A narrative review of medical, chiropractic, and alternative health practices in the treatment of primary dysmenorrhea

Experiences of dysmenorrhea and its treatment among allistic and autistic menstruators: a thematic analysis

BACKGROUND

Dysmenorrhea (i.e., period pain) is common and debilitating. Autistic people are known to experience pain differently, yet little is known about the menstrual pain experiences of autistic menstruators relative to non-autistic peers. This study aimed to explore the experience of period pain and treatment uptake for period pain among allistic and autistic populations.

METHODS

This study used a qualitative design and opportunity sampling approach. Thirty-seven participants (of whom 17 were autistic) were interviewed via video-conferencing software using a semi-structured topic guide. Transcriptions of interviews were analysed using Braun and Clarke's Reflexive Thematic Analysis. Data were initially analysed together for common themes. Autistic menstruators' data was subsequently analysed separately to elucidate the unique experiences of this group.

RESULTS

A total of six themes were constructed from the data. Initial analysis determined three themes related to experiences of period pain and treatment uptake in both allistic and autistic menstruators. Social perception of menstruation was discussed, highlighting the normalisation of pain, the taboo nature, and gendered experience of menstruation, contributing to untreated menstrual pain. Issues within menstrual healthcare were also shared, including experiences of ineffective treatment, dismissive interactions, and insufficient menstrual education. Impaired functionality was repeatedly highlighted, with menstruators detailing significant limitations to their usual functioning due to menstrual pain and ineffective treatment. Three further themes were constructed from separate analysis of data from autistic menstruators. Autistic menstruators discussed the impact of menstruation on their sensory experiences and needs, with many identifying overstimulation during menstruation. Social exclusion was discussed as a factor contributing to the experience of menstrual pain and poor treatment uptake. The final theme identified pain communication differences between autistic and allistic menstruators resulting in reports of ineffective treatment and challenges in healthcare interactions.

CONCLUSIONS

Communication differences, sensory aspects, and social factors contributed to the experience of period pain and treatment uptake for autistic menstruators. The perception of menstruation within society was highlighted by allistic and autistic menstruators as influential to their pain experience and engagement with treatment. Functionality was significantly impacted by pain for this sample. The study highlights societal and healthcare factors that could be improved to ensure accessibility of support and treatment for menstrual issues.

The Effect of Yoga on Pain and Quality of Life in Primary Dysmenorrhea: A Cross Sectional Survey

Dysmenorrhea is a painful syndrome that accompanies the menstrual cycles. Objectives: The main objective of this research was to determine the effects of yoga exercises on pain and quality of life in female undergraduate students suffering from primary dysmenorrhea. Methods: After taking approval from Ethical review committee of Rawal Institute of Health Sciences, an observation type of cross-section survey was conducted in 470 young undergraduate female students of age between 17-26, suffering from primary dysmenorrhea. By non-probability sampling participants were divided into two groups. Group-1 was of those females who had active lifestyle and doing yoga exercises and group-2 were of those who had sedentary lifestyle and didn’t do any kind of exercise. To measure the outcome variables, EQ-5D-5L questionnaire was used to measure QoL & NPRS to measure pain. Data were taken at baseline and after 12th week. Wilcoxon rank test was used for within group analysis and Mann Whitney U test was used to compare mean between groups. Data was analyzed in SPSS software version 21 along with Microsoft Excel 2019. Results: 21.16+2.66 &22.27+2.53 was the Mean+SD of age of group-1 & group-2 respectively. Between groups analysis revealed that p-value for NPRS was <0.05 but was >0.05 in quality of life. Conclusion: Yoga exercises are safer and easiest way to manage pain of primary dysmenorrhea in undergraduate females without any drug use.

Management of Usr-i-Tamth (Menstrual Pain) in Unani (Greco-Islamic) Medicine

Usr-i-tamth in Unani (Greco-Arabic) medicine is pain associated with menstruation, and classical manuscripts are enriched with traditional knowledge for the management of usr-i-tamth (menstrual pain/dysmenorrhoea). Hence, a comprehensive search was undertaken to find classical manuscripts for the management of menstrual pain was. We searched the Cochrane database, PubMed/Google Scholar, and other websites for articles on complementary and alternative medicine treatment and management of menstrual pain. The principal management as per Unani manuscripts is to produce analgesia and to treat the cause of usr-i-tamth such as abnormal temperament, menstrual irregularities/uterine diseases, and psychological and environmental factors. Furthermore, Unani medicines with emmenagogue, antispasmodic, anti-inflammatory, and analgesic properties are beneficial for amelioration of usr-i-tamth. Herbs such as Apium graveolens, Cuminum cyminium, Foeniculum vulgare, Matricaria chamomilla and Nigella sativa possess the aforementioned properties and are proven scientifically for their efficacy in usr-i-tamth. Thus, validation and conservation of the traditional knowledge is essential for prospective research and valuable for use in the contemporary era.

Clinical efficacy of Trigonella foenum graecum (Fenugreek) and dry cupping therapy on intensity of pain in patients with primary dysmenorrhea

OBJECTIVE

To determine the effificacy and safety of fenugreek seed and dry cupping on intensity of pain in primary dysmenorrhea.

METHODS

Sixty patients with primary dysmenorrhea were enrolled in this prospective, open-labeled, randomized, standard-controlled study, conducted in the National Institute of Unani Medicine Hospital between February 2010 and April 2011. In group A (20 cases), 3 g powder of fenugreek seed (3 capsules, 1 g each) was given orally twice daily from day 1 to 3 of menstrual cycle. Group B (20 cases) received the same dose of fenugreek seed as group A along with dry cupping therapy [two 4.2-cm and one 2.5-cm cups (internal diameter)], which was applied below the umbilicus for 15 min on day 1 and day 3 of menstrual cycle for 3 consecutive months. The control group C (20 cases) was given mefenamic acid, 500 mg twice daily, on the same protocol. The reduction in menstrual pain intensity was measured with well validated Visual Analogue Scale and safety of fenugreek seed was evaluated by clinical examination and laboratory investigations.

RESULTS

Baseline characteristics and biochemical parameters were comparable and homogenous among all groups (P>0.05). The percentage reduction in lower abdominal pain was 66.89%, 66.49%, and 62.88% in A, B and C groups respectively at the end of the treatment. No adverse drug effects were noticed.

CONCLUSION

The fenugreek seed and dry cupping are effificacious, safe, cost effective, and well tolerated.

Changes in pain perception after pelvis manipulation in women with primary dysmenorrhea: a randomized controlled trial

OBJECTIVE

This study aims to evaluate the immediate effect of a global pelvic manipulation (GPM) technique, bilaterally applied, on low back pelvic pain in women with primary dysmenorrhea (PD).

DESIGN

A prospective, randomized, double-blind, controlled trial.

SETTING

Faculty of Nursing, Physiotherapy and Podiatry. University of Sevilla, Spain.

METHODS

The sample group included 40 women (30 ± 6.10 years) that were divided into an experimental group (EG) (N = 20) who underwent a bilateral GPM technique and a control group (CG) (N = 20) who underwent a sham (placebo) intervention. Evaluations were made of self-reported low back pelvic pain (visual analog scale), pressure pain threshold (PPT) in sacroiliac joints (SIJs), and the endogenous response of the organism to pain following catecholamines and serotonin release in blood levels.

RESULTS

The intragroup comparison showed a significant improvement in the EG in the self-perceived low back pelvic pain (P = 0.003) and in the mechanosensitivity in both SIJs (P = 0.001). In the between-group comparison, there was a decrease in pain perception (P = 0.004; F(1,38) = 9.62; R(2) = 0.20) and an increase in the PPT of both SIJs, in the right side (P = 0.001; F(1,38) = 21.29; R(2) = 0.35) and in the left side (P = 0.001; F(1,38) = 20.63; R(2) = 0.35). There were no intergroup differences for catecholamines plasma levels (adrenaline P = 0.123; noradrenaline P = 0.281; dopamine P = 0.173), but there were for serotonin levels (P = 0.045; F(1,38) = 4.296; R(2) = 0.10).

CONCLUSION

The bilateral GPM technique improves in a short term the self-perceived low back pelvic pain, the PPT in both SIJs, and the serotonin levels in women with PD. It shows no significant differences with a sham intervention in catecholamines plasma levels.

Managing dysmenorrhea in young women

Primary dysmenorrhea is one of the most common health problems in women of reproductive age; however, it remains the most underdiagnosed gynecologic condition. This article will increase nurse practitioners' knowledge of primary dysmenorrhea, which is essential for diagnosing, providing evidence-based education and treatment, and enhancing patient quality of life.

[Impact of pro-environmental behavior on dysmenorrhea]

PURPOSE

In this study the impact of pro-environmental behavior, well-being oriented behavior, and use of cloth menstrual pads on dysmenorrhea in Korean female adults was examined according to the theory of reasoned action.

METHODS

A cross-sectional study was conducted with 195 Korean female adults. Data were collected from June to August, 2010 using self-report questionnaires. Data were analyzed using t-test, one-way ANOVA, Pearson correlation coefficients, multiple regression, and logit regression with STATA 10.0.

RESULTS

Pro-environmental behavior explained 48% of well-being oriented behavior. Well-being oriented behavior explained 10% of cloth pad use. Use of cloth pad explained 4% of dysmenorrhea and 5% of menstrual pain. The path through well-being oriented behavior had a significant effect from pro-environmental behavior to cloth pad use.

CONCLUSION

Use of cloth pad was significantly related with well-being oriented behavior, pro-environmental behavior, social influence, dysmenorrhea, and menstrual pain. The results of this study suggest that pro-environmental strategies can help health care providers diminish clients' menstrual symptoms. Nursing intervention can support pro-environmental behavioral strategies.

Attitudes of clinicians at the Canadian Memorial Chiropractic College towards the chiropractic management of non-musculoskeletal conditions

OBJECTIVE

The objective of this study was to determine the attitudes of clinical faculty during the 2009-2010 academic year at the Canadian Memorial Chiropractic College towards the treatment of various non-musculoskeletal disorders.

METHODS

A confidential survey was distributed to the clinical faculty via email. It consisted of several questions polling the demographic of the respondent such as years in clinical practice, and a list of 29 non-musculoskeletal conditions. Clinicians were asked to indicate their opinions on each condition on rating scale ranging from strongly agree to strongly disagree.

RESULTS

Twenty of 22 clinicians responded. The conditions garnering the greatest positive ratings include: asthma, constipation, chronic pelvic pain, dysmenorrhea, infantile colic, and vertigo. The options regarding vertigo and asthma, while demonstrating an overall positive attitude towards the benefits of chiropractic care, were stratified amongst clinicians with varying years in clinical practice.

CONCLUSION

This study suggests clinicians at this college are moderately open towards the chiropractic treatment of some non-musculoskeletal disorders.