Therapeutic Exercise in the Treatment of Primary Dysmenorrhea: A Systematic Review and Meta-Analysis

Abstract

Background Dysmenorrhea is a health problem with a high impact on health and society. Some drugs have been shown to be effective at treating dysmenorrhea. Therapeutic exercise is another option for reducing the symptomatology of this health problem, with a low cost and the absence of side effects. Purpose The purposes of this review were to study the efficacy of physical exercise for pain intensity in primary dysmenorrhea and to assess its effectiveness in decreasing the duration of pain and improving quality of life. Data Sources Searches were conducted between February 2017 and May 2017 in the databases Web of Science, Physiotherapy Evidence Database (PEDro), PubMed, Scopus, CINAHL, and Dialnet, using the terms dysmenorrhea, exercise therapy, exercise movement technique, exercise, physical therapy, physical therapy speciality, treatment, primary dysmenorrhea, prevention, etiology, epidemiology, and pain. Study Selection We included randomized controlled trial studies conducted on women who were 16 to 25 years old and had primary dysmenorrhea, studies that included exercise as a type of therapy, studies that assessed the intensity and duration of pain and quality of life, and studies published in English or Spanish. Studies that included women with irregular cycles, women diagnosed with a gynecological disease, women who had had surgery, women with serious diseases, or women who used intracavitary or oral contraceptives were excluded. We started with 455 studies; 16 were included in the systematic review, and 11 were included in the 3 meta-analyses that were carried out. Data Extraction Two authors selected the studies and extracted their characteristics (participants, intervention, comparators, and outcomes) and results. The evaluation of the methodological quality of the studies was carried out by PEDro scale. Data Synthesis There was moderate evidence that therapeutic exercise can be considered a useful tool in the treatment of primary dysmenorrhea in terms of a reduction in pain intensity. Regarding the duration of pain and quality of life, there was low evidence and very low evidence, respectively. In the 3 meta-analyses, the results were significantly positive in favor of exercise for decreases in both the intensity and the duration of pain. Limitations Limitations of this study include the great heterogeneity of the interventions applied in the studies in terms of type of exercise, in combination or alone, and dosage. This review includes a small number of studies with risk of bias, so the present findings must be interpreted with caution. Conclusions Therapeutic exercise reduces pain intensity in patients with primary dysmenorrhea.

Living with Restrictions. The Perspective of Nursing Students with Primary Dysmenorrhea

“…Our results showed that some students give up the practice of sports. In contrast, previous studies [10,45] reported how the practice of certain types of sports can prevent or decrease the intensity of PD. Furthermore, exercise among women with PD has been found to enhance their quality of life [46,47].…”

Perception of Menstrual Normality and Abnormality in Spanish Female Nursing Students

“…Furthermore, it has been identified that most women self-medicate with sub-therapeutic doses, which results in an unsuccessful approach [ 45 ]. Health professionals have an important role to play in this menstrual problem, as they can individually evaluate and detect secondary dysmenorrhea, advise on risk factors and protective factors, on the correct pharmacological approach, as well as report on non-pharmacological methods with proven efficacy that have fewer side effects, such as those based on physical exercise [ 28 , 46 ]. However, young women usually receive information about menstruation within their own families, from their mothers or sisters, yet, they are not sufficiently prepared to meet their needs [ 47 , 48 ].…”

A Complex Case of Dysmenorrhea and Concurrent Acute Appendicitis

“…A systematic review and meta-analysis showed that physical exercise resulted in an improvement in both intensity and duration of pain in those who suffer from dysmenorrhea. This study should be interpreted with care however, as the type of exercise that leads to these positive results is varied [ 7 ].…”