A Randomized Controlled Study of Vitamin D in the Treatment of Primary Dysmenorrhea

Abstract

Aim: The aim of this study was evaluating the effectiveness of vitamin D in the treatment of primary dysmenorrhea. Material and Methods: A total of 142 patients between 16 and 35 years of age who were admitted to a university hospital and diagnosed with primary dysmenorrhea were included in the study in a randomized controlled manner. Cases were randomized into three groups of 667 IU vitamin D once a day, 200 IU vitamin E once a day and 400 mg ibuprofen twice a day. The treatment was given two days before the expected date of menstruation and the first three days of menstruation. Treatment was continued in two consecutive cycles. Severity of menstrual pain was measured with Visual Analogue Scale (VAS), as the primary outcome. Need for using nonsteroidal anti-inflammatory drugs (NSAIDs) during two-month study period was evaluated as the secondary outcome. Results: There were no significant difference in age, body mass index and baseline VAS scores between groups. Pain severity of vitamin D group after treatment was found as low as in the ibuprofen group. Median VAS scores of vitamin D, vitamin E and ibuprofen groups were 5 (1-10), 7 (1-10) and 7 (2-10), respectively after treatment (p<0.001). Requirement of NSAIDs was significantly less in vitamin D group than the vitamin E group (27.3% vs 65.9%, p<0.001). There were no side effects in groups. Conclusion: Both vitamin D and E are effective in alleviation the pain of primary dysmenorrhea, however the effect of vitamin D is clearer.

Vitamin D Supplementation for Patients with Dysmenorrhoea: A Meta-Analysis with Trial Sequential Analysis of Randomised Controlled Trials

“…Despite our attempts to obtain details of pain scores by contacting the first and corresponding authors via email, as of 5 March 2024, we had received no response. Ultimately, 11 studies with a total of 687 participants were included in the meta-analysis [15][16][17][18][19][20][21][22][23][24][25]. We excluded the study by Zangene et al as it utilised the same database (patients, study period, hospital, and results) as that of Ataee et al [16,39].…”

“…Despite our attempts to obtain details of pain scores by contacting the first and corresponding authors via email, as of 5 March 2024, we had received no response. Ultimately, 11 studies with a total of 687 participants were included in the meta-analysis [15][16][17][18][19][20][21][22][23][24][25].…”

“…The characteristics of the included studies are presented in Table 1, with the quality of evidence assessed using the Cochrane Collaboration tool (Figure S1). Among the 11 studies, 3 were not blinded and had unclear definitions of the placebo group [18][19][20]. Of these studies, seven were conducted in Iran, and one each in Italy, Saudi Arabia, Turkey, and the USA.…”

“…The results of the leave-one-out sensitivity analysis demonstrated the robustness of the pooled results. For instance, upon exclusion of the study conducted by Özel et al in 2019 [19], the pooled estimate changed minimally from −1.64 to −1.60 (95% CI, −2.31 to −0.89; p < 0.001; Figure S3). Sensitivity analyses, including 'meta-analysis with a fixedeffect model', 'studies with low risk of bias', 'double-blinded studies', 'non-funded studies', and 'studies with a definitive placebo', consistently showed robustness compared to the primary outcome (Table S2).…”

“…Vitamin D deficiency has been reported to induce or exacerbate dysmenorrhoea symptoms [14]. Notably, several randomised controlled trials (RCTs) have demonstrated that vitamin D supplementation reduces pain intensity in patients with dysmenorrhoea; thus, this may be an alternative treatment option for dysmenorrhoea [15][16][17][18][19][20][21][22]. However, other studies have reported limited effects [23][24][25].…”