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The method used in anthroposophist medicine has proven to be a successful method for pain relief in a current study in regular use in patients with primary dysmenorrhea.
What is dysmenorrhea?
Dysmenorrhea is the medical term for pain with menstruation. There are two types of dysmenorrhea: “primary” and “secondary”.
Primary dysmenorrhea is common menstrual cramps that come back and are not due to other diseases. Pain usually begins 1 or 2 days before, or when menstrual bleeding starts, and is felt in the lower abdomen, back, or thighs. Pain can range from mild to severe, can typically last 12 to 72 hours, and can be accompanied by nausea-and-vomiting, fatigue, and even diarrhea. Common menstrual cramps usually become less painful as a woman ages and may stop entirely if the woman has a baby.
Secondary dysmenorrhea is pain that is caused by a disorder in the woman’s reproductive organs, such as endometriosis, adenomyosis, uterine fibroids, or infection. Pain from secondary dysmenorrhea usually begins earlier in the menstrual cycle and lasts longer than common menstrual cramps. The pain is not typically accompanied by nausea, vomiting, fatigue, or diarrhea.
Up to 90% of adolescent girls and women during their physically fertile period suffer from cramp-like abdominal pain (primary dysmenorrhea) shortly before and or during their menstrual period.
The severity of the complaints ranges from a slight discomfort in the abdominal region to severe pain, which often force the women affected to stay away from work or school.
It is believed that an increased concentration of prostaglandin F2a in the women’s blood is responsible for the symptoms. Anti-inflammatory drugs such as non-steroidal anti-inflammatory drugs (NSAIDs) or hormonal contraceptives are usually recommended to combat pain, but in some cases they can cause side effects and intolerance.
For this reason, scientists examined the effects of a weekly rhythmic massage in comparison with heart rate variability (HRV) biofeedback therapy or standard treatment. 
The specialised massage developed in the 1920s by the anthroposophist doctor Ita Wegman is derived from the classic Swedish massage, but in comparison with this it is more characterized by specific rhythms and circular massage movements.
This special form of massage should not only address physical complaints, it should also have positive effects on the mood and the self-healing powers of the person being treated.
HRV biofeedback therapy focuses on the synchronization of pulse and breathing for the purpose of improving the heart rate and, as a result, improved regulation of the autonomic nervous system using a biofeedback device.
The multi-center study included 60 women between the ages of 16 and 46 with recurring menstrual pain and randomly assigned them to three groups. Over a total period of twelve weeks, 23 women in the first group received a specialised period-pain massage unit of 30-45 minutes once a week, followed by a 15- to 20-minute rest phase.
20 participants in the second group were trained in the HRV biofeedback treatment and then carried out this themselves at home. In total, the patients took part in up to 5 sessions to intensify the therapy they had learned.
The remaining 17 patients in the control group retained the measures they usually used to relieve their menstrual cramps (e.g. taking painkillers, light physical training, heat applications).
The primary endpoint of the study was the determination of the mean pain intensity. Secondary target parameters were the measurement of the maximum pain intensity, the heart rate variability, the frequency and level of pain medication consumption and the restriction of activities in everyday life due to menstrual-related pain (quality of life) during the acute menstrual phases after the twelve weeks.
With regard to the mean and maximum pain intensity and quality of life, significant differences in favour of the two intervention groups (massage, HRV biofeedback) were observed compared with the control group.
Both groups were thus able to achieve equally good results in reducing menstrual pain. In the specialised massage group, after the end of the therapy phase, 10% fewer participants took painkillers than at the start of the study, while in the HRV biofeedback therapy group, the consumption of analgesics increased by 8%.
Twelve participants in all three groups discontinued the study for various reasons (lack of time, change of location, pregnancy, dissatisfaction with the HRV biofeedback treatment).
This first randomized study on the use of specialised period-pain massage for primary dysmenorrhea was able to show the first positive tendencies with regard to pain relief and improvement of the quality of life in patients with recurring menstrual pain through weekly use of the massage.
A slight advantage of this form of treatment over HRV biofeedback therapy could be determined.
In comparison with the HRV biofeedback treatment that can be carried out by yourself or other measures that can be carried out at home to reduce pain in the menstrual phase, performing the specialised massage is more complex, as it needs to be performed by a suitably trained therapist to achieve a positive effect for you.
On the other hand, the patients in the massage group showed a significantly higher willingness to use the massage treatments on a regular basis, which could possibly be due to the appreciation of the higher treatment costs compared to biofeedback therapy.
However, further randomized studies involving a larger number of test persons and potential other therapeutic options than control (yoga, relaxation methods, etc.) over a longer period are necessary in order to consolidate the tendencies achieved here with regard to pain relief through regular specialised period-pain massage treatments.
Other measures to prevent and relieve menstrual pain:
- Tea (yarrow, goose fingerwort, monk’s pepper, lady’s mantle, verbena, nettle)
- Lavender oil bath
- Rub the lower abdomen with lemon balm oil
- Warmth (hot water bottle, grain pillow, warming plaster)
- Regular, moderate training (yoga, Pilates, light running training)
- Balanced diet, rich in vitamin B6 (e.g. in whole grain bread, walnuts, lentils), omega-3 fatty acids (e.g. in linseed or rapeseed oil, salmon), magnesium (bananas, nuts, oat flakes, quinoa, amaranth) and vitamin E (raspberries, peanuts, almonds, wheat germ and sunflower oil)
- Magnesium phosphoricum D6 (“Hot 7”, 10 tablets dissolved in hot water)
- Herbal preparations for menstrual pain (active ingredient: monk’s pepper)
1) Vagedes J, Fazeli A, Boening A, Helmert E, Berger B, Martin D. Efficacy of rhythmical massage in comparison to heart rate variability biofeedback in patients with dysmenorrhea. A randomized, controlled trial. Complement Ther Med 2019 42: 438-444 Abstract