Stretching Exercises vs. Mefenamic acid in Reducing Pain and Menstruation Characteristics in Primary Dysmenorrhea

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Stretching Exercises vs. Mefenamic acid in Reducing Pain and Menstruation Characteristics in Primary Dysmenorrhea
Key Take-Away: 

The results of the study showed that the stretching exercises were as useful as the Mefenamic acid in treating dysmenorrhea and effect of exercise on relieving menstrual pain increases over time.

The term dysmenorrhea implies to painful cramps and heavy menstrual flow, experienced by most of the women during their menstrual cycle. Pain results in when the uterine pressure produced by the cramps becomes more than 60 mmHg.

ABSTRACT: 
Background: 

The term dysmenorrhea implies to painful cramps and heavy menstrual flow, experienced by most of the women during their menstrual cycle. Pain results in when the uterine pressure produced by the cramps becomes more than 60 mmHg. The pain is usually felt in the suprapubic area which may radiate to legs and lower back. 40-50% women are reported to be affected by this common health problem. It is also one of the reasons for absenteeism from school as well as work. It considerably affects the quality of life of an individual and even the family. Women facing this health issue always look for self-care strategies.

Few studies have suggested that an increase or imbalance in prostaglandins leads to dysmenorrhea. Therefore, NSAIDs are the first line treatment option. The anti-inflammatory and pain-relieving effects of NSAIDs are due to the inhibition of COX and reduction in menstrual blood volume. The efficacy of NSAIDs in treating dysmenorrhea has been established by a recent review of 73 randomized controlled trials, but they offer numerous side effects like GI problems and skin reactions. Due to the occurrence of these side effects, physical activity and exercise are gaining importance as a treatment approach to alleviate dysmenorrhea.

Two randomized clinical trials revealed that stretching exercises were highly efficacious in decreasing the intensity of pain in dysmenorrhea. Also, in one of the 2010 literature reviews, it was confirmed that exercise reduces the symptoms associated with dysmenorrhea.

Rationale behind research

  • There is lack of data comparing the effectiveness of exercise and NSAIDs in the treatment of dysmenorrhea and its outcomes. Also, there are few arguments on the efficacy of exercise on dysmenorrhea, which may be due to the different exercise regimen.
  • Therefore, this study was conducted to compare the effect of stretching exercises and Mefenamic acid use on the reduction of pain and other outcomes like menstruation characteristics in primary dysmenorrhea.

Objective

This study aimed to compare the effectiveness of stretching exercises and Mefenamic acid in reducing pain and menstruation characteristics in primary dysmenorrhea

Methods: 

 

Study outcomes

  • Pain Intensity: Intensity of pain was measured using a 10 cm visual analog scale (VAS). The VAS is defined by descriptive words of “no pain” (score of 0) and “very severe pain” (score of 10).

Time Points: Baseline and at the end of first & second menstrual cycles

Results: 

 

Outcomes

Baseline characteristics: The baseline demographic differences between two groups were not statistically significant.

Primary Outcomes:

  • Pain intensity: The mean pain intensity in the exercise group was significantly higher than the Mefenamic acid group in the first cycle after the intervention. Pain intensity was significantly different between the groups in the second cycle as the mean difference between baseline and the first cycle was higher in the exercise group compared to the Mefenamic acid group. Chi-square analysis revealed that the severity of dysmenorrhea and pain duration had no significant difference between the groups during the study

Figure1: Comparison of pain between the Mefenamic acid and exercise group at baseline, first cycle and the second cycle.

  • In the exercise group, length of menstruation in the first and second cycle was longer while there was no considerable difference in the bleeding changes between groups
Conclusion: 

The results of the study showed that despite the decrease in pain in the first month after beginning the treatment in both groups, the mean pain in the exercise group was more than the Mefenamic acid group.  The drop in the intensity of pain in both groups continued, and the mean pain in the exercise group was significantly lower than the Mefenamic acid group.

One of the studies by Abbaspour et al. found that exercise decreases the intensity of dysmenorrhea and sedative use after three and four cycles in high school students. Shahr-jerdy et al., using the same exercise protocol reported the reduction of pain intensity and sedative use after eight weeks. Another study found that after 12 weeks of water exercise, the duration and intensity of pain dropped. All the above findings suggest that the effect of exercise on dysmenorrhea appears over time, but the quality, intensity, and duration of exercise can affect the results.

Oman Medical Journal [2017], Vol. 32, No. 1: 47–53
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