A randomized controlled parallel-group study was conducted with the objective of assessing the comparative efficacy of pharmacological treatment (PT) versus nonpharmacological treatment (NPT) for managing primary dysmenorrhea in women. The study sought to identify the most efficient approach for treating this condition.

A total of 85 volunteers with primary dysmenorrhea were enrolled in the study and randomized to 5 groups as follows: two groups received PT (Naproxen sodium [NS] and micronized purified flavonoid fraction [MPFF]), two groups underwent NPT (motor imagery-focused pelvic floor exercise ][MOPEXE] and acupressure), and a fifth group served as a control with no treatment.

The initial assessment was conducted on the first day of the menstrual cycle for all participants. After completing three menstrual cycles, a final evaluation was done by both a specialized physiotherapist and an obstetrician. Menstrual behaviors and attitudes were evaluated using the Menstruation Attitude Questionnaire (MAQ), while pain intensity and characteristics were assessed using the Short-Form McGill Pain Questionnaire (SF-MPQ).

In terms of total pain dimension scores, which combine the affective and sensory dimensions of pain, the largest difference between pre- and post-treatment scores was observed in the mean total pain dimension. Specifically, the greatest difference was found in the MOPEXE group (15.12 ± 4.44), followed by the MPFF group (7.53 ± 6.8). The acupressure group (7.47 ± 5.28) and the NS group (4.47 ± 4.91) also exhibited more significant changes compared to the control group.

When considering the mean difference in visual analog scale (VAS) scores, the greatest change was observed in the MOPEXE group (4.53 ± 1.5), followed by the acupressure group (2.35 ± 1.66). The MPFF group (1.88 ± 1.73) and the NS group (1.65 ± 1.84) also demonstrated more profound changes in VAS scores compared to the control group. In terms of overall pain intensity, the greatest score was observed in the MOPEXE group (2.59 ± 0.94), followed by the MPFF group (1.18 ± 0.88).

The acupressure group (1.06 ± 0.83) and the NS group (0.82 ± 1.01) also displayed more significant scores in comparison with the control group. However, there were no noteworthy variations in the pre-post difference values for the subparameters of the MAQ. Specifically, parameters such as perceiving menstruation as a deliberate event, finding menstruation bothersome, viewing menstruation as a natural event, anticipating and predicting the menstruation onset, and denying any effects of menstruation all resulted in insignificant alterations.

Both PT and NPT approaches effectively diminished pain associated with primary dysmenorrhea. Notably, MPFF demonstrated greater efficacy in alleviating pain compared to the NS group. Furthermore, when it comes to pain relief, both the MOPEXE and acupressure groups were on par with the PT. Among these treatment methods, the most effective was the MOPEXE group, which was specifically developed by the researcher.