The Effect of Calcium with and without Magnesium on Pain Severity and Resting Duration in Students with Primary Dysmenorrhea: A Randomized Controlled Trial

Abstract

Abstract: Background & objective: There are some evidence on possible positive effect of calcium and magnesium on dysmenorrhea. However, we found no randomized trial on effect of combined calcium and magnesium and only calcium on dysmenorrhea. Therefore, we aimed to assess their effect on pain severity and rest duration (primary outcomes) and menstrual bleeding and menstrual symptoms and use of analgesics (secondary outcome) in students with primary dysmenorrhea residing in dormitories of Tabriz. Material & methods: In this randomized double-blind trial, 63 students who dwelled in dormitories of Tabriz and suffered from moderate or severe dysmenorrhea, were randomly assigned to two intervention groups and control group. Participants in intervention groups got tablet of combination of calcium (600 mg) and magnesium (300 mg) or only calcium (600 mg) and control group got placebo once a day from 15th of menstrual cycle until the day of menstrual pain relief. All participants reported their severity of menstrual pain (using VAS) and duration of rest (hours) and number of Ibuprofen taken in 2 days before and 3 days after starting of menstrual bleeding and their menstrual symptoms (using SSS scale) in 2 days before and 2 days after beginning of menstrual bleeding and their amount of menstrual bleeding (using Higham chart) during four continuous cycles (2 cycles before and 2 cycles under intervention). The data were analyzed using one-way ANOVA and ANCOVA tests. Results: There was no significant difference between the groups in terms of demographic and reproductive characteristics at baseline. One from each intervention groups were lost to follow up. Both intervention groups had better outcomes compared with the control group regarding pain intensity and resting duration. Combined calcium and magnesium group had better outcomes compared it the only calcium group regarding relief pain and resting duration (p<0.001). The mean scores of severity of menstrual symptom (all of items) in the intervention groups were significantly lower than the control group (p<0.001) and mean of menstrual bleeding in the combined calcium-magnesium group were significantly lower than the control group (p<0.029). The number of Ibuprofen taken in both intervention groups were significantly lower than the control group (p<0.001). No side event was reported. Conclusion: Use of calcium and magnesium can reduce severity of menstrual pain with favorable therapeutic effects by reducing the severity symptoms with dysmenorrhea.