Cyclic Perimenstrual Pain and Discomfort and Australian Women's Associated Use of Complementary and Alternative Medicine: A Longitudinal Study

Naturopathic knowledge and approaches to managing endometriosis: a cross-sectional survey of naturopaths with experience in endometriosis care

OBJECTIVES

Endometriosis is a chronic gynaecological disease with varying symptomatology and negative health outcomes. To ensure the best care for women with endometriosis, women require a multidisciplinary team approach. While some women consult with naturopaths for endometriosis, there has been little research on naturopathic knowledge and the naturopathic approach to endometriosis care.

METHODS

This cross-sectional survey recruited naturopaths with experience in menstrual disorders from the Practitioner Research and Collaboration Initiative (PRACI) a Practice-Based Research Network (PBRN). Data collection was conducted via an online self-administrated 62-item questionnaire.

RESULTS

Invitations were sent to 109 naturopaths who self-reported having experience in menstrual disorders, of whom 29 completed the survey (26.6% response rate). Naturopaths perceived endometriosis to be caused by inflammation (n=28, 96.5%) and risk factors associated with familial history (n=26, 89.6%). Many naturopaths aimed at reducing inflammation (n=27, 93.1%) and supporting gastrointestinal function (n=25, 86.2%) in their prescriptions. Naturopaths reported using various healthcare referrals to support women with endometriosis, primarily general practitioners (n=12, 41.3%), acupuncturists/Traditional Chinese Medicine practitioners (n=11, 37.9%), and gynaecologists (n=9, 31%). Naturopaths reported receiving referrals from general practitioners (n=8, 27.5%) and psychologists (n=6, 20.6%).

CONCLUSIONS

Naturopathic knowledge and management of endometriosis targets known problematic areas of endometriosis that can have debilitating effects on women's quality of life. Naturopathic care has the potential to align with important health outcomes for women with endometriosis however, further attention is needed to assess the effectiveness and continue to establish a multidisciplinary approach involving naturopathic care.

Effect of Yoga on Dysmenorrhea in 6th Grade Elementary School Students at Rusunawa Health Center: A Quasi-Experimental Study

BACKGROUND: From 35 elementary school students in Marunda, 23 students (65.7%) had primary dysmenorrhea. Dysmenorrhea can interfere with student learning activities and concentration. Interventions need to be given so that students can increase their productivity and learning achievement. AIM: This study aims to analyze the effect of yoga on dysmenorrhea in 6th grade elementary school students at Rusunawa Health Center. MATERIALS AND METHODS: This study used a quasi-experimental approach with a non-equivalent control group design. The yoga group was given yoga practice for 3 months of the menstrual cycle. The sample consisted of 33 students in the yoga group and 33 students in the control group. Dysmenorrhea pain intensity was measured by Wong Baker Pain Rating Scale. Statistical tests used were Friedman test, Mann–Whitney test, and Ordinal Regression test. RESULTS: There was a significant difference in pain duration and pain intensity of dysmenorrhea in the past 3 months in the yoga group (p < 0.001). There was a significant difference in pain duration and pain intensity of dysmenorrhea between the yoga group and control group on the measurements in the 2nd month (p = 0.009; p < 0.001) and the 3rd month (p < 0.001; p < 0.001). CONCLUSIONS: Yoga had a significant effect in reducing the pain duration and pain intensity of dysmenorrhea in 6th grade elementary school students at Rusunawa Health Center. Midwives can educate elementary school students and young women in the working area of Rusunawa Health Center to use yoga as an alternative therapy to reduce dysmenorrhea.

Integrating Lifestyle Focused Approaches into the Management of Primary Dysmenorrhea: Impact on Quality of Life

OBJECTIVE

This narrative review aims to identify alternative ways to improve the symptoms of primary dysmenorrhea (PD).

BACKGROUND

PD refers to endometrial painful cramps during the premenstrual period. This condition affects a lot of women worldwide and is accompanied with absenteeism and high economic costs, thus, risk-free, and effective therapeutic approaches are needed. Pharmacological agents such as non-steroidal anti-inflammatory drugs (NSAIDs) and oral contraceptive pills (OCPs), which are widely prescribed for these women, demonstrate adequate efficacy in alleviating pain and discomfort. The long natural course of the disease dictates remedies that focus on lifestyle changes and on improvement of Quality-of-Life (QoL) for women suffering with PD.

MATERIALS AND METHODS

Five major search engines, namely MEDLINE, PubMed, EMBASE, and Cochrane Library were searched for articles published prior to October 2020 focused in PD. A total of 74 paper were included.

DISCUSSION

Physical activity, for instance yoga, aromatherapy massage, and other forms of relaxation, vitamins and dietary changes, acupressure and acupuncture,a and some psychological interventions are just few of the proposed health behavior targeted approaches in cases of PD. This review focuses on lifestyle changes and alternative methods that could potentially result in minimizing symptoms of PD and in improving overall QoL for these patients, by providing current scientific evidence on their efficacy.

CONCLUSION

Complementary and alternative medicine practices (CAM) are widely accepted by women. International literature provides controversial scientific evidence, thus further studies need to be conducted in order to prove or disregard their efficacy in cases of PD.

Yoga for menstrual pain in primary dysmenorrhea: A meta-analysis of randomized controlled trials

OBJECTIVES

To assess the overall effect size of the impact of yoga on menstrual pain in primary dysmenorrhea.

METHODS

Randomized controlled trials that were published in the English language until December 2018 in PubMed, EMBASE, Web of Science, and the Cochrane Library electronic databases were searched. The methodologies from 4 trials conducted on 230 participants with primary dysmenorrhea were included in this meta-analysis to compare the effects that performing a yoga program has on menstrual pain (n = 129) to the effects of not performing yoga (n = 101).

RESULTS

The overall effect size of the impact of a yoga program on menstrual pain in primary dysmenorrhea was high with a standardized mean difference of -2.09 (-3.99 to -0.19) (p = 0.031) among the effect sizes of the 4 trials (95% confidence interval).

CONCLUSIONS

Yoga is an effective intervention for alleviating menstrual pain in women with primary dysmenorrhea.

Naturopathic Medicine for the Management of Endometriosis, Dysmenorrhea, and Menorrhagia: A Content Analysis

OBJECTIVES

To explore the recommendations of naturopathic medicine for the management of endometriosis, dysmenorrhea, and menorrhagia, drawing on traditional and contemporary sources.

DESIGN

Content analysis.

SETTING

Australia, Canada, and the United States of America (USA).

SUBJECTS

Contemporary sources were identified from reviewing naturopathic higher education institutions' recommended texts, while traditional sources were identified from libraries which hold collections of naturopathic sources. Sources were included if they were published from 1800 to 2016, were in English, published in Australia, Canada, or the USA, and reported on the topic. Included sources were as follows: 37 traditional texts; 47 contemporary texts; and 83 articles from naturopathic periodicals.

RESULTS

Across included sources, the most reported disciplines were herbal medicine, clinical nutrition, mineral medicines, homeopathy, hydrotherapy, and chemical-based medicines. Herbal medicines were extensively reported from all sources for the management of endometriosis, dysmenorrhea, and menorrhagia. Clinical nutrition was only recommended from contemporary sources for all three conditions. Mineral medicines were mentioned in both traditional and contemporary sources, but were only recommended for dysmenorrhea and menorrhagia. There were limited recommendations for homeopathy and hydrotherapy treatments in all conditions across all sources. Chemical-based medicines were only mentioned for dysmenorrhea and menorrhagia, and recommendations ceased after 1922. Recommendations for endometriosis were not present in any of the traditional sources, across all reported disciplines.

CONCLUSIONS

The findings of this article provide insights into the documented historical and contemporary treatments within naturopathic medicine for endometriosis, dysmenorrhea, and menorrhagia. While philosophical principles remain the core of naturopathic practice, the therapeutic armamentarium appears to have changed over time, and a number of the original naturopathic treatments appear to have been retained as key elements of treatment for these conditions. Such insights into naturopathic treatments will be of particular interest to clinicians providing care to women, educators designing and delivering naturopathic training, and researchers conducting clinical and health service naturopathic research.