Extracorporeal Shock Wave Therapy in the Treatment of Primary Dysmenorrhea
Condition: Dysmenorrhea Primary; Pain, Menstrual
MeSH terms: Dysmenorrhea
Study type: Interventional

Summary: 
      Primary dysmenorrhea (PD) is a common female disease during menstruating. Although
      nonsteroidal anti-inflammatory drug is an effective treatment, there are concerns about side
      effects. Alternative therapies, including acupuncture and moxibustion, are commonly used for
      PD. Nevertheless, traditional Chinese medicine takes longer period than Western medicine to
      release PD. Extracorporeal shock wave therapy (ESWT) originally for the treatment of
      musculoskeletal diseases has characteristics of fast curative effect and no wound. Currently
      there is no report about clinical use of ESWT for the treatment of PD. Our study is to
      determine whether ESWT is effective in the treatment of PD based on meridian theory of
      traditional Chinese medicine. The investigators hypothesis that ESWT during PD is more
      effective than ESWT before PD or abdominal hot paste during PD without ESWT.
    

Detailed description: 
      This randomized sham-controlled trial is to determine whether ESWT is effective in the
      treatment of PD. Patients are randomly divided into 3 groups: 1. ESWT treatment during PD
      (n=15）; 2. ESWT treatment before PD（n=15）; 3. abdominal hot paste during PD without
      ESWT（n=15）.

      Exclusion criteria: secondary PD, concomitant chronic disease (epilepsy, gastrointestinal,
      cardiovascular and renal diseases), taken oral contraceptives or vitamin/ mineral supplements
      in the past 3 months, taking part in other clinical trials.

      Medical history will be recorded before the treatment. A questionnaire will be filled by the
      participant. Blood samples will be collected before and after the treatment. Participants
      will be followed up closely by a professional nurse. Participants in group 1 will receive
      ESWT treatment on day1 and day 3 of each menstrual cycle. Participants in group 2 will
      receive twice ESWT treatment one week before the estimated first day of the menstrual cycle.
      Participants in group 3 will receive hot compress paste on their belly 2 inches under the
      navel whenever they feel painful during the menstrual cycle. Patients with PD are treated for
      three menstrual cycles and followed by three menstrual cycles. Evaluation time point will be
      one-menstrual cycle baseline, third-menstrual cycle treatment, and third-menstrual cycle
      follow-up period. The investigators will inform participants to keep warm, avoid cold drink
      and have a healthy lifestyle via telephone communication each week during the trial.

      The plasma concentrations of prostaglandin F2a metabolite, PGE2, visual analogue scale (VAS),
      and pictorial blood loss assessment chart (PBLA), total pain relief over 4 consecutive hours
      (TOPAR4), Self-Rating Anxiety Scale (SAS) and other questionnaires about menstrual pain will
      be recorded and evaluated before and after treatment.
    

Intervention name(s): extracorporeal shock wave therapy; hot compress paste
Intervention type(s): Other; Other
Intervention description(s): Intervention group is by extracorporeal shock wave therapy.A radial shock wave device (EMS Swiss Dolor, Munich, Germany) was used. Radial shock wave is created ballistically with the pressurized air source accelerating a bullet to strike a metal applicator. The kinetic energy produced is transformed into radially expanding shock waves from the application site into the tissue to be treated. The treatment of area is lower abdomen which has some acupuncture points such as Shenque(CV8) ,Qihai(BL24), Guanyuan(CV4), Zhongji(CV3), Tianshu(ST25), Guilai(ST29) and Zigong(EX-CA1) at the right and left sides of the lower abdomen. All acupuncture points should be placed according to participants' feedback during treatment.; Hot compress pastes will be sticked on the lower abdomen.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: primary dysmenorrhea; extracorporeal shock wave therapy; traditional Chinese medicine