Home Medicine Neutral douche: a hydrotherapeutic tool to manage pain and systemic symptoms in primary dysmenorrhea - a randomised controlled study
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Neutral douche: a hydrotherapeutic tool to manage pain and systemic symptoms in primary dysmenorrhea - a randomised controlled study

  • Sataz Rahmania , Vanitha Shetty and Balakrishnan Ragavendrasamy EMAIL logo
Published/Copyright: October 12, 2020
Journal of Complementary and Integrative Medicine
From the journal Journal of Complementary and Integrative Medicine Volume 18 Issue 1

Abstract

Background & Objectives

The douche, one of the hydrotherapeutic treatment modality is commonly used by Naturopathy physicians as a treatment of choice in the management of several ailments. This study was done to assess the effect of full body neutral douche in the management of pain and systemic symptoms in adult females with primary dysmenorrhoea.

Methods

68 subjects of age 18-22 years with primary dysmenorrhoea were recruited for the study and were randomly divided into two groups: the experimental group (n = 34) and the control group (n = 34). The experimental group received whole body neutral douche, whereas the control group followed the routine as usual. Assessments for the pain, systemic symptoms and menstrual cramps were done by using McGill Pain Questionnaire, Verbal multidimensional scoring system and analog scale for severity of pain and menstrual cramps respectively at baseline, day 30 and day 60 of intervention. Two- way repeated measures of ANOVA was performed to understand the between group changes, adjusted for the respective baseline values and age.

Result

Data was analyzed with SPSS (Version 21.0) package. Neutral douche resulted in significant improvement in pain [F(2,66) = 114.564, p < 0.0005, partial ?2 = 0.771], severity of pain [F(2,66) = 70.418, p < 0.0005, partial ?2 = 0.681], cramps [F(2,66) = 75.986, p < 0.0005, partial ?2 = 0.697] and systemic symptoms [F(2,66) = 14.64, p < 0.0005, partial ?2 = 0.307] as compared to the control group.

Conclusion

Findings suggest that neutral douche can be used as a non-pharmacological intervention in the management of pain and systemic symptoms in primary dysmenorrhea.

Keywords: hydrotherapy; naturopathy; neutral douche; pain; primary dysmenorrhea
Corresponding author: Balakrishnan Ragavendrasamy, Assistant Medical Officer, Yoga and Naturopathy Lifestyle Clinic, Government Hospital, Udumalpet, India, E-mail:

  1. Research funding: None declared.

  2. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  3. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

  4. Employment or leadership: None declared.

  5. Honorarium: None declared.

References

1. Hiralal, K, DC Dutta's textbook of gynaecology 2016.Search in Google Scholar

2. Durain, D. Primary dysmenorrhea: assessment and management update. J Midwifery Womens Health 2004;49:520-28. https://doi.org/10.1016/j.jmwh.2004.08.013.10.1016/j.jmwh.2004.08.013Search in Google Scholar

3. Ju, H, Jones, M, Mishra, G. The prevalence and risk factors of dysmenorrhea. Epidemiol Rev 2014;36:104-13. https://doi.org/10.1093/epirev/mxt009.10.1093/epirev/mxt009Search in Google Scholar

4. Hillen, TI, Grbavac, SL, Johnston, PJ, Straton, JA, Keogh, JM. Primary dysmenorrhea in young Western Australian women: prevalence, impact, and knowledge of treatment. J Adolesc Health 1999;25:40-5. https://doi.org/10.1016/s1054-139x(98)00147-5.10.1016/S1054-139X(98)00147-5Search in Google Scholar

5. Rapkin, AJ, Berek, H. Novak's gynecology, 14th edition (Novak's textbook gynecology) - EPDF.TIPS. Lippincot Williams and Wilkins 2007;505-40. https://doi.org/10.1001/jama.289.10.1314.10.1001/jama.289.10.1314Search in Google Scholar

6. Kaur, S, Sarin, J. Assessment and comparison of dysmenorrhea in terms of severity of pain and utilization of non steroid anti-inflammatory drugs among unmarried and married women. Int J Caring Sci 2015;8:737-46. https://doi.org/10.16965/ijpr.2020.102.10.16965/ijpr.2020.102Search in Google Scholar

7. Harlow, SD, Park, M. A longitudinal study of risk factors for the occurrence, duration and severity of menstrual cramps in a cohort of college women. BJOG An Int J Obstet Gynaecol 1996;103:1134-142. https://doi.org/10.1111/j.1471-0528.1996.tb09597.x.10.1111/j.1471-0528.1996.tb09597.xSearch in Google Scholar PubMed

8. Proctor, M, Farquhar, C. Diagnosis and management of dysmenorrhoea. BMJ 2006;332:1134-8. https://doi.org/10.1136/bmj.332.7550.1134.10.1136/bmj.332.7550.1134Search in Google Scholar PubMed PubMed Central

9. Harlow, SD, Campbell, OMR. Epidemiology of menstrual disorders in developing countries: a systematic review. BJOG An Int J Obstet Gynaecol. 2004;111:6-16. https://doi.org/10.1111/j.1471-0528.2004.00012.x.10.1111/j.1471-0528.2004.00012.xSearch in Google Scholar PubMed

10. Unsal, A, Ayranci, U, Tozun, M, Arslan, GUL, Calik, E. Prevalence of dysmenorrhea and its effect on quality of life among a group of female university students. 2010;138-45. https://doi.org/10.3109/03009730903457218.10.3109/03009730903457218Search in Google Scholar PubMed PubMed Central

11. Agarwal, AK, Agarwal, A. A study of dysmenorrhea during menstruation in adolescent girls. Indian J Community Med 2010;35:159-64. https://doi.org/10.4103/0970-0218.62586.10.4103/0970-0218.62586Search in Google Scholar PubMed PubMed Central

12. Omidvar, S, Bakouei, F, Amiri, F. N, Begum, K. Primary dysmenorrhea and menstrual symptoms in indian female students: prevalence , impact and management. Glob J Health Sci. 2016;8. https://doi.org/10.5539/gjhs.v8n8p135.10.5539/gjhs.v8n8p135Search in Google Scholar

13. Omidvar, S, Begum, K. Menstrual pattern among unmarried women from south India. J Nat Sci Biol Med. 2011;2:174-9. https://doi.org/10.4103/0976-9668.92329.10.4103/0976-9668.92329Search in Google Scholar

14. George, N, Priyadarshini, S, Shetty, S. Dysmenorrhoea among adolescent girls-characteristics and symptoms experienced during menstruation. Nitte Univ J Heal Sci. ISSN 2249 - 7110 2014;4:45-2.Search in Google Scholar

15. Charu, S, Amita, R, Sujoy, R, Thomas, GA. Menstrual characteristics' and 'Prevalence and effect of dysmenorrhea' on quality of life of medical students. Int J Collab Res Intern Med Public Health. 2012;4.Search in Google Scholar

16. McEvoy, M, Chang, J, Susan, MC. Common menstrual disorders in adolescence: nursing interventions. The American J Maternal/Child Nursing 2004. https://doi.org/10.1097/00005721-200401000-00011.10.1097/00005721-200401000-00011Search in Google Scholar

17. Klein, JR, Litt, IF. Epidemiology of adolescent dysmenorrhea. Pediatrics 1981;68:661-4.10.1542/peds.68.5.661Search in Google Scholar

18. Johnson, J. Level of knowledge among adolescent girls regarding effective treatment for dysmenorrhea. J Adolesc Health Care 1988;9:398-402.10.1016/0197-0070(88)90036-8Search in Google Scholar

19. Wilson, CA, Keye, WR. A survey of adolescent dysmenorrhea and premenstrual symptom frequency: a model program for prevention, detection and treatment. J Adolesc Health Care 1989;10:317-22.10.1016/0197-0070(89)90065-XSearch in Google Scholar

20. Kural, M, Noor, N. N, Pandit, D, Joshi, T, Patil, A. Menstrual characteristics and prevalence of dysmenorrhea in college going girls. J Fam Med Prim Care 2015;4:426-31. https://doi.org/10.4103/2249-4863.161345.10.4103/2249-4863.161345Search in Google Scholar

21. Mirabi, P, Dolatian, M, Mojab, F, Namdari, M. Effects of valerian on bleeding and systemic manifestations of menstruation. J Med Plants 2012;4:155-63.Search in Google Scholar

22. Proctor, M, Murphy, PA. Herbal and dietary therapies for primary and secondary dysmenorrhoea. Cochrane Database Syst Rev 2001.10.1002/14651858.CD002124Search in Google Scholar

23. Helms, JM. Acupuncture for the management of primary dysmenorrhea. Obstet Gynecol. 1987;69:51-6. https://doi.org/10.1016/0020-7292(87)90381-x.10.1016/0020-7292(87)90381-XSearch in Google Scholar

24. Barnard, ND, Scialli, AR, Hurlock, D, Bertron, P. Diet and sex-hormone binding globulin, dysmenorrhea, and premenstrual symptoms. Obstet Gynecol. 2000;95:245-50. https://doi.org/10.1016/s0029-7844(99)00525-6.10.1016/S0029-7844(99)00525-6Search in Google Scholar

25. Deutch, B. Menstrual pain in Danish women correlated with low n-3 polyunsaturated fatty acid intake. Eur J Clin Nutr 1995;49:508-16.Search in Google Scholar

26. Dawood, M, Gynecology, JRO, undefined, Transcutaneous electrical nerve stimulation (TENS) for the treatment of primary dysmenorrhea: a randomized crossover comparison with placebo TENS and ibuprofen. Europepmc.Org, 1990.Search in Google Scholar

27. Matthewman, G, Lee, A, Kaur, JG, Daley, AJ. Physical activity for primary dysmenorrhea: a systematic review and meta-analysis of randomized controlled trials. Am J Obstet Gynecol. 2018. https://doi.org/10.1016/j.ajog.2018.04.001.10.1016/j.ajog.2018.04.001Search in Google Scholar

28. S Saleh, H, E Mowafy, H. Stretching or core strengthening exercises for managing primary dysmenorrhea. J Womens Heal Care 2016;05. https://doi.org/10.4172/2167-0420.1000295.10.4172/2167-0420.1000295Search in Google Scholar

29. Chen, H.-M, Chen, C.-H. Effects of acupressure at the Sanyinjiao point on primary dysmenorrhoea. J Adv Nurs 2004;48:380-387. https://doi.org/10.1111/j.1365-2648.2004.03236.x.10.1111/j.1365-2648.2004.03236.xSearch in Google Scholar

30. Gharloghi, S, Torkzahrani, S, Akbarzadeh, AR, Heshmat, R. The effects of acupressure on severity of primary dysmenorrhea background: dysmenorrhea constitutes one of the most frequent disorders in women of a fertile. Patient Prefer. Adherence 2012;6:137-42. https://doi.org/10.2147/ppa.s27127.10.2147/PPA.S27127Search in Google Scholar

31. Rezvani, S, Taghian, F, Valiani, M. The effect of aquatic exercises on primary dysmenorrhoea in nonathlete girls. Iran J Nurs Midwifery Res. 2013;18:378-83.Search in Google Scholar

32. Pizzorno, J, Textbook of natural medicine. 2013.Search in Google Scholar

33. Kellog, JH. Rational hydrotherapy, a manual of the physiological and therapeutic effects of hydriatic procedures, and the technique of their application in the treatment of disease". 2005.Search in Google Scholar

34. Coco, AS. Primary dysmenorrhea. Am Fam Physician 1999;60:489-96. https://doi.org/10.1007/978-3-540-29805-2_3534.10.1007/978-3-540-29805-2_3534Search in Google Scholar

35. Yildirir, A, Kabakci, G, Akgul, E, Tokgozoglu, L, Oto, A. Effects of menstrual cycle on cardiac autonomic innervation as assessed by heart rate variability. Ann. Noninvasive Electrocardiol. 2002;7:60-3. https://doi.org/10.1111/j.1542-474x.2001.tb00140.x.10.1111/j.1542-474X.2001.tb00140.xSearch in Google Scholar

36. L|, FX, Ma, Z, Moser, S, Evans, TG, Miller, CJ. Effects of ovarian steroids on immunoglobulin-secreting cell function in healthy women. Clin Diagn Lab Immunol. 2003;10:944-9. https://doi.org/10.1128/cdli.10.5.944-949.2003.10.1128/CDLI.10.5.944-949.2003Search in Google Scholar

37. Melzack, R. The short-form McGill pain questionnaire. Pain 1987;30:191-197. https://doi.org/10.1016/0304-3959(87)91074-8.10.1037/t04167-000Search in Google Scholar

38. Chan, WY, Fuchs, F, Powell, AM. Effects of naproxen sodium on menstrual prostaglandins and primary dysmenorrhea. Obstet Gynecol. 1983;61:285-91. https://doi.org/10.1016/0090-6980(77)90056-9.10.1016/0090-6980(77)90056-9Search in Google Scholar

39. Khorshidi, N, Ostad, SN, Mosaddegh, M, Soodi, M, Clinical Effects of Fennel Essential oil on Primary Dysmenorrhea. 2003;89-93.Search in Google Scholar

40. Omidvar, S, Bakouei, F, Amiri, FN, Begum, K. Primary dysmenorrhea and menstrual symptoms in indian female students: prevalence, impact and management. Glob J Health Sci 2015;8:135. https://doi.org/10.5539/gjhs.v8n8p135.10.5539/gjhs.v8n8p135Search in Google Scholar PubMed PubMed Central

41. Juang, CM, Yen, MS, Twu, NF, Horng, HC, Yu, HC, Chen, CY. Impact of pregnancy on primary dysmenorrhea. Int J Gynecol Obstet. 2006;92:221-227.10.1016/j.ijgo.2005.12.006Search in Google Scholar PubMed

42. Ahn, MH, Jeon, SH, Yoon, Y. The effect of stonetherapy and hydrotherapy on dysmenorrhea and premenstrual syndrome of unmarried women in their 20s-30s. Kor J Aesthet Cosmetol 11:85-92. https://doi.org/10.4069/kjwhn.2002.8.2.212.10.4069/kjwhn.2002.8.2.212Search in Google Scholar

43. Soni, K, Shetty, P, Sujatha, KJ. A comparative study on effects of neutral and cold underwater massage on the physiological parameters of healthy individuals. IOSR-JDMS 2016;15:32-6. https://doi.org/10.9790/0853-1509103236.10.9790/0853-1509103236Search in Google Scholar

44. Afazel, MR, Jalali, E, Sadat, Z, Mahmoodi, H. comparing the effects of hot pack and lukewarm-water-soaked gauze on postoperative urinary retention; a randomized controlled clinical trial. Nurs Midwifery Stud 2014;3. https://doi.org/10.17795/nmsjournal24606.10.17795/nmsjournal24606Search in Google Scholar PubMed PubMed Central

45. Lim, KO, Lee, DY, Shin, WS. The effects of a warm whirlpool bath on pain and stiffness of patients with chronic stroke induced knee osteoarthritis. J Phys Ther Sci. 2013;25:873-5. https://doi.org/10.1589/jpts.25.873.10.1589/jpts.25.873Search in Google Scholar PubMed PubMed Central

46. Munguma-Izquierdo, D, Legaz-Arrese, A. Exercise in warm water decreases pain and improves cognitive function in middle-aged women with fibromyalgia. Clin Exp Rheumatol. 2007;25:823-30. https://doi.org/10.1002/art.21718.10.1002/art.21718Search in Google Scholar PubMed

47. Yang, HL, Chen, XP, Lee, KC, Fang, FF, Chao, YF. The effects of warm-water footbath on relieving fatigue and insomnia of the gynecologic cancer patients on chemotherapy. Cancer Nurs 2010;33:454-60. https://doi.org/10.1097/ncc.0b013e3181d761c1.10.1097/NCC.0b013e3181d761c1Search in Google Scholar PubMed

48. Skurvydas, A, Kamandulis, S, Stanislovaitis, A, Streckis, V, Mamkus, G, Drazdauskas, A. Leg immersion in warm water, stretch-shortening exercise, and exercise-induced muscle damage. 2008 43:592-9. https://doi.org/10.4085/1062-6050-43.6.592.10.4085/1062-6050-43.6.592Search in Google Scholar PubMed PubMed Central

Supplementary Material

The online version of this article offers supplementary material (https://doi.org/10.1515/jcim-2019-0241).

Received: 2019-09-12
Accepted: 2020-02-18
Published Online: 2020-10-12

© 2020 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/jcim-2019-0241
Keywords for this article
hydrotherapy; naturopathy; neutral douche; pain; primary dysmenorrhea

Articles in the same Issue

  1. Frontmatter
  2. Reviews
  3. Endocannabinoids release after Osteopathic Manipulative Treatment. A brief review
  4. A pervasive scientific overview on mangiferin in the prevention and treatment of various diseases with preclinical and clinical updates
  5. Clinical trials of homeopathy in urological disorders: a systematic review
  6. Strategies in traditional Persian medicine to maintain a healthy life in the elderly
  7. Research articles Basic
  8. Cytoprotective and antisecretory properties of methanolic extract of Distemonanthus benthamianus (Caesalpiniaceae) stem bark on acute gastric ulcer in rats
  9. Screening chemical inhibitors for alpha-amylase from leaves extracts of Murraya koenigii (Linn.) and Aegle marmelos L.
  10. Ayurvedic formulations containing benzoic and ascorbic acids as additives: benzene formation during storage and impact of additives on quality parameters
  11. High cholesterol diet promotes dysfunction of arginase and cholinergic enzymatic system in rats: ameliorative role of caffeic and chlorogenic acids
  12. Cytokine and inflammatory mediators are associated with cytotoxic, anti-inflammatory and apoptotic activity of honeybee venom
  13. Anti-anaemic effect of ethanol leaf extract of Cnidosculus aconitifolius on cyclophosphomide-induced anaemia in rats
  14. Alterations in histological, biochemical and hematological parameters in Plasmodium berghei NK-65 infected balb/c mice treated with Bridelia ferruginea stem bark extract
  15. Structural characterization, antioxidant, and antibiofilm activities of Coffea canephora green seeds
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  17. Safety, efficacy and tolerability of a combination micronutrient and polyherbal preparation (GoutFighterTM) for gout: a single-arm open-label pilot study
  18. Efficacy of Habbul aas (fruits of Myrtus communis) in menorrhagia: a single blinded randomized standard control study
  19. Ginger (Zingiber officinale) and turmeric (Curcuma longa L.) supplementation effects on quality of life, body composition, bone mineral density and osteoporosis related biomarkers and micro-RNAs in women with postmenopausal osteoporosis: a study protocol for a randomized controlled clinical trial
  20. Lithotriptic effect of Safūf Hajar-al Yahūd in patients of Hasat-ul Kilya (Nephrolithiasis) – an open prospective clinical validation trial
  21. Efficacy of Qurs-e-Gulnar in Ziabetus (type 2 Diabetes Mellitus): a single blind randomized controlled trial
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