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Use of complementary and alternative therapies for the treatment of dysmenorrhea among undergraduate pharmacy students in Malaysia: a cross sectional study

BMC Complementary Medicine and Therapies volume 20, Article number: 285 (2020) Cite this article

Abstract

Background

Dysmenorrhea is a common problem that affects female students’ quality of life and academic activities. Complementary and alternative therapies (CATs) are used for the treatment of dysmenorrhea. This study investigated the practices and perceptions of female undergraduate students with dysmenorrhea towards CATs.

Methods

This was a cross-sectional study conducted among undergraduate pharmacy students in a public university in Malaysia using a validated and pre-tested self-administered questionnaire. The study was conducted in November and December 2019. The data was analysed using descriptive and inferential statistical tests.

Results

Of the 318 female undergraduate students invited, 219 completed the questionnaire (response rate: 68.9%) with 52% aged between 21 and 23 years. The prevalence of dysmenorrhea was 72.1%, and the prevalence of ever-use and current use of CATs was 70.3 and 54.4%, respectively. Bed rest (71.5%), hot compress/heating pad (47.5%) and massage (43.0%) were the most common CATs used by the respondents. The most common reasons for using CAT were to reduce the need for analgesics (61.4%), efficacy (37.3%) and recommendation by others (32.9%). About 23 and 9% of the respondents believed that CATs were equally “effective” and “more effective” than analgesics, respectively. Reducing the need for analgesics (AOR: 4.066, 95% CI: 2.136–7.739) and those who agreed that CATs are effective (AOR: 2.701, 95% CI: 1.337–5.457) were independently associated with the current use CATs for the treatment of menstrual pain.

Conclusion

The prevalence of ever-use and current use of CATs is high among female undergraduate pharmacy students. Bed rest and heat applications are the most common CATs used. Reducing the need for analgesics and efficacy are the factors associated with the current use of CATs. Students should be educated about the safe and effective use of CATs to reduce adverse effects and improve their quality of life.

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Background

Dysmenorrhea is a public health problem that affects adolescent girls and women of child bearing age [1]. The prevalence of dysmenorrhea ranges between 34 and 94% worldwide with severe dysmenorrhea reported in about 1–60% of the cases [1]. Dysmenorrhea is classified into primary and secondary dysmenorrhea. In primary dysmenorrhea there is no underlying uterine pathology while secondary dysmenorrhea is associated with pelvic pathology [2]. Factors that increase the risk of dysmenorrhea include a positive family history, age, stress, age at menarche, obesity, irregular cycle, long cycle, and heavy bleeding as well as skipping breakfast, eating snacks, smoking and alcohol use [1, 3,4,5]. The condition causes symptoms such as lower abdominal cramp, low back pain, nausea, vomiting, diarrhoea, headache and fatigue, as well as emotional instability, loss of appetite, sleeplessness and depression [1, 3, 4, 6, 7].

The exact mechanism of dysmenorrhea is unknown, however, studies have suggested that prostaglandins play a major role in the pathogenesis of primary dysmenorrhea [2]. Unfertilized egg (ovum) causes a decrease in progesterone level resulting in the contraction of the uterus and shedding of its lining. The reduction in the level of progesterone leads to an increase in prostaglandin production. Prostaglandin hyper-secretion results in vasoconstriction and myometrial contractions, which cause a reduction in uterine blood flow and pain [2]. Dysmenorrhea has a negative impact on daily physical activities including daily chores; work or school activities such as absenteeism, loss of concentration, and reduced participation or productivity; as well as social interactions and psychological status [1, 4, 7, 8]. Most women and adolescents with dysmenorrhea do not seek medical treatment from healthcare professionals and most of them resort to self-medication with analgesics and complementary and alternative therapies (CATs) [1, 9]. There is a growing interest for the use of CATs among women with reproductive health issues [10]. Previous studies revealed that 15.5–79.3% of women with dysmenorrhea use CATs [11,12,13]. Self-medication therapies used by most women with dysmenorrhea are not effective in the treatment of menstrual pain [9]. Therefore, counselling on appropriate use of CATs and management of dysmenorrhea are recommended.

In Malaysia, approximately 56–85% of adult women use CATs for women health issues including: pregnancy, labour, post-menopausal symptoms and infertility [14, 15]. The use of CATs among women is associated with both beneficial and adverse health outcomes [14]. There is limited data describing the use of CATs for the treatment of dysmenorrhea among women and young adults in Malaysia. This information is important to understand the usage of CATs for menstrual pain and to design interventions to promote safe and effective use of CATs. The objective of this study was to investigate the practices and perceptions of female undergraduate pharmacy students towards the use of CATs for the treatment of dysmenorrhea in Malaysia.

Method

Study design and setting

This study was a cross sectional study conducted among female undergraduate pharmacy students in a public university located in the East Coast of the Malaysian peninsular using a validated and pre-tested questionnaire. The school of pharmacy involved in this study has a population of 474 undergraduate students and females represent 74.3% of the population. The school offers a 4-year Bachelor of Pharmacy degree program.

Study population and sample size

All female undergraduate students in all four levels (year 1, 2, 3 and 4) in the school of pharmacy were invited to participate in the study. Students who provided consent to participate in the study were included. Those who participated in the pilot study, those with amenorrhea, those who declined to participate and female postgraduate students in the school as well as students from other schools were excluded from the study. There were 474 undergraduate pharmacy students (348 of whom are females) at the school at the time of the survey. The sample size was calculated using Raosoft Sample Size Calculator using the following assumptions; 95% confidence interval, 5% margin of error and 50% response distribution. The minimum sample size required was calculated as 183 female undergraduate pharmacy students. A convenient sampling technique was used to recruit participants in this study.

Survey instrument

The questionnaire was developed in the English language after the review of relevant previous literatures on dysmenorrhea and the usage of CAT as well as analgesics [16,17,18,19,20,21,22,23,24]. The initial questionnaire was validated by three senior lecturers in the Department of Pharmacy Practice and the questionnaire was revised based on the comments and suggestions of the reviewers. The final questionnaire (see supplementary material) consists of 38 items divided into 6 sections as follows; sections A and B that collected data on demographic (3 items) and menstrual (6 items) characteristics, respectively; section C assessed menstrual pain, level of severity and its effect on daily and academic activities (11 items). Section D and E gathered information on practices towards analgesics (6 items) and CATs (5 items), respectively. The last section assessed the perception towards the usage of analgesics and complementary and alternative therapy in the management of dysmenorrhea (7 items). In this report, we described the practices and perception towards the use of CATs among female undergraduate students. The results for the prevalence of dysmenorrhea and its effect on academic activities will be published elsewhere. The severity of dysmenorrhea was assessed using WaLIDD scale [20]. WaLIDD score measures the severity of dysmenorrhea on a scale of 0–12 with scores 0, 1–4, 5–7, and 8–12 representing no, mild, moderate and severe dysmenorrhea, respectively [20]. A five-point Likert scale was used to assess the student’s perceptions towards analgesics and CATs. A pilot study was conducted among 30 students in the school to get feedbacks to the questions in the questionnaire. The data was analysed and the Cronbach alpha value was 0.704. In this study, dysmenorrhea is defined as the presence of pelvic, lower abdominal or back pain during menstruation [25]. CATs users were defined as those who used or are currently using traditional Chinese, Indian and Malay medicines, homeopathy, yoga, exercise, massage, cupping, bed rest, hot compresses, supplements and spiritual/prayer for the treatment of dysmenorrhea.

Data collection

The data was collected in November and December 2019. A self-administered questionnaire was distributed to the students. A cover letter was attached to the questionnaire and it explained the objective of the study to the potential respondents. Participants were informed that participation in the study is voluntary and all respondents were required to provide consent before they complete the questionnaire. The respondents were given the option to either complete the questionnaire on the spot or submit the completed questionnaire later. Reminders were sent to non-respondents every week through the WhatsApp group of the respective student levels.

Data analysis

The data was entered, double checked for coding errors, and analysed using Statistical Package for the Social Sciences (SPSS) version 23. Categorical data was described as frequency and percentage while continuous data was presented as mean (standard deviation). Associations between demographics and menstrual characteristics, dysmenorrhea as well as perceptions with the current use of complementary and alternative therapies were assessed using univariate and multivariate logistic regression analyses. The variables with p <  0.05 in the univariate regression analysis were included in the multivariate regression model. A value of p <  0.05 was considered to be statistically significant.

Results

Demographic and menstrual characteristics of the respondents

Of the 318 (348 female students minus 30 who participated in the pilot study) female students invited to participate in the survey, 219 students completed the questionnaire; corresponding to a 68.9% response rate. Fifty two percent of the respondents were aged 21–23 years while the mean age at menarche was 11.9 ± 1.2 years. Most of the respondents (81.3%) had regular menstruation while 50.7% had a family history of dysmenorrhea and 73.1% had normal menstrual flow (Table 1).

Table 1 Demographic and menstrual characteristics of the students who participated in the study
Full size table

Prevalence of dysmenorrhea among the respondents

Of the 219 respondents, 72.1% indicated that they experienced menstrual pain (dysmenorrhea) during their menstruation. The symptoms reported by the respondents include cramp in lower abdomen (88.0%), fatigue (52.5%), headache (31.6%) and nausea and vomiting (16.5%). The severity of dysmenorrhea, assessed using WaLIDD scale, showed that 60.7, 24.1 and 15.2% of the respondents had moderate, severe and mild dysmenorrhea, respectively (Table 2).

Table 2 Prevalence, symptoms and severity of dysmenorrhea among the students
Full size table

Use of complementary and alternative therapies for the treatment of dysmenorrhea

More than two-third (70.3%) of the respondents had used CATs before while 54.4% were current users of CATs. Bed rest (71.5%), hot compress/heating pad (47.5%) and massage (43.0%) were the most common complementary and alternative therapies used by the students for the treatment of dysmenorrhea. Natural herbs/remedies/supplements (10.1%) and exercise/yoga/meditation (9.5%) were the least common CATs used by the students. The reasons for the usage of CATs among the students included to reduce the need for analgesics (61.4%), efficacy (37.3%) and based on recommendation (32.9%). Availability (17.1%) and cost (6.3%) were the least common reasons for the usage of CATs for the treatment of dysmenorrhea. Approximately 41% of the students with dysmenorrhea used analgesics for the treatment of their pain. One-third of the students believed that CATs are less effective than analgesics, while 22.8 and 8.9% indicated that CATs are equally effective and more effectively than analgesics, respectively (Table 3).

Table 3 Prevalence, types and reasons for the use of complementary and alternative therapies among the respondents
Full size table

Perceptions towards the use of complementary and alternative therapies for dysmenorrhea

Approximately 61 and 12.0% of the students agreed and strongly agreed, respectively, that CATs were effective in relieving menstrual pain. About 50% neither agreed nor disagreed that CATs are safer than analgesics for relieving menstrual pain. Only 15.2 and 33.5% strongly agreed and agreed, respectively, that CATs are safer than analgesics (Table 4).

Table 4 Respondent’s perception towards complementary and alternative therapies
Full size table

Factors associated with the current use of complementary and alternative therapies

Univariate logistic regression analysis showed that students with multiple (three or more) symptoms of dysmenorrhea (OR: 2.377, 95% confidence interval (CI): 1.366–4.136, P = 0.002), those who use analgesics (OR: 2.317, 95% CI: 1.369–4.129, P = 0.004), those who want to reduce the need for analgesics (OR: 5.557, 95% CI: 3.099–9.967, P <  0.001) and those who agreed that CATs are effective for the treatment of dysmenorrhea (OR: 3.233, 95% CI: 1.740–6.007, P <  0.001) were significantly associated with the current use of CATs for the treatment of dysmenorrhea. There was no significant association between demographic and other menstrual characteristics with the current use of CATs. Multivariate logistic regression analysis demonstrated that those who want to reduce the need for analgesics (AOR: 4.066, 95% CI: 2.136–7.739) and those who agreed that CATs are effective for the treatment of dysmenorrhea (AOR: 2.701, 95% CI: 1.337–5.457) were independently associated with the current use CATs for the treatment of dysmenorrhea (Table 5).

Table 5 Univariate and multivariate regression analyses of factors associated with the current use of complementary and alternative therapies among the students
Full size table

Discussion

The current study found that more than two-third of female undergraduate pharmacy students experienced dysmenorrhea and this result corroborate previous findings in Malaysia 62–72% [26, 27]. It was also found that among those with dysmenorrhea, about two-third had moderate dysmenorrhea and this was higher than previous studies conducted in Turkey and Mexico, where moderate dysmenorrhea accounts for less than 50% of the cases [21, 28], although different scales were used to classify the severity of the symptoms. Clinical evidence demonstrates that CATs including exercise, yoga, heat, acupressure and home remedies such as oral ginger are effective in alleviating menstrual pain in women with dysmenorrhea [29,30,31]. The current study revealed that more than two-third and a little more than half of the students had used and were current users of CATs for the treatment of dysmenorrhea, respectively. This was not consistent with the result of a similar study conducted among high school girls in Ghana [12] and could be attributed to the differences in age, educational background and socioeconomic status of the respondents. Our result is consistent with the result of an Australian study which revealed high rate of CATs use among women with cyclic peri-menstrual pain and discomfort [32].

The most common CAT used by the students was bed rest, and this corroborates the finding of a Ghanaian study [4]. This is because sleep may be considered as a positive distraction from dysmenorrhea-associated pain. Heat application has been found to have a moderate effect in alleviating pain associated with dysmenorrhea and it is considered as an alternative to analgesics [31, 33]. This is because heat application improves blood flow and causes relaxation of the uterine muscles which results in reduction in pain [10, 31]. The current study found that hot compress/heating pad was the second most common CAT used by the students to relieve menstrual pain and this was not in agreement with the result of a previous study [4]. Natural herbs/remedies/supplements and exercise/yoga/meditation were the least common CATs used for menstrual pain, similar with a previous study [4]. The reason for this observation is unknown. Future studies should investigate the reasons for the low usage of natural herbs and remedies in the treatment of dysmenorrhea.

The current study also revealed that most of the students used CATs for the treatment of dysmenorrhea in order to reduce the need for analgesics. This could be attributed to the fear of the side effects associated with analgesics, particularly non-steroidal anti-inflammatory drugs (NSAIDs) which cause gastrointestinal ulcer and chronic kidney disease. In addition, women with dysmenorrhea are reluctant to use analgesic medications due to fears of reduction in menstrual flow and infertility [16]. Also, most of the students used CAT for dysmenorrhea due to its efficacy and safety. The efficacy of CATs have been affirmed in previous studies [29,30,31, 34], however, there is paucity of data to describe their safety profile. In addition, availability and cost are less common reasons for the use of CATs and this indicate that those who have dysmenorrhea are more interested in relieving their menstrual pain than the cost or availability of the treatment.

Another finding of this study is that about two out of five students with dysmenorrhea used analgesics to relieve pain. This was lower than the rate of analgesic use for dysmenorrhea in previous studies conducted in Turkey and Saudi Arabia [6, 19]. The difference could be explained by the educational background of the students in the current study. Pharmacy students are more likely to be aware of the side effects of analgesics than non-medical based students. Studies have demonstrated that CATs are equally effective compared to analgesics for the treatment of dysmenorrhea [35, 36]. In the current study, less than one-third of the respondents believed that CATs are equally or more effective than analgesics for the treatment of menstrual pain. There was doubt regarding the safety profile of analgesics as one-fifth of the students used CAT due to its safety while approximately 50% strongly agreed/agreed that CATs are safer than analgesics for alleviating menstrual pain. The comparative safety advantage of some CATs including home remedies such as ginger has been previously reported [35], although there is insufficient evidence to support the hypothesis that CATs are associated with fewer side effects than analgesics.

The present study found that there was no association between the current use of CATs and menstrual characteristics. However, the number of symptoms (multiple) and the severity of the symptoms (WaLIDD score) were significantly associated with current use of CATs for dysmenorrhea. These reflect the desire to relieve menstrual pain among those with severe dysmenorrhea because they have more difficulty with daily chores and academic activities compared to those with mild dysmenorrhea [7]. There was also significant association between the need to reduce analgesic use and the current use of CATs suggesting the possibility of using both therapies concurrently and highlights to need for education to promote appropriate health seeking behaviours for the treatment of dysmenorrhea. The current study also revealed that the efficacy of CATs and those who want to reduce the need for analgesics were independently associated with the current use of CATs. The high rate of CATs use among women and adolescents with dysmenorrhea warrants further research to ascertain their effectiveness and safety in the management of dysmenorrhea. There are weak evidence to support the use of CATs in dysmenorrhea [10], and their safety profile have not been adequately investigated [31]. Healthcare providers and community pharmacists should ask women and adolescents with dysmenorrhea about the use of CATs and provide counselling on the safe and effectively use of CATs and conventional medicines considering the potential for interaction between both medicines.

This study has some limitations and thus, the result should be interpreted with caution. First, the study was conducted among undergraduate students in one pharmacy school and thus the results may not be generalizable. Secondly, the study did not distinguish between primary and secondary dysmenorrhea and this could affect the result of the study considering the fact that there are different treatment approaches for the two conditions. Thirdly, the study required respondents to recall historical information and could be susceptible to recall bias. Fourthly, there responses provided by the students were self-reported and could be influenced by social desirability bias. Fifthly, the current study used a cross-sectional design to determine causal association between variables as against longitudinal study design which is more reliable. Lastly, dysmenorrhea is a sensitive issue among women and this may have had an influence on the response rate. Despite these limitations, this study has provided information about the prevalence and factors associated with the use of CATs for the treatment of dysmenorrhea among university students. Future studies should target a larger population and distinguish between primary and secondary dysmenorrhea as well as address the limitations described in this study.

Conclusion

Two-third and a little more than half of pharmacy students with dysmenorrhea are ever- and current users of CATs, respectively. Bed rest, hot compress/heating pad and massage are the most common CATs used by the students. The need to reduce the use of analgesics and believe that CAT is effective in relieving menstrual pain are independently associated with the current use of CATs. Healthcare providers should enquire about the use of CATs among patients with dysmenorrhea and ensure safe and effective use of CATs and conventional medicines.

Availability of data and materials

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Abbreviations

CATs:

Complementary and alternative therapies

OR:

Odds ratio

AOR:

Adjusted odds ratio

CI:

Confidence interval

WaLIDD:

Working ability, Location, Intensity, Days of pain and Dysmenorrhea

NSAIDs:

Non-steroidal anti-inflammatory drugs

References

  1. De Sanctis V, Soliman AT, Elsedfy H, Soliman NA, Elalaily R, El Kholy M. Dysmenorrhea in adolescents and young adults: a review in different countries. Acta Biomed. 2016;87(3):233–46.

    PubMed  Google Scholar 

  2. Iacovides S, Avidon I, Baker FC. What we know about primary dysmenorrhea today: a critical review. Hum Reprod Update. 2015;21(6):762–78.

    Article  CAS  PubMed  Google Scholar 

  3. Helwa HA, Mitaeb AA, Al-Hamshri S, Sweileh WM. Prevalence of dysmenorrhea and predictors of its pain intensity among Palestinian female university students. BMC Womens Health. 2018;18(1):18.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Ameade EP, Amalba A, Mohammed BS. Prevalence of dysmenorrhea among university students in northern Ghana; its impact and management strategies. BMC Womens Health. 2018;18(1):39.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Najafi N, Khalkhali H, Tabrizi FM, Zarrin R. Major dietary patterns in relation to menstrual pain: a nested case control study. BMC Womens Health. 2018;18(1):69.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Alsaleem MA. Dysmenorrhea, associated symptoms, and management among students at King Khalid University, Saudi Arabia: an exploratory study. J Family Med Prim Care. 2018;7(4):769.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Banikarim C, Chacko MR, Kelder SH. Prevalence and impact of dysmenorrhea on Hispanic female adolescents. Arch Pediatr Adolesc Med. 2000;154(12):1226–9.

    Article  CAS  PubMed  Google Scholar 

  8. Schoep ME, Adang EM, Maas JW, De Bie B, Aarts JW, Nieboer TE. Productivity loss due to menstruation-related symptoms: a nationwide cross-sectional survey among 32 748 women. BMJ Open. 2019;9(6):e026186.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Armour M, Parry K, Al-Dabbas MA, Curry C, Holmes K, MacMillan F, et al. Self-care strategies and sources of knowledge on menstruation in 12,526 young women with dysmenorrhea: a systematic review and meta-analysis. PLoS One. 2019;14(7):e0220103.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Yu A. Complementary and alternative treatments for primary dysmenorrhea in adolescents. Nurse Pract. 2014;39(11):1–2.

    Article  CAS  PubMed  Google Scholar 

  11. Gebeyehu MB, Mekuria AB, Tefera YG, Andarge DA, Debay YB, Bejiga GS, et al. Prevalence, impact, and management practice of dysmenorrhea among University of Gondar Students, northwestern Ethiopia: a cross-sectional study. Int J Reprod Med. 2017;2017:3208276.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Samba Conney C, Akwo Kretchy I, Asiedu-Danso M, Allotey-Babington GL. Complementary and alternative medicine use for primary dysmenorrhea among senior high school students in the Western region of Ghana. Obstet Gynecol Int. 2019;2019:8059471.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Yesuf TA, Eshete NA, Sisay EA. Dysmenorrhea among university health science students, northern Ethiopia: impact and associated factors. Int J Reprod Med. 2018;2018:9730328.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Yusof J, Mahdy ZA, Noor RM. Use of complementary and alternative medicine in pregnancy and its impact on obstetric outcome. Complement Ther Clin Pract. 2016;25:155–63.

    Article  PubMed  Google Scholar 

  15. Mohamad TA, Islahudin F, Jasamai M, Jamal JA. Preference, perception and predictors of herbal medicine use among Malay women in Malaysia. Patient Prefer Adherence. 2019;13:1829.

    Article  Google Scholar 

  16. Kartal YA. Complementary and alternative medicine therapy use of Western Turkish students for menstrual symptoms. Int J Caring Sci. 2019;12(2):1097.

    Google Scholar 

  17. Parker MA, Sneddon AE, Arbon P. The menstrual disorder of teenagers (MDOT) study: determining typical menstrual patterns and menstrual disturbance in a large population-based study of Australian teenagers. BJOG. 2010;117(2):185–92.

    Article  CAS  PubMed  Google Scholar 

  18. Kural M, Noor NN, Pandit D, Joshi T, Patil A. Menstrual characteristics and prevalence of dysmenorrhea in college going girls. J Family Med Prim Care. 2015;4(3):426.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Oksuz E, Sozen F, Kavas E, Arik EP, Akgun Y, Bingol P, et al. Usage of analgesics among young girls and dysmenorrhea. Konuralp Tıp Dergisi. 2017;9(3):213–21.

    Google Scholar 

  20. Teherán AA, Piñeros LG, Pulido F, Guatibonza MC. WalIDD score, a new tool to diagnose dysmenorrhea and predict medical leave in university students. Int J Womens Health. 2018;10:35.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Potur DC, Bilgin NC, Komurcu N. Prevalence of dysmenorrhea in university students in Turkey: effect on daily activities and evaluation of different pain management methods. Pain Manag Nurs. 2014;15(4):768–77.

    Article  PubMed  Google Scholar 

  22. Al-Jefout M, Seham AF, Jameel H, Randa AQ, Luscombe G. Dysmenorrhea: prevalence and impact on quality of life among young adult Jordanian females. J Pediatr Adolesc Gynecol. 2015;28(3):173–85.

    Article  PubMed  Google Scholar 

  23. Aktaş D. Prevalence and factors affecting dysmenorrhea in female university students: effect on general comfort level. Pain Manag Nurs. 2015;16(4):534–43.

    Article  PubMed  Google Scholar 

  24. Fernández-Martínez E, Onieva-Zafra MD, Parra-Fernández ML. Lifestyle and prevalence of dysmenorrhea among Spanish female university students. PLoS One. 2018;13(8):e0201894.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Osayande AS, Mehulic S. Diagnosis and initial management of dysmenorrhea. Am Fam Physician. 2014;89(5):341–6.

    PubMed  Google Scholar 

  26. Sukalingam K, Ganesan K. Health-related quality of life in young adult girls with dysmenorrhea among university medical students in Shah Alam, Malaysia: a cross-sectional study. Recent Adv Biol Med. 2016;2(2016):968.

    Google Scholar 

  27. Jaiprakash H, Myint KK, Chai LY, Nasir BM. Prevalence of dysmenorrhea and its sequel among medical students in a Malaysian University. J Adv Med Medical Res. 2016;4:1–8.

    Google Scholar 

  28. Ortiz MI. Primary dysmenorrhea among Mexican university students: prevalence, impact and treatment. Eur J Obstet Gynecol Reprod Biol. 2010;152(1):73–7.

    Article  PubMed  Google Scholar 

  29. Kim SD. Yoga for menstrual pain in primary dysmenorrhea: a meta-analysis of randomized controlled trials. Complement Ther Clin Pract. 2019;36:94–9.

    Article  PubMed  Google Scholar 

  30. Chen CX, Barrett B, Kwekkeboom KL. Efficacy of oral ginger (zingiber officinale) for dysmenorrhea: a systematic review and meta-analysis. Evid Based Complement Alternat Med. 2016;2016:6295737.

    PubMed  PubMed Central  Google Scholar 

  31. Armour M, Smith CA, Steel KA, Macmillan F. The effectiveness of self-care and lifestyle interventions in primary dysmenorrhea: a systematic review and meta-analysis. BMC Complement Altern Med. 2019;19(1):22.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Fisher C, Adams J, Hickman L, Sibbritt D. The use of complementary and alternative medicine by 7427 Australian women with cyclic perimenstrual pain and discomfort: a cross-sectional study. BMC Complement Altern Med. 2016;16(1):129.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Jo J, Lee SH. Heat therapy for primary dysmenorrhea: a systematic review and meta-analysis of its effects on pain relief and quality of life. Sci Rep. 2018;8(1):1–8.

    Article  Google Scholar 

  34. Shah M, Monga A, Patel S, Shah M, Bakshi H. The effect of hypnosis on dysmenorrhea. Int J Clin Exp Hypn. 2014;62(2):164–78.

    Article  PubMed  Google Scholar 

  35. Shirvani MA, Motahari-Tabari N, Alipour A. The effect of mefenamic acid and ginger on pain relief in primary dysmenorrhea: a randomized clinical trial. Arch Gynecol Obstet. 2015;291(6):1277–81.

    Article  CAS  PubMed  Google Scholar 

  36. Salmalian H, Saghebi R, Moghadamnia AA, Bijani A, Faramarzi M, Amiri FN, et al. Comparative effect of thymus vulgaris and ibuprofen on primary dysmenorrhea: a triple-blind clinical study. Caspian J Intern Med. 2014;5(2):82.

    PubMed  PubMed Central  Google Scholar 

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Acknowledgements

The authors wish to acknowledge all the students who participated in this study as well as the senior lecturers who validated the initial questionnaire.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Pharmacy Practice, Kulliyah of Pharmacy, International Islamic University Malaysia, 25200, Kuantan, Pahang, Malaysia

    Usman Abubakar, Amni Izzati Zulkarnain, Fatihah Samri, Sabrina Ros Hisham, Anis Alias, Muhammad Ishak, Hajarah Sugiman & Taufik Ghozali

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  1. Usman Abubakar
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Contributions

UA, AIZ, FS, SRH, AA, MI, HS and TG conceived the project idea, UA, AIZ, FS, SRH, AA, MI, HS and TG analysed and interpreted the data and UA wrote the manuscript. UA, AIZ, FS, SRH, AA, MI and HS collected the data. UA supervise the project. All authors discussed the results and contributed to the final manuscript. The authors read and approved the final manuscript.

Corresponding author

Correspondence to Usman Abubakar.

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Ethics approval and consent to participate

Ethics approval was obtained from the Research and Ethics committee of the school of pharmacy as well as the International Islamic University Malaysia Institutional Research and Ethics Committee (IIUM IREC). Reference number: IIUM/504/14/11/2/IREC 2020–023. Data was also de-identified before analysis. All the respondents were required to provide written consent (by ticking “agree” on the consent form attached to the questionnaire).

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The authors declare that there is no competing interests.

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Abubakar, U., Zulkarnain, A.I., Samri, F. et al. Use of complementary and alternative therapies for the treatment of dysmenorrhea among undergraduate pharmacy students in Malaysia: a cross sectional study. BMC Complement Med Ther 20, 285 (2020). https://doi.org/10.1186/s12906-020-03082-4

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  • DOI: https://doi.org/10.1186/s12906-020-03082-4

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BMC Complementary Medicine and Therapies

ISSN: 2662-7671

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