Sir,We have recently read the paper by Fisher et al.(1) evaluating the complementary and alternative medicine use by women with cyclic perimenstrual pain and discomfort.In their review, the authors have reported that cyclic perimenstrual pain and discomfort was widely experienced by women across cultures, and that the papers they reviewed clearly showed women used complementary and alternative medicine to treat a wide range of cyclic perimenstrual pain and discomfort.We were surprised to see that although they have mentioned almost all of the popular complementary and alternative medical approaches througout the world, such as vitamin/mineral supplements, evening primrose oil, herbal teas, acupuncture, massage, mind body therapies, yoga and meditation, they have not mentioned local heat applications as a remedy for especially cyclic perimenstrual pain.Hosono et al.(2) mentioned that warming the abdomen/ lumbar region is a well-known non-pharmacological remedy for dysmenorrhea which often has been recommended by mothers to their daughters, and hot baths and heating pads for pain relief have been used widely by teenagers, as much as 75 and 50%, respectively.Similarly, Potur and K€ om€ urc€ u (3) reported that the use of heat in different forms, for example as a hot bag, a towel or in a bottle, traditionally has been used to ease menstrual pain in many cultures, and has had a long history in common use and folklore. They concluded that local low-dose heat application would be an easy to apply noninvasive method that could be recommended to relieve menstrual pain, and since it did not require any special equipment or an expert's application in a clinical setting, would also be economic and time efficient.Newsweek magazine, in their issue of 29 April 2016 (4), shows a picture of a young woman holding a heat bag over her pelvic region for its topic on menstruation, showing the wide acceptance of the method all over the world.We believe, since the authors have already a large amount of data in their hands, that they may like to consider adding a search on the use of heat applications as a form of complementary/alternative medicine. Clearly, a large population of women all over the world are motivated to use local heat applications in many forms during their menstrual period.On the other hand, they might have deliberately omitted to include heat applications for perimenstrual pain, in which case it would have been informative for readers if they had mentioned their reasons in their manuscript. References 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 selfperceived efficacy. Acta Obstet Gynecol Scand. 2016;95:861-71. 2. Hosono T, Takashima Y, Morita Y, Nishimura Y, Sugita Y, Isami C, et al. Effects of a heat-and steam-generating sheet on relieving symptoms of primary dysmenorrhea in young women. J Obst...