Dysmenorrhea : Alternative and Complementary Approach
Ph D Scholar, Professor Cum Principal, Shri Shankaracharya College of Nursing, Amdi Nagar, Hudco, Bhilai (C.G.), Chhattisgarh 490009, India.
*Corresponding Author E-mail: 1203veena@gmail.com
Dysmenorrhea is a common ailment among women that can cause substantial physical and emotional suffering as well as life disruption. Women, on the other hand, may not seek professional help in order to alleviate this ailment. It is usually primary (functional) in teens and young adults, and is linked with normal ovulatory cycles and no pelvic disease. Reproductive age. Pelvic abnormalities such as endometriosis or uterine anomalies are observed in about 10% of adolescents and young adults with severe dysmenorrhea symptoms. Dysmenorrhea is the most prevalent cause of recurring short-term school absence in adolescent girls and a common condition in reproductive-age women.
KEYWORDS: Dysmenorrhea, Adolescents, Young adults, menstrual pain, complementary and alternative medicine.
Primary dysmenorrhea is a very common problem in young women. It is usually defined as cramping pain in the lower abdomen occurring at the onset of menstruation in the absence of any identifiable pelvic disease. Primary dysmenorrhea is by far the most common gynecologic problem in menstruating women. It is so common that many women fail to report it in medical interviews, even when their daily activities are restricted. Reported prevalence rates are as high as 90 percent. A recent prospective study of college students, based on diaries kept for one year, found that 72 percent of monitored periods were painful, most commonly during the first day of menses. Sixty percent of the women studied reported at least one episode of severe pain1.
Today, due to the effects of chemical drugs, the high economic cost of importing raw materials, and lack of desire of young girls to use hormonal drugs to reduce pain, use of medicinal plants is a step toward self- sufficiency and has attracted the attention of researchers. The usual medical treatments for painful periods (dysmenorrhoea) are painkillers (analgesics), generally nonsteroidal anti-inflammatory drugs (NSAIDs like ibuprofen), or the oral contraceptive pill. Not everyone wants to take NSAIDs as they can cause adverse effects such as gastrointestinal discomfort and bleeding; they also do not effectively alleviate the pain for everyone. Alternative and Complementary therapies may effectively reduce the need for medical treatment 2.
A variety of alternative and complementary treatments, including diet, exercise, acupuncture, chiropractic, transcutaneous electrical nerve stimulation (TENS), herbs, and dietary supplements, are used to treat dysmenorrhea.3
Besides getting enough sleep and rest, things might be tried including:
Most alternative therapies for treating menstrual cramps haven't been studied enough for experts to recommend those 4. However, some alternative treatments might help, including:
Transcutaneous electrical nerve stimulation (TENS). A TENS device connects to the skin using adhesive patches with electrodes in them. The electrodes deliver a varying level of electric current to stimulate nerves4,5,6. TENS might work by raising the threshold for pain signals and stimulating the release of your body's natural painkillers (endorphins). In studies, TENS was more effective than a placebo in relieving menstrual cramp pain. A small battery-operated device that delivers a mild electrical current to your tummy to help reduce pain7
Regularly physical activity helps ease menstrual cramps for some women. Exercising during a painful period is not feel good, but being active may reduce pain; try some gentle swimming, walking or cycling, Women who exercise appear to have fewer menstrual symptoms than women who do not exercise. A review of studies on dysmenorrhea and exercise identified seven trials on the subject (three observational studies and four randomized controlled trials)3, 5. the four randomized, controlled trials (two compared different types of exercise and two compared exercise to no exercise), all found a significant reduction in dysmenorrhea among exercisers. Two observational studies found a lower prevalence of dysmenorrhea in regular exercisers; the third (which adjusted scores for disposition, medication, stress, and mood) found that regular exercisers had more menstrual symptoms than non-exercisers 8.
Soaking in a hot bath or using a heating pad, hot water bottle or heat patch on your lower abdomen might ease menstrual cramps. Putting a heat pad or hot water bottle (wrapped in a tea towel) on tummy may help reduce pain
Psychological stress might increase risk of menstrual cramps and their severity 9.
Inhaling and exhaling deeply repetitively (5-7 times) helps to decrease the extremity of cramps. Additionally, try to divert your attention and focus on something completely different, the distraction will divert your mind from the severity of the cramps. Apply pressure on the area while practicing deep breathing exercise can also help to relieve your body. You can do this by breathing in, putting your hand on the pressure points and applying pressure on the region by pressing, then
breath out and loosen the pressure 10.
Relaxing activities, such as yoga or pilates may help distract you from feelings of pain and discomfort 7.
Research suggests some physical therapies such as local heat application (heat packs), TENS (transcutaneous electrical nerve stimulation), acupuncture and acupressure are helpful for reducing menstrual pain and cramps. Physiotherapy may also be helpful for lower back pain associated with PMS 6.
Stress can exacerbate extreme PMS symptoms and lead to a lower quality of life. In decreasing extreme PMS, daily relaxing may be beneficial. In order to relieve menstrual pain, some women may find yoga beneficial in easing menstrual pain.
A small study found that– light, circular massage around lower abdomen weekly over five weeks reduce the level of pain and mood disorders and reduced fluid retention experienced by women during their menstrual cycle 5,7.
Chiropractic treatment plan is driven by the patient's pain and disability issues and activity intolerance 11.
A blend of essential oils like rosemary, marjoram, and lavender specially designed for easing muscle spasms and relieving cramping. Any one of these specialty products could be used in conjunction with some of our techniques to reduce pain 1.
Chiropractic uses manual techniques to adjust spinal vertebrae. Although this treatment is more accepted for back pain or musculoskeletal disorders, chiropractic is used commonly to treat excessive bleeding or dysmenorrhea. In this procedure manipulating the lower spine can improve blood flow to the pelvic area of the
body and so help with painful periods caused by restricted blood flow 5 at least twice a week 2. Women treated with chiropractic experienced decreased pain and disability 12. Chiropractic mobilization refers to low velocity manipulation, movement and stretching of the muscles and joints, with the goal of increasing the range of motion within those areas. Many studies have concluded that manual therapies commonly used by chiropractors are generally effective for the treatment of lower back pain36. There may also be accompanying treatments like massage or use of pressure points, laser acupuncture, and exercises 2, 13.
There are numerous pressure points on our body each targeting a certain area of the body considered to produce significant pain. This is the same when it comes to abdominal muscles, which are responsible for causing pain during periods.
§ Beneath the navel: this is approximately 4 finger levels, using your middle finger, press the region slightly and hold for 3-5 minutes before releasing.
§ The front side of the hip bones: this region contains several pressure points if massaged can relieve them.
§ Abdominal muscles: gently rubbing on this region can eliminate or alleviate cramping.
§ Lower back: gently massaging your lower back in a circular motion decreases the severity of period cramps (10).
§ Light Exercise in pain and just want to veg out... but a bit of exercise may help solve pain problem.
According to Farley, aerobic exercise provides natural pain relief. “The increased blood flow and the endorphins help counter act the prostaglandins and reduce cramping.” Gaither even compares these endorphins to a “natural morphine."
But Parikh concedes that exercise can seem impossible when client are feeling a great deal of pain, and therefore suggests low impact activities like walking or yoga, which "are still great for helping fight menstrual pain and are easier to do when they are feeling unwell1.”
Acupressure also involves stimulating certain points on the body, but with gentle pressure on the skin instead of needles. Although research on acupressure and menstrual cramps is limited, it appears that acupressure may be more effective than a placebo in easing menstrual cramps 9.
Auricular acupressure is an effective noninvasive intervention that increases HF to maintain autonomic function homeostasis in young women with primary dysmenorrhea. It may be valuable in alleviating menstrual pain and menstrual distress in high-life stress conditions14, 5. In a review article, P.-W. Hou et al. examined the history, mechanism, and clinical application of auricular therapy in traditional Chinese medicine. Auricular therapy includes acupuncture, electroacupuncture, acupressure, lasering, cauterization, moxibustion, and bloodletting in the auricle15. It is a form of alternative medicine based on the idea that the ear is a micro system, which reflects the entire body, represented on the auricle, the outer portion of the ear. Conditions affecting the physical, mental or emotional health of the patient are assumed to be treatable by stimulation of the surface of the ear exclusively. Similar mappings are used in many areas of the body, including the practices of reflexology and iridology16. In this procedure uses needles, seeds, or crystals, with applications in specific points of the ear. The stimulation of these points transmits signals to the brain and specific organs, modulating and harmonizing their physiological functions. The pinna has reflex zones, a micro system with the representation of all the organs and structures of the human body. Auricular evaluation and inspection were performed with the participants in the sitting position, asepsis of the ear that would receive the intervention using cotton with 70% alcohol. Then, 0.25x15mm needles were inserted in the right ear with a guide tube at the indication points14.
Ooracupunctuurpunten
In ear acupuncture the idea is that the needles just penetrate the skin to a depth of around 2 mm. Let the needles stay in place for at least 25min, but preferably 40 minutes. In cases of severe menstrual pain it is better for the needles to stay in longer, for several hours 17.
One of these plants is lavender. Lavender is a plant belonging to the family of mints, and its scientific name is Lavandula. It can be administered through oral use, inhalation, and massage. Overall, the essential oils that are generally extracted from a plant are hundred times more effective than the plant itself. Lavender oil contains linalool, linalyl acetate, cineol, lavender, geraniol tannin, flavonoids and has antifungal, antimicrobial, antibiotic, and antidepressant effects. The most common form of aromatherapy used by nurses is massage. It is said that massage relieves pain by stimulating endorphins, and lavender oil, by reducing anxiety, causes more pain relief. Lavender oil increases adrenocorticotropic hormone that stimulates menstrual blood flow and decreases toxicity and allergies. Aromatherapy massage is used extensively in complementary therapies in nursing 18.
In a randomized controlled trial of 45 women with primary dysmenorrhea, 24 women received spinal manipulative therapy (SMT) and 21 women received "sham" manipulation.6 A Menstrual Distress Questionnaire (MDQ) and a visual analog pain scale were administered 15 minutes before and 60 minutes after treatment, and blood was drawn. Compared with pretreatment values, the SMT group had less abdominal pain than the sham-treated group and lower scores on the MDQ. Groups experienced significantly decreased levels of the prostaglandin F2a metabolite 15 keto-13, 14- dihydroprostaglandin (prostaglandin F2a is increased in women with dysmenorrheal5.
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Received on 18.07.2021 Modified on 05.08.2021
Accepted on 20.08.2021 © AandV Publications all right reserved
Int. J. Nur. Edu. and Research. 2021; 9(4):491-494.
DOI: 10.52711/2454-2660.2021.00115