Transcutaneous electrical nerve stimulation for treatment of primary dysmenorrhea: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND

Primary dysmenorrhea (PD) affects 50% to 90% of menstruating individuals, causing painful cramps and systemic symptoms like nausea and fatigue. Current treatments like non-steroidal anti-inflammatory drugs and hormonal contraceptives may have limited efficacy or side effects. Transcutaneous electrical nerve stimulation (TENS) is a noninvasive option that may help alleviate pain. This study aims to evaluate the efficacy and safety of TENS for managing PD by analyzing randomized controlled trials (RCTs).

METHODS

A systematic review and meta-analysis were conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, including RCTs comparing TENS to controls. Primary outcomes were changes in Visual Analog Scale scores, pain relief duration, and ibuprofen usage. Secondary outcomes included abdominal, lower back, and thigh pain, and Brief Pain Inventory scores. Data analysis was performed using RevMan 5.3 with a random-effects model.

RESULTS

Thirteen RCTs with 779 patients showed that TENS significantly reduced Visual Analog Scale scores (mean difference [MD]: -1.97, P = .0009), prolonged pain relief (standardized mean difference: 0.78, P < .00001), and reduced ibuprofen use (MD: -1.29, P = .04). It also alleviated lower abdominal, back, and thigh pain. However, no significant difference was found in Brief Pain Inventory scores (MD: 0.01, P = .95).

CONCLUSION

TENS is an effective, non-pharmacological treatment for PD, reducing pain intensity, prolonging relief, and lowering non-steroidal anti-inflammatory drugs use, though further research is needed on its impact on pain-related disability.