Proctor, M., & Farquhar, C. (2006). Diagnosis and management of dysmenorrhoea. BMJ (Clinical research ed.), 332(7550), 1134-8. https://doi.org/10.1136/bmj.332.7550.1134
Proctor M, Farquhar C. Diagnosis and management of dysmenorrhoea. BMJ (Clinical research ed.). 2006;332(7550):1134-8. doi:10.1136/bmj.332.7550.1134
Proctor, Michelle, and Cynthia Farquhar. "Diagnosis and management of dysmenorrhoea." BMJ (Clinical research ed.), vol. 332, no. 7550, 2006, pp. 1134-8.
Most Period Pain Responds to NSAIDs, a Review Finds
This 2006 BMJ review looked at past studies on period pain, called dysmenorrhea. NSAIDs relieved pain in most women across the trials reviewed. A review of nine trials found no clear evidence that surgery to cut pelvic nerves helps. The review also explains when period pain points to a disease like endometriosis.
Key Findings
NSAIDs relieved pain in 17% to 95% of women across trials (mean 67%). The number needed to treat was 2.1 for at least moderate relief over three to five days.
In one open (non-blinded) trial of 100,000 women, 65% of those with pre-existing painful periods reported relief while using a combined oral contraceptive, a suppressive medication.
A Cochrane review of nine trials found insufficient evidence to recommend surgical nerve-interruption procedures, such as uterine nerve ablation, for treating period pain.
Dysmenorrhea prevalence estimates range from 45% to 95%, depending on definition. 13% to 51% of women report missing school or work at least once because of it.
Heat therapy was as effective as an NSAID for pain relief in one trial. Thiamine, magnesium, and vitamin E each showed benefit in separate small trials, with caution flagged for vitamin E.
Interpretation
The source is a review. It is not a new study. The authors summed up existing Cochrane reviews and trials. They did not collect new data. Quality varies by treatment. NSAID trials include several systematic reviews and an effect-size figure, the number needed to treat. Birth control pill trials for period pain are weaker, the authors say. Heat therapy was tested against a pain reliever and against placebo. Vitamin E, magnesium, and thiamine mostly come from small trials that need more proof. The review covers primary dysmenorrhea, meaning no underlying disease, and secondary dysmenorrhea, caused by a disease such as endometriosis. In most sections, it does not split results by cause.
RRM Context
The review splits period pain into two kinds: pain with no disease behind it, and pain caused by a disease. That split matches how restorative reproductive medicine works, which starts by finding the cause. The review notes that pain caused by a disease, such as endometriosis, fibroids, or adenomyosis, needs its own workup. Pain relief alone is not enough. The review also lists drugs such as birth control pills, progestogens, and GnRH agonists for endometriosis pain. The drugs manage the pain. They do not treat the disease behind it.
Our editorial summary of this paper, not the article's abstract.
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