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

Orestis Tsonis, Fani Gkrozou, Zoi Barmpalia, Annamaria Makopoulou, Vassiliki Siafaka, Orestis Tsonis, Fani Gkrozou, Zoi Barmpalia, Annamaria Makopoulou, Vassiliki Siafaka

Abstract

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.

Keywords: complementary and alternative medicine; pain relief; primary dysmenorrhea; quality-of-life; therapy.

Conflict of interest statement

All authors declare no conflicts of interest nor funding of any kind.

© 2021 Tsonis et al.

Figures

Figure 1
Figure 1
Benefits of lifestyle targeted approaches on the management of PD.
Figure 2
Figure 2
Integrating lifestyle focused approaches into the management of PD.

References

    1. Hu Z, Tang L, Chen L, Kaminga AC, Xu H. Prevalence and risk factors associated with primary dysmenorrhea among Chinese female university students: a cross-sectional study. J Pediatr Adolesc Gynecol. 2020;33(1):15–22. doi:10.1016/j.jpag.2019.09.004
    1. Fisher C, Sibbritt D, Hickman L, Adams J. A critical review of complementary and alternative medicine use by women with cyclic perimenstrual pain and discomfort: a focus upon prevalence, patterns and applications of use and users’ motivations, information seeking and self-perceived efficacy. Acta Obstet Gynecol Scand. 2016;95(8):861–871. doi:10.1111/aogs.12921
    1. Sharghi M, Mansurkhani SM, Ashtary-Larky D, et al. An update and systematic review on the treatment of primary dysmenorrhea. J Bras Reprod Assist. 2019;23(1):51–57. doi:10.5935/1518-0557.20180083
    1. Fernández-Martínez E, Onieva-Zafra MD, Laura Parra-Fernández M. Lifestyle and prevalence of dysmenorrhea among Spanish female university students. PLoS One. 2018;13(8):1–11. doi:10.1371/journal.pone.0201894
    1. Lippke S, Ziegelmann JP. Theory-based health behavior change: developing, testing, and applying theories for evidence-based interventions. Appl Psychol. 2008;57(4):698–716. doi:10.1111/j.1464-0597.2008.00339.x
    1. Fisher C, Adams J, Hickman L, Sibbritt D. The use of complementary and alternative medicine by 7427 Australian women with cyclic perimenstrual pain and discomfort: a cross-sectional study. BMC Complement Altern Med. 2016;16(1):1–11. doi:10.1186/s12906-016-1119-8
    1. De Franciscis P, Colacurci N, Riemma G, et al. A nutraceutical approach to menopausal complaints. Medicina. 2019;55(9):544. doi:10.3390/medicina55090544
    1. Fisher C, Hickman L, Adams J, Sibbritt D. Cyclic perimenstrual pain and discomfort and Australian women’s associated use of complementary and alternative medicine: a longitudinal study. J Womens Health. 2018;27(1):40–50. doi:10.1089/jwh.2016.6253
    1. Dias SFL, Pereira LCA. Scientific and technological prospection on transdermal formulations and complementary therapies for the treatment of primary dysmenorrhea. Expert Opin Ther Pat. 2019;29(2):115–126. doi:10.1080/13543776.2019.1562547
    1. Doğan H, Eroğlu S, Akbayrak T. The effect of kinesio taping and lifestyle changes on pain, body awareness and quality of life in primary dysmenorrhea. Complement Ther Clin Pract. 2020;39:101120. doi:10.1016/j.ctcp.2020.101120
    1. Chen L, Tang L, Guo S, Kaminga AC, Xu H. Primary dysmenorrhea and self-care strategies among Chinese college girls: a cross-sectional study. BMJ Open. 2019;9(9):e026813. doi:10.1136/bmjopen-2018-026813
    1. Pattanittum P, Kunyanone N, Brown J, et al. Dietary supplements for dysmenorrhoea. Cochrane Database Syst Rev. 2016;2016(3). doi:10.1002/14651858.CD002124.pub2
    1. Kim SD. Yoga for menstrual pain in primary dysmenorrhea: a meta-analysis of randomized controlled trials. Complement Ther Clin Pract. 2019;36(February):94–99. doi:10.1016/j.ctcp.2019.06.006
    1. Rakhshaee Z. Effect of three yoga poses (cobra, cat and fish poses) in women with primary dysmenorrhea: a randomized clinical trial. J Pediatr Adolesc Gynecol. 2011;24(4):192–196. doi:10.1016/j.jpag.2011.01.059
    1. McGovern CE, Cheung C. Yoga and quality of life in women with primary dysmenorrhea: a systematic review. J Midwifery Womens Health. 2018;63(4):470–482. doi:10.1111/jmwh.12729
    1. Fernández-Martínez E, Onieva-Zafra MD, Parra-Fernández ML. The impact of dysmenorrhea on quality of life among Spanish female university students. Int J Environ Res Public Health. 2019;16(5):713. doi:10.3390/ijerph16050713
    1. Azima S, Bakhshayesh HR, Kaviani M, Abbasnia K, Sayadi M. Comparison of the effect of massage therapy and isometric exercises on primary dysmenorrhea: a randomized controlled clinical trial. J Pediatr Adolesc Gynecol. 2015;28(6):486–491. doi:10.1016/j.jpag.2015.02.003
    1. Ortiz MI, Cortés-Márquez SK, Romero-Quezada LC, Murguía-Cánovas G, Jaramillo-Díaz AP. Effect of a physiotherapy program in women with primary dysmenorrhea. Eur J Obstet Gynecol Reprod Biol. 2015;194:24–29. doi:10.1016/j.ejogrb.2015.08.008
    1. Armour M, Sinclair J, Chalmers KJ, Smith CA. Self-management strategies amongst Australian women with endometriosis: a national online survey. BMC Complement Altern Med. 2019;19(1). doi:10.1186/s12906-019-2431-x
    1. Sultana A, Lamatunoor S, Begum M, Qhuddsia QN. Management of Usr-i-Tamth (menstrual pain) in unani (greco-islamic) medicine. J Evid Based Complement Alternat Med. 2017;22(2):284–293. doi:10.1177/2156587215623637
    1. Pellow J, Nienhuis C. Medicinal plants for primary dysmenorrhoea: a systematic review. Complement Ther Med. 2018;37(November2017):13–26. doi:10.1016/j.ctim.2018.01.001
    1. Abdollahi NG, Mirghafourvand M, Mollazadeh S. The effects of fennel on menstrual bleeding: a systematic review and meta-analysis. J Complement Integr Med. 2018;15(3):1–13. doi:10.1515/jcim-2017-0154
    1. Hashemi SA, Azadeh S, Nouri BM, Navai RA. Review of pharmacological effects of Zataria multiflora Boiss. (thyme of Shiraz). Int J Med Sci Public Health. 2017;6(8):78–84.
    1. Iravani M. Clinical effects of Zataria multiflora essential oil on primary dysmenorrhea. J Med Plants. 2009;8(30). doi:10.1016/s1550-8579(06)80120-8
    1. Shirvani MA, Motahari-Tabari N, Alipour A. The effect of mefenamic acid and ginger on pain relief in primary dysmenorrhea: a randomized clinical trial. Arch Gynecol Obstet. 2015;291(6):1277–1281. doi:10.1007/s00404-014-3548-2
    1. Jahangirifar M, Taebi M, Dolatian M. The effect of Cinnamon on primary dysmenorrhea: a randomized, double-blind clinical trial. Complement Ther Clin Pract. 2018;33(June):56–60. doi:10.1016/j.ctcp.2018.08.001
    1. Raisi Dehkordi Z, Hosseini Baharanchi FS, Bekhradi R. Effect of lavender inhalation on the symptoms of primary dysmenorrhea and the amount of menstrual bleeding: a randomized clinical trial. Complement Ther Med. 2014;22(2):212–219. doi:10.1016/j.ctim.2013.12.011
    1. Pio IDSL, Lavor AL, Damasceno CMD, Menezes PMN, Silva FS, Maia GLA. Traditional knowledge and uses of medicinal plants by the inhabitants of the islands of the são francisco river, Brazil and preliminary analysis of rhaphiodon echinus (Lamiaceae). Braz J Biol. 2019;79(1):87–99. doi:10.1590/1519-6984.177447
    1. Ghasemzadeh Rahbardar M, Amin B, Mehri S, Mirnajafi-Zadeh SJ, Hosseinzadeh H. Anti-inflammatory effects of ethanolic extract of rosmarinus officinalis L. and rosmarinic acid in a rat model of neuropathic pain. Biomed Pharmacother. 2017;86:441–449. doi:10.1016/j.biopha.2016.12.049
    1. He X, Wang X, Fang J, et al. The genus achyranthes: a review on traditional uses, phytochemistry, and pharmacological activities. J Ethnopharmacol. 2017;203:260–278. doi:10.1016/j.jep.2017.03.035
    1. Jan S, Khan MR. Antipyretic, analgesic and anti-inflammatory effects of kickxia ramosissima. J Ethnopharmacol. 2016;182:90–100. doi:10.1016/j.jep.2016.02.020
    1. Lee H, Choi TY, Myung CS, Lee JA, Lee MS. Herbal medicine (Shaofu Zhuyu decoction) for treating primary dysmenorrhea: a systematic review of randomized clinical trials. Maturitas. 2016;86:64–73. doi:10.1016/j.maturitas.2016.01.012
    1. Moteetee A, Seleteng Kose L. Medicinal plants used in lesotho for treatment of reproductive and post reproductive problems. J Ethnopharmacol. 2016;194:827–849. doi:10.1016/j.jep.2016.10.062
    1. Gao L, Jia C, Zhang H, Ma C. Wenjing decoction (herbal medicine) for the treatment of primary dysmenorrhea: a systematic review and meta-analysis. Arch Gynecol Obstet. 2017;296(4):679–689. doi:10.1007/s00404-017-4485-7
    1. Jesuíno FW, Reis JP, Whitaker JCP. Effect of synadenium grantii and its isolated compound on dysmenorrhea behavior model in mice. Inflammopharmacology. 2019;27(3):613–620. doi:10.1007/s10787-018-0501-1
    1. Seo J, Lee H, Lee D, Jo H-G. Dangguijagyag-san for primary dysmenorrhea. Medicine (Baltimore). 2020;99(42):e22761. doi:10.1097/md.0000000000022761
    1. Barassi G, Bellomo RG, Porreca A, Di Felice PA, Prosperi L, Saggini R. Somato-visceral effects in the treatment of dysmenorrhea: neuromuscular manual therapy and standard pharmacological treatment. J Altern Complement Med. 2018;24(3):291–299. doi:10.1089/acm.2017.0182
    1. Cha NH, Sok SR. Effects of auricular acupressure therapy on primary dysmenorrhea for female high school students in South Korea. J Nurs Scholarsh. 2016;48(5):508–516. doi:10.1111/jnu.12238
    1. Abaraogu UO, Igwe SE, Tabansi-Ochiogu CS. Effectiveness of SP6 (Sanyinjiao) acupressure for relief of primary dysmenorrhea symptoms: a systematic review with meta- and sensitivity analyses. Complement Ther Clin Pract. 2016;25:92–105. doi:10.1016/j.ctcp.2016.09.003
    1. Zhao MY, Zhang P, Li J, et al. Influence of de qi on the immediate analgesic effect of SP6 acupuncture in patients with primary dysmenorrhoea and cold and dampness stagnation: a multicentre randomised controlled trial. Acupunct Med. 2017;35(5):332–338. doi:10.1136/acupmed-2016-011228
    1. Blödt S, Pach D, Eisenhart-Rothe SV. Effectiveness of app-based self-acupressure for women with menstrual pain compared to usual care: a randomized pragmatic trial. Am J Obstet Gynecol. 2018;218(2):227.e1–227.e9. doi:10.1016/j.ajog.2017.11.570
    1. Zhai SJ, Ruan Y, Liu Y, et al. Time-effective analgesic effect of acupressure ankle strip pressing wrist and ankle acupuncture point on primary dysmenorrhea: study protocol clinical trial (SPIRIT compliant). Med. 2020;99:12. doi:10.1097/MD.0000000000019496
    1. Abaraogu UO, Igwe SE, Tabansi-Ochiogu CS, Duru DO. A systematic review and meta-analysis of the efficacy of manipulative therapy in women with primary dysmenorrhea. Explore. 2017;13(6):386–392. doi:10.1016/j.explore.2017.08.001
    1. Özgül S, Üzelpasaci E, Orhan C, Baran E, Beksaç MS, Akbayrak T. Short-term effects of connective tissue manipulation in women with primary dysmenorrhea: a randomized controlled trial. Complement Ther Clin Pract. 2018;33:1–6. doi:10.1016/j.ctcp.2018.07.007
    1. Demirtürk F, Yilar Erkek Z, Alparslan Ö, Demirtürk F, Demir O, Inanir A. Comparison of reflexology and connective tissue manipulation in participants with primary dysmenorrhea. J Altern Complement Med. 2016;22(1):38–44. doi:10.1089/acm.2015.0050
    1. Ruffini N, D’Alessandro G, Cardinali L, Frondaroli F, Cerritelli F. Osteopathic manipulative treatment in gynecology and obstetrics: a systematic review. Complement Ther Med. 2016;26:72–78. doi:10.1016/j.ctim.2016.03.005
    1. Smith CA, Armour M, Zhu X, Li X, Lu ZY, Song J. Acupuncture for dysmenorrhoea. Cochrane Database Syst Rev. 2016;2016(4). doi:10.1002/14651858.CD007854.pub3
    1. Shetty GB, Shetty B, Mooventhan A. Efficacy of acupuncture in the management of primary dysmenorrhea: a randomized controlled trial. J Acupunct Meridian Stud. 2018;11(4):153–158. doi:10.1016/j.jams.2018.04.001
    1. French L. Dysmenorrhea. Am Fam Physician. 2005;71(2):285–292.
    1. Gaubeca-Gilarranz A, Fernández-De-Las-Peñas C, Medina-Torres JR, et al. Effectiveness of dry needling of rectus abdominis trigger points for the treatment of primary dysmenorrhoea: a randomised parallel-group trial. Acupunct Med. 2018;36(5):302–310. doi:10.1136/acupmed-2017-011566
    1. Armour M, Dahlen HG, Zhu X, Farquhar C, Smith CA. The role of treatment timing and mode of stimulation in the treatment of primary dysmenorrhea with acupuncture: an exploratory randomised controlled trial. PLoS One. 2017;12(7):1–20. doi:10.1371/journal.pone.0180177
    1. Armour M, Smith CA. Treating primary dysmenorrhoea with acupuncture: a narrative review of the relationship between acupuncture “dose” and menstrual pain outcomes. Acupunct Med. 2016;34(6):416–424. doi:10.1136/acupmed-2016-011110
    1. Wang H, Cao Y, Jin X, et al. Effect of an acupuncture technique of penetrating through zhibian (BL54) to shuidao (ST28) with long needle for pain relief in patients with primary dysmenorrhea: a randomized controlled trial. Pain Res Manag. 2019;2019:1–6. doi:10.1155/2019/7978180
    1. Sut N, Kahyaoglu-Sut H. Effect of aromatherapy massage on pain in primary dysmenorrhea: a meta-analysis. Complement Ther Clin Pract. 2017;27:5–10. doi:10.1016/j.ctcp.2017.01.001
    1. Uysal M, Doğru HY, Sapmaz E, et al. Investigating the effect of rose essential oil in patients with primary dysmenorrhea. Complement Ther Clin Pract. 2016;24:45–49. doi:10.1016/j.ctcp.2016.05.002
    1. Song J-A, Lee M-K, Min E, Kim M-E, Fike G, Hur M-H. Effects of aromatherapy on dysmenorrhea: a systematic review and meta-analysis. Int J Nurs Stud. 2018;84:1–11. doi:10.1016/j.ijnurstu.2018.01.016
    1. Charandabi SMA, Biglu MH, Rad KY. Effect of homeopathy on pain intensity and quality of life of students with primary dysmenorrhea: a randomized controlled trial. Iran Red Crescent Med J. 2016;18(9):1–8. doi:10.5812/ircmj.30902
    1. Reid R, Steel A, Wardle J, Adams J. Naturopathic medicine for the management of endometriosis, dysmenorrhea, and menorrhagia: a content analysis. J Altern Complement Med. 2019;25(2):202–226. doi:10.1089/acm.2018.0305
    1. Navvabi Rigi S, Kermansaravi F, Navidian A, et al. Comparing the analgesic effect of heat patch containing iron chip and ibuprofen for primary dysmenorrhea: a randomized controlled trial. BMC Womens Health. 2012;12(1):25. doi:10.1186/1472-6874-12-25
    1. Shin Y Il, Kim NG, Park KJ, Kim DW, Hong GY, Shin BC. Skin adhesive low-level light therapy for dysmenorrhoea: a randomized, double-blind, placebo-controlled, pilot trial. Arch Gynecol Obstet. 2012;286(4):947–952. doi:10.1007/s00404-012-2380-9
    1. Lee JM, Kim KH. Effect of near-infrared rays on female menstrual pain in Korea. Nurs Health Sci. 2017;19(3):366–372. doi:10.1111/nhs.12356
    1. Abubakar U, Zulkarnain AI, Samri F, Hisham SR, Alias A, Ishak M. CAM and dysmenorrhoea in Malaysia undergraduates. BMC Complement Altern Med. 2020;4:1–8.
    1. Pakpour AH, Kazemi F, Alimoradi Z, Griffiths MD. Depression, anxiety, stress, and dysmenorrhea: a protocol for a systematic review. Syst Rev. 2020;9(1):65. doi:10.1186/s13643-020-01319-4
    1. Bajalan Z, Moafi F, MoradiBaglooei M, Alimoradi Z. Mental health and primary dysmenorrhea: a systematic review. J Psychosom Obstet Gynaecol. 2018;1–10. doi:10.1080/0167482X.2018.1470619
    1. Rodrigues AC, Gala S, Neves Â, et al. Dysmenorrhea in adolescents and young adults: prevalence, related factors and limitations in daily living. Acta Med Port. 2011;24(Suppl 2):383–392.
    1. Payne LA, Rapkin AJ, Lung KC, Seidman LC, Zeltzer LK, Tsao JCI. Pain catastrophizing predicts menstrual pain ratings in adolescent girls with chronic pain. Pain Med. 2016;17(1):16–24. doi:10.1111/pme.12869
    1. Walsh TM, LeBlanc L, McGrath PJ. Menstrual pain intensity, coping, and disability: the role of pain catastrophizing. Pain Med. 2003;4(4):352–361. doi:10.1111/j.1526-4637.2003.03039.x
    1. Mellegård M, Grossi G, Soares JJF. A comparative study of coping among women with fibromyalgia, neck/shoulder and back pain. Int J Behav Med. 2001;8(2):103–115. doi:10.1207/S15327558IJBM0802_02
    1. Keefe FJ, Lumley M, Anderson T, Lynch T, Carson KL. Pain and emotion: new research directions. J Clin Psychol. 2001;57(4):587–607. doi:10.1002/jclp.1030
    1. Yilmaz B, Sahin N. The effects of a dysmenorrhea support program on university students who had primary dysmenorrhea: a randomized controlled study. J Pediatr Adolesc Gynecol. 2020;33(3):285–290. doi:10.1016/j.jpag.2019.12.008
    1. Proctor M, Murphy PA, Pattison HM, Suckling J, Farquhar CM. Behavioural interventions for primary and secondary dysmenorrhoea. Cochrane Database Syst Rev. 2007;2007(3). doi:10.1002/14651858.CD002248.pub3
    1. Stones RW, Mountfield J. Interventions for treating chronic pelvic pain in women. Cochrane Database Syst Rev. 2000;(4):CD000387. doi:10.1002/14651858.CD000387
    1. De Sanctis V, Soliman A, Bernasconi S, et al. Primary dysmenorrhea in adolescents: prevalence, impact and recent knowledge. Pediatr Endocrinol Rev. 2015;13(2):512–520.
    1. Dalpiaz O, Kerschbaumer A, Mitterberger M, Pinggera G, Bartsch G, Strasser H. Chronic pelvic pain in women: still a challenge. BJU Int. 2008;102(9):1061–1065. doi:10.1111/j.1464-410X.2008.07771.xsssssss

Source: PubMed

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