TENS for Menstrual Cramps (Dysmenorrhea)

INTRO

Did you know that there have been studies documenting the effectiveness of Transcutaneous electrical nerve stimulation (TENS) on period pain? And that it works?

There are a number of ways you can treat your painful periods at home. For example, gentle exercise, a hot water bottle, a warm bath, massage of the lower abdomen or relaxation techniques such as Pilates.  Although you may not stop your pain completely, these measures can often help to ease or reduce it.

Another way to help alleviate the pain is by using TENS (Transcutaneous electronic nerve stimulation).

A TENS machine is ideal for the treatment of painful menstruation.  It is non-evasive and drug free. Electrode pads are placed near the area of pain (see diagram). TENS uses soothing pulses that are sent via the pads through the skin and along the nerve fibres. The pulses suppress menstrual pain signals to the brain. TENS also encourages the body to produce higher levels of its own natural pain killing chemicals ie endorphins and encephalins.

RESEARCH

The first study (from 2003) can be found here and was documented by Howard Smith, MD and Vian Younan, MD.  They found that transcutaneous electrical nerve stimulation (TENS)—as a treatment modality for primary dysmenorrhea—can act as a pain relief mechanism for women with painful menstrual cramps.


Smith and Younan concluded that a review of published studies shows that TENS may be an effective treatment modality and/or therapeutic adjunct for primary dysmenorrhea. The most serious side effect of TENS was discomfort at the site of electrical stimulation. However, the women that had this uncomfortable sensation, stated that they would still be willing to undergo the treatment in order to be rid of painful menstrual cramps that hinders their lives for a few days each month.14 However, more studies need to be done on the practicality of using a TENS unit on adolescent women who are more affected by primary dysmenorrhea than the rest of the population.

Currently available studies suggest that high frequency TENS (50 to 120 Hz) seems to be more effective for pain relief than placebo TENS (see Table 1). Low frequency TENS (1 to 4 Hz) may not be more effective than placebo TENS. High intensity transcutaneous electrical nerve stimulation appears to be an effective and safe form of therapy in patients with primary dysmenorrhea.

Another study by Mannheimer et al in 1985, randomized women to the following three groups; High frequency TENS, Low frequency TENS, and placebo TENS. Treatment for all groups was 30 minutes in duration and then discontinued until pain returned. Upon return of pain, the subjects could reinstitute TENS and a record of use was kept. Pain was rated immediately before and after use. There was no significant difference between the two types of TENS but the high frequency TENS achieved slightly more pain relief.

A study by Proctor, Farquhar et al in 2002 concluded that high-frequency nerve stimulation may help relieve painful menstrual cramps. Dysmenorrhoea is a very common complaint that refers to painful menstrual cramps in the uterus. Transcutaneous electrical nerve stimulation (TENS) involves the sending of an electric current by placing electrodes on the skin to stimulate the nerves and reduce pain. It is thought to alter the body’s ability to receive and understand pain signals rather than by having a direct effect on the uterine contractions. The review of trials found that high-frequency TENS may help but there is not enough evidence to assess the effect of low-frequency TENS.

REFERENCES

Carol GT Vance, Dana L Dailey, Barbara A Rakel, Kathleen A Sluka

Pain Manag. 

Published in final edited form as: Pain Manag. 2014 May; 4(3): 197–209. doi: 10.2217/pmt.14.13 Using TENS for pain control: the state of the evidence

Dawood MY and Ramos J. Transcutaneous electrical nerve stimulation (TENS) for the treatment of primary dysmenorrhea: a randomized crossover comparison with placebo TENS and ibuprofen. Obstetrics & Gynecology. 1990. 75(4):656-660.

Kaplan B, Peled Y, Pardo J, Rabinerson D, Hirsh M, Ovadia J, Neri A. Transcutaneous electrical nerve stimulation (TENS) as a relief for dysmenorrhea. Clin Exp Obstet Gynecol. 1994. 21(2):87-90.

Milsom I, Hedner N and Mannheimer C. A comparative study of the effect of high intensity transcutaneous nerve stimulation and oral naproxen on intrauterine pressure and menstrual pain in patients with primary dysmenorrhea. American Journal of Obstetrics & Gynecology. 1994. 170(1):123-129.

http://www.practicalpainmanagement.com/pain/other/tens-treatment-primary-dysmenorrhea

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD002123/full

 

 

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