumption, and exercise habits of adolescent girls in Jakarta with the incidence of primary dysmenorrhea. Methods: This study used a cross-sectional design, the population of this study was all grade 11 students in Jakarta (East Jakarta, South Jakarta, West Jakarta, Central Jakarta, North Jakarta). The method of obtaining samples used was purposive sampling. The instrument used was a questionnaire regarding nutritional status, exercise habits and junk food consumption patterns assessed using the Food Frequency Questionnaire (FFQ) through Google Forms. Results: The results showed a significant relationship between nutritional status (p = 0.022), junk food consumption (p = 0.000), and exercise habits (p = 0.000) with the incidence of primary dysmenorrhea. Conclusions: There was a correlation between nutritional status, junk food consumption, and exercise habits on the incidence of primary dysmenorrhea in adolescent girls in Jakarta. Further research is needed on the relationship between nutritional status, junk food consumption and exercise habits with the incidence of primary dysmenorrhea in other age groups, and with different methods to expand knowledge related to factors that cause primary dysmenorrhea. [ABSTRACT FROM AUTHOR]

Introduction: According to the high prevalence of primary dysmenorrhea and its consequences on the quality of life and the effects of nonsteroidal anti- inflammatory drugs consumption, the present study was performed with aim to investigate the effect of the capsella bursa-pastoris on the severity of primary dysmenorrhea. Methods: This triple-blind clinical trial study was conducted in 2022 on 80 girls referred to the comprehensive health service centers of Kermanshah University of Medical Sciences with a history of primary dysmenorrhea. The participants were divided into two groups of 40 people, intervention and control. The intervention group received capsules containing 400 mg of hydroalcoholic extract of the "Capsella bursa pastoris" plant and the control group received 250 mg capsules of mefenamic acid every 8 hours for 3 days for 2 consecutive periods. The research tools were demographic profile questionnaire, menstrual status and physical activity questionnaire, and visual analog scale. Data were analyzed by SPSS software (version 19) and independent t-tests, chi-square, Bonferroni and analysis of variance with repeated measures. P

Primary dysmenorrhea is considered one of the main causes of pelvic pain during a woman’s childbearing years, resulting in poor quality of life. The objective was to evaluate the effectiveness of transcutaneous tibial nerve stimulation (TTNS) in painful symptomatology improvement and non-steroidal anti-inflammatory drug (NSAID) intake reduction in women with primary dysmenorrhea (PD) compared with a control group in the short, medium, and long terms. A single-blind, controlled clinical trial was developed. Participants were randomized to the experimental (TTNS) and control group (sham TTNS). Both groups received 12-weekly 30-min sessions with a NeuroTracTM PelviTone electrostimulation device. The intensity and severity of pain and non-steroidal anti-inflammatory drug (NSAID) intake were evaluated in the short-term (after treatment), medium-term (1–3 months), and long-term (6 months). A total of 61 participants were randomized, with a split of 31 (experimental group) and 30 (control group), but 55 participants completed the study and were analyzed. Statistically significant differences between both groups in the maximum pain intensity decrease (F = 4.88, p = 0.0043) measured with the visual analogue scale, as well as NSAID intake decrease (F = 4.68, p = 0.011) and days of their ingestion (F = 4.57, p = 0.012) occurred in the short term. Furthermore, significant decreases in the total number of NSAIDs ingested during the cycle (F = 3.82, p = 0.011) and the number of days on which patients ingested NSAIDs (F = 3.59, p = 0.015) in the medium–long term occurred. TTNS could be an effective and safe strategy to reduce pain caused by PD, which could reduce or complement the use of pharmacological techniques and other more invasive methods.

In recent years, photobiomodulation (PBM) has attracted widespread attention for the treatment of various causes of pain and inflammation. Primary dysmenorrhea (PD) is a common gynecological condition characterized by severe menstrual pain, and the limited effectiveness and side effects of conventional treatments have highlighted the urgent need to develop and identify new adjunct therapeutic strategies. The present study from the perspective of light morphology aimed to bypass the heat risk limitation and evaluate the efficacy and safety of pulsed 630 nm PBM therapy for reducing pain associated with PD. The pulse light parameters were designed according to the transmittance of red light. In this randomized, cross-over design, sham-controlled study, 46 women with PD were included and randomly assigned to either pulsed 630 nm light therapy or white light sham control therapy. The intervention lasted for 20 min per day and was administered for 7 consecutive days before and during menstruation. The results showed that the pulsed 630 nm PBM treatment demonstrated a significant reduction in pain levels compared to the placebo treatment (p < 0.001), with 55.00% of active treatment participants experiencing a pain intensity differential concentration exceeding 50.00%. Moreover, participants reported an improved quality of life during the active treatment phase and generally preferred it as a more effective method for relieving PD. No adverse events or side effects were reported throughout the trial. Based on the results, pulsed 630 nm LED therapy showed significant relief of menstrual pain compared to white light placebo treatment and improved quality of life under certain circumstances. Therefore, this study proposes that pulsed red light PBM therapy may be a promising approach for future clinical treatment of PD. [ABSTRACT FROM AUTHOR]

Background: The most prevalent gynecological condition in young girls, dysmenorrhea, is experienced by over 50% of girls. The Myometrium's hyperactivity and the co-occurrence of uterine ischemia are believed to be the primary causes of pain. Prostaglandins seem to play a major role in the development of myometrial hyperactivity. Soft tissue manipulation, a form of therapeutic tissue massage, may be beneficial for the treatment of dysmenorrhea, according to the scant research on the subject and the personal clinical experience of one of the authors. This has been suggested that therapeutic tissue massage, which involves applying pressure to soft tissues, is effective in relieving menstrual discomfort. The entire process was performed from November 2022 to April 2023. Purpose: The study aims to determine the efficacy of soft tissue manipulation for primary dysmenorrhea among late-adolescent girls. Materials and Methods: 62 subjects in total were chosen based on the inclusion and exclusion criteria. The Soft tissue manipulation group (n=31) received treatment over the course of two sessions. The stretching group (n=31) received treatment with 5 stretches in 2 sessions, each stretch lasting for 10 seconds of hold with a 3 seconds rest in between. The material used were Couch, Pillow, Bedsheet, Petroleum Gel, Gloves, Yoga Mat, Sanitizer. Result: The result showed significant improvement in minimizing symptoms of menstrual cramps among late adolescent girls using soft tissue manipulation. Conclusion: This study concluded that the effect of soft tissue manipulation was found to be more significant than stretching in reducing primary dysmenorrhea. [ABSTRACT FROM AUTHOR]

Purpose: To conduct a systematic review of the quality of patient-reported outcome measures (PROMs) for primary dysmenorrhea (PDys) using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology, and to derive recommendations for use of the PROMs. Methods: We searched PubMed and Web of Science for studies reporting on the development and/or validation of any PROMs for women with PDys. Applying the COSMIN Risk of Bias Checklist, we assessed the methodological quality of each included study. We further evaluated the quality of measurement properties per PROM and study according to the criteria for good measurement properties, and graded the evidence. Based on the overall evidence, we derived recommendations for the use of the included PROMs. Results: Data from seven studies reporting on four PROMs addressing different outcomes were included. Among those, the Adolescent Dysmenorrhic Self-Care Scale (ADSCS) and the on-menses version of the Dysmenorrhea Symptom Interference Scale (DSI) can be recommended for use. The Exercise of Self-Care Agency Scale (ESCAS) and the Dysmenorrhea Daily Diary (DysDD) have the potential to be recommended for use, but require further validation. The off-menses version of the DSI cannot be recommended for use. Conclusions: The ADSCS can be recommended for the assessment of self-care behavior in PDys. Regarding measures of impact, the on-menses version of the DSI is a suitable tool. Covering the broadest spectrum of outcomes, the DysDD is promising for use in medical care and research, encouraging further investigations. Further validation studies are indicated for all included PROMs. [ABSTRACT FROM AUTHOR]

Primary dysmenorrhea (PD) is a common gynecological condition causing depression. Acupuncture is an effective option for PD management but its effects on PD-associated depression remain unclear. A retrospective cohort study involving 35,099 propensity score-matched pairs of acupuncture users and non-users with PD was conducted using data from Taiwan's Longitudinal Generation Tracking Database 2000. Cox proportional hazard models were used to estimate depression risk, and bioinformatics analyses were performed to uncover underlying molecular mechanisms. The risk of developing depression was reduced by 64 % in acupuncture users compared with non-acupuncture users during the 19-year follow-up period. The decrease was dose-dependent. Bioinformatics analyses identified 34 co-expressed targets for acupuncture, PD, and depression; and eight hub genes (coding for interleukin 6 and 1B, tumor necrosis factor, albumin, vascular endothelial growth factor A, C-reactive protein, prostaglandin-endoperoxide synthase 2, and brain-derived neurotrophic factor) potentially involved in the therapeutic effects of acupuncture. Several molecular pathways were found to be involved, including cytokine-cytokine receptor interaction, neuroactive ligand-receptor interaction, cyclic adenosine 3′,5′-monophosphate signaling pathway, mitogen-activated protein kinase signaling pathway, serotonergic synapse, and estrogen signaling pathway. Bias in the selection of participants could have been introduced as a consequence of the retrospective nature of the study. Data were derived from a single national database, and acupuncture treatment details were unavailable. Acupuncture may protect against the development of depression in patients with PD. This study provides insight into the potential molecular mechanisms underlying the therapeutic effects of acupuncture in PD management and depression prevention. • A large cohort study compares acupuncture users and non-users with primary dysmenorrhea, showing reduced depression risk. • A dose-dependent decrease in depression risk with increasing use of acupuncture treatment was observed. • Study uncovers acupuncture's mechanisms on primary dysmenorrhea and depression: immune, neuromodulatory, and signaling paths. [ABSTRACT FROM AUTHOR]

Primary dysmenorrhea is one of the types of gynecological pathology, the frequency of which is 45-53% in girls and young women aged 13 to 45 years, which is not given enough attention in diagnosis and treatment. The pathogenesis takes into account the increased secretion of prostaglandins F2α and E2 in the period from the beginning of pregnancy to birth, which cause pelvic pain. The diagnosis is based on the patient's history, symptoms, examination, the treatment is aimed at improving the quality of life by prescribing nonsteroidal antiinflammatory drugs, hormonal contraceptives and the use of non-medicinal means. Purpose: to specify some links in the pathogenesis of primary dysmenorrhea and, taking into account its multicomponent nature, to evaluate the effectiveness of the proposed treatment. Under observation there were 68 women who were divided into 2 groups: 34 women with primary dysmenorrhea (main group) and 34 healthy women (control group). The diagnosis of primary dysmenorrhea was established on the basis of complaints of patients about painful menstruation and accompanying symptoms during consultations with a gynecologist and endocrinologist. Treatment of patients in the main group was carried out with the drug, which includes Vitex agnus castus L, indinol-3-carbinol, 3,3-diindolyl-methane, extract of passionflower, California Eschscholzia. In women with typical symptoms, dysmenorrhea can be diagnosed on the basis of medical information without physical pelvic examination, empirical treatment should be initiated, including nonsteroidal anti-inflammatory drugs and/or oral contraceptives, because it is a functional condition resulting from an imbalance in the hormonal regulation of myometrial contraction. As a result of the proposed treatment, pain disappeared completely in 70% of patients (23/34), as well as vegetative-vascular (from 18 to 2% of patients), vegetative (from 10 to 1% of patients), metabolic and endocrine disorders (from 15 to 2% female patients), disorders of the emotional and mental sphere (from 25 to 10% of patients). Improvement in quality of life was noted by 80% (26/34) of patients, improvement in working capacity – by 70% (23/34) of patients, after 2 months – by 95% (31/34) and 85% (28/34), respectively, after 3 months all examined patients with primary dysmenorrhea noted an improvement in the quality of life and an increase in work capacity. Sexually active women with symptoms of inflammatory processes of the genital tract, severe dysmenorrhea should undergo pelvic examination. In view of safety and high therapeutic efficiency, the drug based on Vitex agnus castus can be offered for the treatment over the period lasting at least for3 months for girls and young women aged 13 to 45 years with primary dysmenorrhea. [ABSTRACT FROM AUTHOR]

Copyright of Osmangazi Journal of Medicine / Osmangazi Tip Dergisi is the property of Eskisehir Osmangazi University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and Objective: Primary dysmenorrhea (PD) is one of the most common clinical disorders in women of reproductive age. Our aim was to examine whether a twice-weekly thirty-minute Aviva exercise intervention could result in improvements in pain level and body awareness in patients with PD. Materials and Methods: In our prospective observational trial, the observation period included two consecutive menstrual cycles and the period of the next menstrual bleeding. The first menstrual bleeding period was the first measurement time (T1), the second was the second measurement time (T2), and the third was the third measurement time (T3) in a total of 78 volunteers. The primary endpoint was the change in the level of menstrual pain according to the Numeric Rating Scale (NRS) questionnaire between the intervention group (IG) and the control group (CG) at T1, T2, and T3. In this study, the secondary outcomes were the differences between the IG and CG regarding the different subscales of the Hungarian version of the Body Awareness Questionnaire (BAQ-H) at T1, T2, and T3; the Borg scale results of the IG; and adherence to the intervention. Statistical tests such as independent-sample t-tests, chi-square tests, Pearson's linear correlation coefficient, and repeated-measure ANCOVA were used for the analyses. Results: In total, 78 volunteers were enrolled: 40 persons in the IG and 38 in the CG. There was a significant change in the level of menstruation pain according to the NRS questionnaire between the IG and CG (p < 0.001). There was no significant difference between the IG and CG regarding the different subscales of the BAQ-H. Only in the case of the "Note responses or changes in body process" subscale of the BAQ-H was there a trend-like effect from the Aviva exercises (p = 0.086). Conclusions: The Aviva exercise could contribute to pain relief from PD. Regarding body awareness, no significant difference was found between the two groups. Due to the short detection period and prospective observational design, our results are preliminary and need to be confirmed in larger clinical trials. [ABSTRACT FROM AUTHOR]

Aim: To assess and compare the effectiveness of Kinesiotaping and hot pack versus Massage and hot pack using VAS Scale for pain on Primary Dysmenorrhea in Hostel girls. Material and Methods: This comparative study was conducted in girls hostel of Ruxmaniben depchand Gardi Medical College, Ujjain (M.P). It involved 30 females aged 18-25 years who had been experiencing menstrual pain which were divided into two groups of 15 each by simple random sampling. Group A (Kinesiotaping and hot pack) and Group B(Massage and hot pack). Duration of study was three months. Each female was treated for first 2 days of her period or until the pain disappears for three consecutive months. Pain intensity was noted using VAS Scale. Results: The results of the study showed that there was a significant reduction in the pain intensity on VAS scale. On comparison of mean of both the groups using Independent T test, there was some difference found, but statistically it was not significant.(p>0.05). Conclusion: In the present study, both the groups showed significant improvement in terms of pain which was assessed by VAS over the course of 3 months. Despite the kinesiotaping and hot pack group showed immediate and better results than the massage and hot pack group, the results were not statistically significant. Therefore we can conclude that both kinesiotaping and Massage along with hot pack can be used for pain management in primary dysmenorrhea in hostel girls. [ABSTRACT FROM AUTHOR]

Peony pollen contains multiple nutrients and components and has been used as a traditional Chinese medicine with a long history, but the effect of the treatment of primary dysmenorrhea remains to be clarified. The aim of this study is to investigate the therapeutic effect of peony pollen on primary dysmenorrhea mice and the potential mechanism. A uterus contraction model in vitro and primary dysmenorrhea mice were used to evaluate the treatment effect of peony pollen on primary dysmenorrhea. The primary dysmenorrhea mice were treated with 62.5 mg/kg, 125 mg/kg, or 250 mg/kg of peony pollen, and the writhing response, latency period, histopathological changes in the uterus, prostaglandin E2 (PGE2) and prostaglandin F2α (PGF2α) levels, and infiltration of neutrophils and macrophages were investigated. Protein expression of interleukin 1 β (IL-1β), interleukin 6 (IL-6), NOD-like receptor thermal protein domain associated protein 3 (NLRP3), cyclooxygenase-2 (COX-2), microsomal prostaglandin-E synthase 1 (mPGEs-1), BCL2-Associated X (Bax), B-cell lymphoma-2 (BCL-2), caspase-3, and cleaved caspase-3 were detected by Western blot, and the oxidative stress related marker malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and reactive oxygen species (ROS) were evaluated. Peony pollen could attenuate spontaneous or oxytocin-induced uterus contractions in vitro. Moreover, peony pollen decreased the writhing times, prolonged the writhing latency, and reduced the pathological damage of uterine tissues. Furthermore, the inflammatory cell infiltration and the protein expression of IL-1β, IL-6, and NLRP3 were decreased. The COX-2/PGE2 pathway was inhibited; oxidative stress and apoptosis in the uterus also improved in the uterus of primary dysmenorrhea mice. Peony pollen exerts a positive effect on primary dysmenorrhea by inhibiting the inflammatory response and modulating oxidative stress and apoptosis by regulating the COX-2/PGE2 pathway. [ABSTRACT FROM AUTHOR]

One of the most common female reproductive health problems is primary dysmenorrhea. Data on the incidence of primary dysmenorrhea complained about 50-90% of women in the world. Primary dysmenorrhea data in the US is 30-70%, in Sweden is 30%, in Mexico is 64%, in Italy is 68%, in Jordan is 55.8%, in Turkey is 84.9%, and in Malaysia is 74.5%, in Indonesia is 60-70 and 15% of its, it interferes with daily activities including work. The cause of this is hypercontractility of the myometrium due to excessive secretion of prostaglandins. This study aims to explore the most effective non-pharmacological therapies in reducing the level of primary dysmenorrhea pain in women of childbearing age. The design of this study is a literature review with the PRISMA method. Database Google, Google Scholar, Research gate, Cochran Data Base, Embase, NCBI, Sciendirect, SAGE, Elsevier, Sinta. The population of this study was all full-text international journals indexed by Scopus and national journals indexed by Sinta 1-6 published in 2011-2021 including RCT amount of 114 articles. A sample of 23 articles meets the inclusion criteria and used thematic data analysis. The results of non-pharmacological therapy that effectively overcome primary dysmenorrhea pain, namely the first group with (P=0.000). The conclusions showed that Murrotal Qur'an, yoga, acupressure, counter pressure massage, effleurage massage, consume green coconut water and avocado juice combination with massage were proven to be equally effective in overcoming complaints of primary dysmenorrhea pain quickly without being accompanied by side effects. [ABSTRACT FROM AUTHOR]

Purpose Primary dysmenorrhea (PD) is 1 of the most prevalent gynecologic conditions. The main aim of this umbrella review was to assess the effects of therapeutic exercise (TE) on PD. Methods A systematic search was carried out in PubMed, Embase, SPORTDiscus, CINAHL, and PEDro (December 10, 2022). The outcome measures assessed were menstrual pain intensity, menstrual pain duration, and quality of life. Methodological quality was analyzed using the AMSTAR and ROBIS scales, and the strength of evidence was established according to the advisory committee grading criteria guidelines. Results Nine systematic reviews were included. The results showed that TE, regardless of the exercise model and intensity, has a clinical effect in improving menstrual pain intensity in women with PD with moderate quality of evidence. In addition, the results showed that TE has a clinical effect in improving the duration of menstrual pain in women with PD with a limited quality of evidence. However, the results are controversial on the improvement of quality of life in women with PD with a limited quality of evidence. Conclusions TE seems an effective option to implement in women with PD to improve the intensity and duration of menstrual pain. We cannot draw robust results for quality of life due to the low number of primary studies. More research in this field can help us establish more robust conclusions, as well as to assess whether there is one exercise model or intensity of training that is more effective than others. PROSPERO number: This review was previously registered in PROSPERO (CRD42022371428). [ABSTRACT FROM AUTHOR]

Introduction: According to the high prevalence of primary dysmenorrhea and its consequences on the quality of life and the effects of nonsteroidal anti- inflammatory drugs consumption, the present study was performed with aim to investigate the effect of the capsella bursa-pastoris on the severity of primary dysmenorrhea. Methods: This triple-blind clinical trial study was conducted in 2022 on 80 girls referred to the comprehensive health service centers of Kermanshah University of Medical Sciences with a history of primary dysmenorrhea. The participants were divided into two groups of 40 people, intervention and control. The intervention group received capsules containing 400 mg of hydroalcoholic extract of the "Capsella bursa pastoris" plant and the control group received 250 mg capsules of mefenamic acid every 8 hours for 3 days for 2 consecutive periods. The research tools were demographic profile questionnaire, menstrual status and physical activity questionnaire, and visual analog scale. Data were analyzed by SPSS software (version 19) and independent t-tests, chi-square, Bonferroni and analysis of variance with repeated measures. P<0.05 was considered statistically significant. Results: Before the intervention, the two groups were similar in terms of pain intensity (p=0.689). The two-factor variance test showed that the two groups had a significant difference in terms of pain intensity after the intervention (p=0.001), but the reduction of pain was more in the capsella bursa-pastoris group. Conclusion: The Capsella bursa-pastoris plant can reduce the severity of primary dysmenorrhoea; Therefore, it is recommended to conduct more researches to confirm the effectiveness and safety of the Capsella bursa pastoris plant. [ABSTRACT FROM AUTHOR]

Copyright of Istanbul Gelisim University Journal of Health Sciences / İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi is the property of Istanbul Gelisim Universitesi Saglik Bilimleri Yuksekokulu and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

According to prescriptions from famous gynecologists, Si-Wu-Tang (SWT) has been one of the main treatments for primary dysmenorrhea (PD). This systematic review and meta-analysis aim to test the efficacy and safety of SWT in treating PD. First, randomized controlled trials (RCTs) of SWT in treating PD were researched. Data were from the Year 2000 to June 2022. A cumulative meta-analysis was then performed based on those data. A total of 228 potential studies relevant to this study were searched, and 22 RCTs were included. Twenty studies compared the effect of SWT with Western medicine (WM) in treating PD. In addition, two studies compared the effect of SWT with Danggui Shaoyaosan (DSS) in treating PD. The results revealed that SWT was more effective than Nonsteroidal anti-inflammatory drugs (NSAIDs), and SWT was more effective than DSS in treating PD. These results indicate that SWT might be effective in treating PD. [ABSTRACT FROM AUTHOR]

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, = 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. [ABSTRACT FROM AUTHOR]