Physical activity for primary dysmenorrhea: a systematic review and meta-analysis of randomized controlled trials.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 29630882 · doi:10.1016/j.ajog.2018.04.001
What was done
Authors conducted a systematic review and random-effects meta-analysis of randomized controlled trials evaluating physical activity for primary dysmenorrhea. Multiple databases (MEDLINE, Embase, Cochrane, Web of Science, CINAHL, PsycINFO, SPORTDiscus, PEDro, AMED, WHO ICTRP, ClinicalTrials.gov, OpenGrey) were searched from inception to May 24, 2017. Eligible studies enrolled nonathlete females with primary dysmenorrhea receiving at least 2 menstrual cycles of physical activity versus any comparator and reported pain intensity or duration. Study quality was evaluated using the Cochrane risk of bias tool, and certainty was assessed with GRADE.
What was found
Fifteen randomized controlled trials comprising 1,681 participants met inclusion criteria, with 11 trials included in meta-analyses. Compared to controls, physical activity significantly reduced pain intensity (-1.89 cm on a visual analog scale; 95% CI, -2.96 to -1.09) and pain duration (-3.92 hours; 95% CI, -4.86 to -2.97). Heterogeneity was high for both outcomes and only partly explained by intervention type subgroups. Primary study quality was low to moderate, though pain intensity results remained stable during sensitivity analysis.
Why it matters
Physical activity represents an effective, nonpharmacological treatment option that meaningfully reduces both menstrual pain severity and duration for nonathlete women.
Limits
Included primary studies were of low or moderate methodological quality, high statistical heterogeneity was present across analyses, and GRADE certainty was moderate for pain intensity and low for pain duration.
Cited by
- supports Physical activity can help alleviate menstrual symptoms such as cramps by increasing blood flow.