Chinese Herbal Medicine for the treatment of Dysmenorrhea: a Community-based Qualitative Study
Dysmenorrhea is a common condition suffered by between 52% and 90% of women and can be severe enough to cause absence from work in about 2% of women. Primary dysmenorrhea (PD) refers to severe pain with no identifiable pelvic pathology that can account for painful menstruation. Evidence of efficacy supports use of pharmacological agents such as NSAIDs, or the use of oral contraceptives to alleviate menstrual pain. However, despite this wide range of treatments, pain relief may be inadequate for some women, or side effects may not be well tolerated and given that conventional treatment for primary dysmenorrhoea has a failure rate of 20% to 25%, Chinese Herbal Medicine (CHM) may be a suitable alternative.
A prospective, uncontrolled naturalistic study was carried out in which 10 participants received treatment with a modified Traditional Chinese Herbal formula Xiao Yao Wan during three menstrual periods. Participants were followed for four menstrual cycles; the first one was without treatment and was considered as a baseline. Modified questionnaires for the assessment of menstrual pain were used for data collection in different phases of the study: a retrospective questionnaire at the beginning of the study, a daily questionnaire during 4 menstrual periods, to be filled out on the days with menstruation, and a final questionnaire.
Results and conclusions
This study assesses the efficacy of treatment of menstrual pain with modified Xiao Yao Wan with a sample of 10 women. For assessing the evolution of menstrual pain, of premenstrual pain, the number of days with pain, the number of days of use of analgesia and the number of days of abandonment of activities due to pain the SPSS programme was used to apply the Student’s t-test for related samples. As well, since the study sample number is small, in order to confirm the results the Wilcoxon test was also used, which makes no assumption as to the normal distribution of the frequency of the variables. The analysis of the study data shows improvement in all menstrual characteristics, with some of these being statistically significant and others not. The analysis of the results partially confirms the working hypothesis, showing that Xiao Yao Wan is significantly effective (p≤0.05) for treatment of maximum menstrual pain and reduces the number of days with pain and the number of days of use of analgesia in primary dysmenorrhea. The results of the study seem to show the effectiveness of treatment of menstrual and premenstrual discomfort in PD with the modified Xiao Yao Wan formula, especially when the predominant disharmony patterns are Qi stagnation, Qi/Xue vacuity and/or Xue stasis. The study seems to show these as the main TCM disharmony patterns causing dysmenorrhea. There also seems to be a relationship between the characteristics of the menstrual bleeding and the intensity and duration of both menstrual and premenstrual pain.
Primary dysmenorrhea, Dysmenorrhoea, Menstrual Pain, Painful menstruation, Tradicitonal Chinese Herbal Medicine, Tradicitonal Chinese Medicine