The role of exercise in the treatment of menstrual disorders: the evidence

Abstract

Two of the most commonly experienced menstrual disorders are premenstrual syndrome (PMS) and primary dysmenorrhoea (that is, menstrual cramps or period pain), which can both adversely effect women's functioning and quality of life.1–3 Several evidence-based treatments are available for these menstrual disorders such as oral contraceptive pills, non-steroidal anti-inflammatory drugs and gonadotropin-releasing hormone (GnRH) agonist treatment. In terms of non-pharmacological treatments, it is popularly thought that exercise participation reduces the frequency and/or severity of PMS and primary dysmenorrhoea. Studies4 have shown that clinicians often recommended exercise and women frequently use it for symptom management,3 but this in itself does not constitute evidence of effectiveness. The American College of Obstetricians and Gynecologists has stated in their patient information leaflet (http://www.acog.org/publications/patient_education/bp057.cfm) that ‘for many women aerobic exercise lessens PMS symptoms’, although the frequency and duration of exercise required to gain relief from symptoms is not specified. Similarly in the UK, the NHS direct website (http://www.nhsdirect.nhs.uk/articles/article .aspx?articleId=578&sectionId=11) which offers advice to women about possible treatment for menstrual pain, states that ‘moderate physical exercise may help with relieving pain’. However, a question remains about whether this advice is warranted, if so, on what evidence is it based? Trials involving general populations have shown that participation in regular exercise can improve some of the types of symptoms (that is, mood disturbance, fatigue, cognitive dysfunction, and bloating) typically experienced by women who suffer from PMS and/or primary dysmenorrhoea.5 On this basis, it might seem intuitively appealing to promote exercise as treatment for these disorders, but these data are a long way off from telling us we have evidence that exercise is an effective treatment for these conditions.