Effects of somatothermal far-infrared ray on primary dysmenorrhea: a pilot study

Dysmenorrhea, a Narrative Review of Therapeutic Options

Dysmenorrhea is the most common pathology women of childbearing age face. It is defined as painful uterine cramping associated with menstruation. Primary dysmenorrhea occurs in the absence of an organic cause, whereas secondary dysmenorrhea is pelvic pain associated with an underlying pelvic pathology. The purpose of this review is to discuss the pathophysiology of dysmenorrhea and provide a discussion of pharmacologic and non-pharmacologic treatment options. Prostaglandins play a large role in the pathophysiology of dysmenorrhea by causing myometrial contraction and vasoconstriction. The first-line treatment for dysmenorrhea is with nonsteroidal anti-inflammatory drugs due to the inhibition of cyclooxygenase enzymes, thereby blocking prostaglandin formation, as well as hormonal contraception. Other pharmacologic treatment options include Paracetamol, as well as Gonadotrophic Release Hormone Analogs, which are typically used in the treatment for endometriosis. Non-pharmacologic treatments with strong evidence include heat therapy and physical exercise. There are less evidence-based data behind other modalities for treating dysmenorrhea, such as dietary supplements, acupuncture, and transcutaneous nerve stimulation, and these methods should be used in conjunction with first-line therapy after a discussion of risks and benefits. Lastly, for women who fail medical management, surgical options include endometrial ablation, presacral neurectomy, and laparoscopic uterosacral nerve ablation. Further research is needed to measure the socioeconomic burden of dysmenorrhea on the healthcare system and to evaluate the efficacy of treatment combinations, as a multi-modal approach likely provides the most benefit for women who suffer from this condition.

A Phase 1 randomized, open-label clinical trial to evaluate the effect of a far-infrared emitting patch on local skin perfusion, microcirculation and oxygenation

Far-infrared radiation (FIR) has been investigated for reduction of pain and improvement of dermal blood flow. The FIRTECH patch is a medical device designed to re-emit FIR radiated by the body. This phase 1 study was conducted to evaluate the local effects of the FIRTECH patch on local skin perfusion, microcirculation and oxygenation. This prospective, randomized, open-label, parallel designed study admitted 20 healthy participants to a medical research facility for treatment for 31 h on three anatomical locations. During treatment, imaging assessments consisting of laser speckle contrast imaging, near-infrared spectroscopy, side-stream dark-field microscopy, multispectral imaging and thermography were conducted regularly on patch-treated skin and contralateral non-treated skin. The primary endpoint was baseline perfusion increase during treatment on the upper back. Secondary endpoints included change in baseline perfusion, oxygen consumption and temperature of treated versus untreated areas. The primary endpoint was not statistically significantly different between treated and non-treated areas. The secondary endpoints baseline perfusion on the forearm (least square means [LSMs] difference 2.63 PU, 95% CI: 0.97, 4.28), oxygen consumption (LSMs difference: 0.42 arbitrary units [AUs], 95% CI: 0.04, 0.81) and skin temperature (LSMs difference 0.35°C, 95% CI: 0.16, 0.6) were statistically significantly higher in treated areas. Adverse events observed during the study were mild and transient. The vascular response to the FIRTECH patch was short-lived suggesting a non-thermal vasodilatory effect of the patch. The FIRTECH patch was well tolerated, with mild and transient adverse events observed during the study. These results support the therapeutic potential of FIR in future investigations.

Enhanced far infrared emissivity, UV protection and near-infrared shielding of polypropylene composites via incorporation of natural mineral for functional fabric development

Far infrared radiation in the range of 4-20 µm has been showed to have biological and health benefits to the human body. Therefore, incorporating far-infrared emissivity additives into polymers and/or fabrics hold promise for the development of functional textiles. In this study, we incorporated nine types of natural minerals into polypropylene (PP) film and examined their properties to identify potential candidates for functional textiles and apparels. The addition of 2% mineral powders into PP film increased the far-infrared emissivity (5-14 µm) by 7.65%-14.48%. The improvement in far-infrared emissivity within the range of 5-14 µm, which overlaps with the peak range of human skin radiation at 8-14 µm, results in increased absorption efficiency, and have the potential to enhance thermal and biological effects. Moreover, the incorporation of mineral powders in PP films exhibited favorable ultraviolet (UV) protection and near-infrared (NIR) shielding properties. Two films, specifically those containing red ochre and hematite, demonstrated excellent UV protection with a UPF rating of 50+ and blocked 99.92% and 98.73% of UV radiation, respectively. Additionally, they showed 95.2% and 93.2% NIR shielding properties, compared to 54.1% NIR shielding properties of PP blank films. The UV protection and NIR shielding properties offered additional advantages for the utilization of polymer composite with additives in the development of sportswear and other outdoor garments. The incorporation of minerals could absorb near-IR radiation and re-emit them at longer wavelength in the mid-IR region. Furthermore, the incorporation of minerals significantly improved the heat retention of PP films under same heat radiation treatment. Notably, films with red ochre and hematite exhibited a dramatic temperature increase, reaching 2.5 and 3.2 times the temperature increase of PP films under same heat radiation treatment, respectively (46.8 °C and 59.9 °C higher than the temperature increase of 20.9 °C in the PP film). Films with additives also demonstrated lower thermal effusivity than PP blank films, indicating superior heat insulation properties. Therefore, polypropylene films with mineral additives, particularly those containing red ochre and hematite, showed remarkable heat capacity, UV-protection, NIR-shielding properties and enhanced far infrared emissivity, making them promising candidates for the development of functional textiles.

Dysmenorrhea Heat Therapy Injury in a Post-Abdominoplasty Patient: A Case Report

The anterolateral abdominal wall has rich neurosensory innervation from many sensory nerves, and in abdominoplasty surgical procedures, these nerves are invariably cut, resulting in anesthesia or hypoesthesia in their respective territories. Here we report a 26-year-old healthy female post-abdominoplasty patient who sustained an incidental contact burn injury from a common home remedy for her menstrual pain. Fortunately, the burn healed with secondary intent. Post-surgical loss of protective sensation facilitated this injury from heat therapy for spasmodic dysmenorrhea. Therefore, the patients planned for abdominoplasty should be informed in advance about the possibility of the development of this complication with its associated sequelae and its prevention. Early recognition of this surgical complication and timely intervention will prevent the consequent disfiguring of the rejuvenated abdominal wall.

Clinical monitoring of safety and functionality of a non-medicated patch for pain alleviation associated to dysmenorrhea

FIT® Lady patch is an easy-to-use class I medical device, developed to relieve pain associate to menstrual period, without pharmacological substances. The patch is based on far infrared (FIR) electromagnetic waves reflection properties that normally are emitted from the body, as a consequence of body heat dispersion between the difference of cutaneous body and ambient temperature. Consequently, infrared (IR) waves are reflected and resorbed at cutaneous level and thermal energy again locally introduced leads to a better microcirculation. Although biological IR waves properties and mechanisms of action are extensively studied, there are still few references on patches based on FIR properties. The aim of this study was the evaluation of FIR technology applied to FIT® Lady patch thought to be used to alleviate pain associated to menstrual period (dysmenorrhea). The FIT® Lady patch medical device (active patch) was evaluated in comparison with a placebo patch, in order to assess its action in reducing pain related to menstrual period in 40 women patients enrolled according to specific inclusion/exclusion criteria. This study confirmed a good tolerability of the product, by demonstrating the ability to significantly reduce inconvenience and feeling of pain. The mineral that was responsible of the reflection activity (titanium dioxide), conveniently entrapped in a patch, was able to work without any active substances in contact with and absorbed from the skin. (www.actabiomedica.it)

Heat therapy for primary dysmenorrhea: A systematic review and meta-analysis of its effects on pain relief and quality of life

Primary dysmenorrhea, which is menstrual pain without pelvic pathology, is the most common gynecologic condition in women. Heat therapy has been used as a treatment. We assessed the evidence on heat therapy as a treatment for primary dysmenorrhea. We searched 11 databases for studies published through July 2018. All randomized controlled trials (RCTs) that addressed heat therapy for patients with primary dysmenorrhea were included. Data extraction and risk-of-bias assessments were performed by two independent reviewers. Risk of bias was assessed using the Cochrane risk-of-bias tool. Six RCTs met our inclusion criteria. Two RCTs found favorable effects of heat therapy on menstrual pain compared with unheated placebo therapy. Three RCTs found favorable effects of heating pads on menstrual pain compared with analgesic medication (n = 274; SMD −0.72; 95% confidence interval −0.97 to −0.48; P < 0.001; two studies). One RCT showed beneficial effects of heat therapy on menstrual pain compared with no treatment (n = 132; MD −4.04 VAS; 95% CI −4.88 to −3.20; P < 0.001). However, these results are based on relatively few trials with small sample sizes. Our review provided suggestive evidence of the effectiveness of heat therapy for primary dysmenorrhea, but rigorous high-quality trials are still needed to provide robust evidence.

Far infrared-emitting ceramics decrease Freund's adjuvant-induced inflammatory hyperalgesia in mice through cytokine modulation and activation of peripheral inhibitory neuroreceptors

OBJECTIVE

The present study aimed to evaluate the analgesic and anti-inflammatory effects of far infrared-emitting ceramics (cFIRs) in a model of persistent inflammatory hyperalgesia and to elucidate the possible mechanisms of these effects.

METHODS

Mice were injected with complete Freund's adjuvant (CFA) and treated with cFIRs via placement on a pad impregnated with cFIRs on the bottom of the housing unit for different periods of time. Mice underwent mechanical hyperalgesia and edema assessments, and tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and IL-10 levels were measured. Twenty-four hours after CFA injection and 30 min before cFIR treatment, mice were pretreated with a nonselective adenosinergic antagonist, caffeine, the selective adenosine receptor A₁ antagonist, 1,3-dipropyl-8-cyclopentylxanthine (DPCPX), the selective cannabinoid receptor type 1 antagonist, AM281, the selective cannabinoid receptor type 2 antagonist, AM630, or the nonselective opioid receptor antagonist, naloxone, and mechanical hyperalgesia was assessed.

RESULTS

cFIRs statistically (P < 0.05) decreased CFA-induced mechanical hyperalgesia ((82.86 ± 5.21)% in control group vs (56.67 ± 9.54)% in cFIR group) and edema ((1699.0 ± 77.8) μm in control group vs (988.7 ± 107.6) μm in cFIR group). cFIRs statistically (P < 0.05) reduced TNF-α ((0.478 ± 0.072) pg/mg of protein in control group vs (0.273 ± 0.055) pg/mg of protein in cFIR group) and IL-1β ((95.81 ± 3.95) pg/mg of protein in control group vs (80.61 ± 4.71) pg/mg of protein in cFIR group) levels and statistically (P < 0.05) increased IL-10 ((18.32 ± 0.78) pg/mg of protein in control group vs (25.89 ± 1.23) pg/mg of protein in cFIR group) levels in post-CFA-injected paws. Peripheral pre-administration of inhibitory neuroreceptor antagonists (caffeine, DPCPX, AM281, AM630 and naloxone) prevented the analgesic effects of cFIRs (P < 0.05).

CONCLUSION

These data provide additional support for the use of cFIRs in the treatment of painful inflammatory conditions and contribute to our understanding of the neurobiological mechanisms of the therapeutic effects of cFIRs.

Randomized Controlled Trial Comparing the Effects of Far-Infrared Emitting Ceramic Fabric Shirts and Control Polyester Shirts on Transcutaneous PO2

Our aim was to confirm earlier studies showing tcPO₂ to be higher under clothing made with polyethylene terephalate (PET) fabric containing ceramic particles (CEL) compared to standard PET fabric. In previous studies PET garments were donned first to avoid possible persistent effects from ceramic particles. This study randomized donning sequence to avoid bias.

Effect of near-infrared rays on female menstrual pain in Korea

Most Korean women who experience menstrual pain have reported taking pain medicine and making use of complementary alternative therapies. However, because some interventions may cause side effects, more effective pain-relieving measures need to be identified. This study using a non-equivalent group design, evaluated the effects of near-infrared rays on dysmenorrhea among Korean women. The experimental group wore a near-infrared ray abdominal belt for the duration of one menstrual cycle until the end of the menstrual period, while the control group used hot packs. The level of menstrual pain, menstrual pain duration, and pain medicine use were measured. The menstrual pain, average menstrual pain duration, and use of analgesics were reduced in the near-infrared rays group. The results of this study indicate that the near-infrared ray LED belt was effective in reducing menstrual pain, menstrual pain duration compared to the use of analgesics in Korean women with dysmenorrhea. Therefore, near-infrared rays may be used to relieve menstrual pain and improve the quality of life of women with dysmenorrhea in Korea.

Comparison of abdominal skin temperature between fertile and infertile women by infrared thermography: A diagnostic approach

This retrospective study aimed to evaluate the differences in abdominal temperature (AT) between fertile (n=206; age) and infertile (n=250) women between the ages of 30 and 39 years. We evaluated the differences in two distinctive skin temperatures by thermography: ΔT₁ (CV8 index) - difference in temperature between the mid-abdomen (CV8 acupuncture area) and ventral upper arm (VUA) and ΔT₂ (CV4 index) - difference in temperature between the lower abdomen (CV4 acupuncture area) and VUA. The results indicated that the ΔT₁ and ΔT₂ of infertile women were significantly lower (by 1.05°C and 0.79°C, respectively; p<0.001, both) compared to those of fertile women. Additionally, the area under the curve of ΔT₁ (0.78) was greater compared to that of ΔT₂ (0.736), and its threshold was set at 0.675°C, by which, the sensitivity and specificity of ΔT₁ for determination of fertility were found to be 80.8% and 68.4%, respectively. In conclusion, infertility is associated with lower AT. The decrease in AT in infertile women might be due to poor blood perfusion to the core muscles and tissues of the body. These findings provide a basis for further research for evaluation of clinical feasibility of thermography for analysis of infertility in women. Further evaluation of the influence of AT on fertility outcomes is required to determine the causal relationship between AT and infertility.

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.

TENS and heat therapy for pain relief and quality of life improvement in individuals with primary dysmenorrhea: A systematic review

The present systematic review aimed to synthesize evidence for the effectiveness of TENS and heat therapy interventions from randomized trials. Six relevant databases were searched for studies on TENS and heat therapy for primary dysmenorrhea. Menstrual pain intensity and quality of life were the primary and secondary outcomes respectively. The search yielded 46 citations from which six studies on TENS and three studies on heat therapy were systematically reviewed. On the PEDRO quality scale, the trials methodological quality was 4.8 out of 10 for TENS and 6.3 out of 10 for heat therapy. TENS and heat therapy both showed evidence of pain reduction, but no study included quality of life as an outcome. Meta-analysis was not possible due to substantial heterogeneity in included studies. TENS and heat therapy show potential as adjunct remedies in the management of primary dysmenorrhea, but rigorous high quality trials are still needed to made conclusive recommendation.

A Parallel-Arm Randomized Controlled Trial to Assess the Effects of a Far-Infrared-Emitting Collar on Neck Disorder

The purpose of this study is to assess the beneficial effects of a far-infrared-emitting collar (FIRC) on the management of neck disorders. A neck disorder is generalized as neck muscle pain and its relative mental disorders because the etiologies of the neck's multidimensional syndrome are either muscle impairment or psychiatric distress. This is the first study to determine the efficacy of a FIRC by evaluating objective physical evidence and psychometric self-reports using a parallel-arm randomized sham-controlled and single-blinded design. In this trial, 60 participants with neck disorders were observed at baseline and post-intervention. Compared to the placebo group after a 30-min intervention, the FIRC demonstrated a statistically significant biological effect in elevating skin temperature and promoting blood circulation with p-values 0.003 and 0.020, respectively. In addition, FIRC application significantly reduced neck muscle tension, relieved pain, ameliorated fatigue, improved depression, and decreased anxiety. The FIRC could therefore be a potential treatment for neck disorders.