Exercise for dysmenorrhoea (Intervention Review)

Background: Exercise has a number of health benefits and has been recommended as a treatment for primary dysmenorrhoea (period pain), but the evidence for its effectiveness on primary dysmenorrhoea is unclear. This review examined the available evidence supporting the use of exercise to treat primary dysmenorrhoea. Objectives: To evaluate the effectiveness and safety of exercise for women with primary dysmenorrhoea. Search methods: We searched the Cochrane Gynaecology and Fertility specialised register, CENTRAL, MEDLINE, Embase, PsycINFO, AMED and CINAHL (from inception to July 2019). We searched two clinical trial databases (inception to March 2019) and handsearched reference lists and previous systematic reviews. Selection criteria: We included studies if they randomised women with moderate"to"severe primary dysmenorrhoea to receive exercise versus no treatment, attention control, non"steroidal anti"inflammatory drugs (NSAIDs) or the oral contraceptive pill. Cross"over studies and cluster"randomised trials were not eligible for inclusion. Data collection and analysis: Two review authors independently selected the studies, assessed eligible studies for risk of bias, and extracted data from each study. We contacted study authors for missing information. We assessed the quality of the evidence using GRADE. Our primary outcomes were menstrual pain intensity and adverse events. Secondary outcomes included overall menstrual symptoms, usage of rescue analgesic medication, restriction of daily life activities, absence from work or school and quality of life. Main results: We included a total of 12 trials with 854 women in the review, with 10 trials and 754 women in the meta"analysis. Nine of the 10 studies compared exercise with no treatment, and one study compared exercise with NSAIDs. No studies compared exercise with attention control or with the oral contraceptive pill. Studies used low"intensity exercise (stretching, core strengthening or yoga) or high"intensity exercise (Zumba or aerobic training); none of the included studies used resistance training.