Elboim-Gabyzon, M., & Kalichman, L. (2020). Transcutaneous Electrical Nerve Stimulation (TENS) for Primary Dysmenorrhea: An Overview. International journal of women's health, 12, 1-10. https://doi.org/10.2147/IJWH.S220523
Elboim-Gabyzon M, Kalichman L. Transcutaneous Electrical Nerve Stimulation (TENS) for Primary Dysmenorrhea: An Overview. International journal of women's health. 2020;12:1-10. doi:10.2147/IJWH.S220523
Elboim-Gabyzon, Michal, and Leonid Kalichman. "Transcutaneous Electrical Nerve Stimulation (TENS) for Primary Dysmenorrhea: An Overview." International journal of women's health, vol. 12, 2020, pp. 1-10.
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RRM Academy Synopsis
High-frequency TENS eased primary dysmenorrhea pain in reviewed trials
High-frequency TENS gave more pain relief than placebo TENS in the trials reviewed, according to a 2020 overview of studies in women with primary dysmenorrhea. Low-frequency TENS worked about as well as placebo TENS or pills. Many of the trials varied in design, participants and treatment dose.
Key Findings
A 2002 Cochrane review of seven earlier studies found that high-frequency TENS reduced menstrual pain. The 2009 update added no new studies.
Six trials published after the 2009 update lend further support to high-frequency TENS for primary dysmenorrhea, according to the authors.
Compared with placebo TENS, high-frequency TENS gave greater pain relief. Low-frequency TENS gave pain relief similar to placebo TENS or pills.
Only two studies compared high-frequency with low-frequency TENS. On a visual analog scale the difference was not significant, with a trend toward greater relief with high-frequency.
In one trial, ibuprofen alone gave better pain relief than active or sham TENS, and TENS combined with ibuprofen gave better pain reduction than TENS alone.
Interpretation
The paper is an overview of earlier studies and reports no new data. Many of the trials differed in design, participants, current settings, electrode placement, blinding and control group, so comparing them was hard. The authors advise caution with the frequency comparison, which rests on two studies. One study reported three months of self-use and did not evaluate effectiveness over time. The authors note methodological limits in the studies and call for larger, higher quality research in women with primary dysmenorrhea.
RRM Context
The overview notes that primary dysmenorrhea occurs only during ovulatory cycles. The diagnosis applies when no reproductive pathology can be found. RRM reads cycle pain as information about the ovulatory cycle and puts evaluation before treatment. TENS aims at pain relief.
Our editorial summary of this paper, not the article's abstract.
Abstract
Primary dysmenorrhea is a chronic health condition that affects primarily young women. Transcutaneous electrical nerve stimulation (TENS) has been suggested as an effective pain reduction modality in primary dysmenorrhea. TENS is a noninvasive, inexpensive, portable method with minimal risks and a few contraindications. When necessary, it can be self-administered on a daily basis during everyday activities. Several studies have investigated the effectiveness of TENS in reducing pain, decreasing the use of analgesics, and improving the quality of life in primary dysmenorrhea patients. These studies have some limitations in methodological quality and therapeutic validation. However, the overall positive effects of TENS in primary dysmenorrhea encountered in all prior studies indicated its potential value. This review presents the clinical recommendations for TENS parameters for treating primary dysmenorrhea symptoms based on previously published studies.
