Original Study| Volume 28, ISSUE 6, P486-491, December 2015

Comparison of the Effect of Massage Therapy and Isometric Exercises on Primary Dysmenorrhea: A Randomized Controlled Clinical Trial

Published:March 04, 2015DOI:


      Study Objective

      Dysmenorrhea is the most common cyclic pelvic pain, and it affects the quality of life of many women. We sought to compare the effects of massage and isometric exercises on primary dysmenorrhea.

      Design, Setting, and Participants

      We conducted a randomized controlled trial at the dormitories of Shiraz University among 102 students with primary dysmenorrheal.


      The student groups were randomly divided into massage, isometric exercises, and control groups. The first group received 2 consecutive cycles of effleurage massage with lavender oil. The second group had 8 weeks of isometric exercises. No intervention was performed for the control group.

      Main Outcome Measurements

      Pain intensity was measured and recorded by using a visual analog scale. In addition, the duration of pain was measured in hours, and Spielberger's questionnaire was used to measure the anxiety level.


      Pain intensity had significantly reduced in the massage and exercises groups; the reduction was more significant in the massage group (P < .001). The results revealed a significant difference among the 3 groups in regard to the mean duration of pain after the third cycle (P = .006). However, no significant difference was found among the 3 groups concerning the mean level of anxiety. The results of intragroup comparisons only showed a significant reduction of anxiety level in the massage group after the third cycle (P = .017).


      Based on the present findings, it seems that massage therapy and isometric exercises were effective in reducing some symptoms of dysmenorrhea.

      Key Words

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        • Rasoolzadeh N.
        • Zebardast J.
        • Zolphagari M.
        • et al.
        Effects of relaxation on primary dysmenorhea among first year nursing and midwifery female students.
        Hayat. 2007; 13: 23
        • Latthe P.M.
        • Champaneria R.
        • Khan K.S.
        BMJ Clin Evid. 2011; 2011: 0813
        • Chantler I.
        • Mitchell D.
        • Fuller A.
        The effect of three cyclo-oxygenase inhibitors on intensity of primary dysmenorrheic pain.
        Clin J Pain. 2008; 24: 39
        • Dawood M.Y.
        Primary dysmenorrhea: advances in pathogenesis and management.
        Obstet Gynecol. 2006; 108: 428
        • Diaz A.
        • Laufer M.
        • Breech L.
        Menstruation in girls and adolescents: using the menstrual cycle as a vital sign.
        Pediatrics. 2006; 118: 2245
        • Ambresin A.-E.
        • Belanger R.E.
        • Chamay C.
        • et al.
        Body dissatisfaction on top of depressive mood among adolescents with severe dysmenorrhea.
        J Pediatr Adolesc Gynecol. 2012; 25: 19
        • Costello E.J.
        • Mustillo S.
        • Erkanli A.
        • et al.
        Prevalence and development of psychiatric disorders in childhood and adolescence.
        Arch Gen Psychiatry. 2003; 60: 837
        • Berek J.S.
        • Novak E.
        Berek & Novak’s Gynecology.
        15th ed. Wolters Kluwer Health/Lippincott Williams & Wilkins, Philadelphia, PA2012: 257-258
        • Yaghmaei M.
        • Mirteymouri M.
        • Mokhtari M.
        • et al.
        The comparison of the therapeutic effect of mefenamic acid and mefenamic acid plus vitamin E on severity of pain in primary dysmenorrhea.
        Reprod Infertil. 2005; 6: 187
        • Kim Y.-J.
        • Lee M.S.
        • Yang Y.S.
        • et al.
        Self-aromatherapy massage of the abdomen for the reduction of menstrual pain and anxiety during menstruation in nurses: a placebo-controlled clinical trial.
        Eur J Integrat Med. 2011; 3: e165
        • Lee Y.M.
        Effects of aroma-foot-reflexology on premenstrual syndrome, dysmenorrhea and lower abdominal skin temperature of nursing students.
        Kor J Adult Nursing. 2011; 23: 472
        • Mirbagher-Ajorpaz N.
        • Adib-Hajbaghery M.
        • Mosaebi F.
        The effects of acupressure on primary dysmenorrhea: a randomized controlled trial.
        Complement Therapies Clin Pract. 2011; 17: 33
        • Chen Y.
        • Shang G.
        • Fu G.
        Effect of massage on hemodynamics parameters of uterine artery and serum prostaglandin in treating patients with primary dysmenorrhea.
        Zhongguo Zhong Xi Yi Jie He Za Zhi. 2011; 31: 1355
        • Onur O.
        • Gumus I.
        • Derbent A.
        • et al.
        Impact of home-based exercise on quality of life of women with primary dysmenorrhoea.
        South Afr J Obstet Gynaecol. 2012; 18: 15
        • Lowdermilk D.L.
        • Perry S.E.
        • Bobak I.M.
        Maternity & Women's Health Care.
        8th ed. Mosby, St. Louis2004: 331-333
        • Buckle J.
        Clinical aromatherapy.
        Churchill Livingstone, New York2003: 102
        • Apay S.E.
        • Arslan S.
        • Akpinar R.B.
        • et al.
        Effect of aromatherapy massage on dysmenorrhea in Turkish students.
        Pain Manag Nurs. 2012; 13: 236
        • Abbaspour Z.
        • Rostami M.
        • Najjar S.
        The effect of exercise on primary dysmenorrhea.
        J Res Health Sci. 2006; 6: 26
        • Kubo K.
        • Kanehisa H.
        • Fukunaga T.
        Influences of repetitive drop jump and isometric leg press exercises on tendon properties in knee extensors.
        J Strength Cond Res. 2005; 19: 864
        • Blakey H.
        • Chisholm C.
        • Dear F.
        • et al.
        Is exercise associated with primary dysmenorrhoea in young women?.
        BJOG. 2010; 117: 222
        • Shavandi N.
        • Taghian F.
        • Soltani V.
        The effect of isometric exercise on primary dismenorrhea.
        Arak Med Univ J. 2010; 13: 71
        • Aghamohammadi-Kalkhora M.
        • Karimollahi M.
        Religiousness and preoperative anxiety: a correlational study.
        Ann Gen Psychiatry. 2008; 69: 1195
        • Perry A.G.
        • Potter E.A.
        • Ostedorf W.R.
        Clinical Nursing Skills & Techniques.
        8th ed. Mosby, St Louis, MO2013: 228
        • El-gilany A.
        • Badawi K.
        • El-fedawy S.
        Epidemiology of dysmenorrhoea among adolescent students in Mansoura, Egypt.
        East Mediterr Health J. 2005; 11: 155
        • Hur M.-H.
        • Lee M.S.
        • Seong K.-Y.
        • et al.
        Aromatherapy massage on the abdomen for alleviating menstrual pain in high school girls: a preliminary controlled clinical study.
        Evidence-Based Complement Alternat Med. 2012; 2012: 187163
        • Porter S.
        Tidy's Physiotherapy.
        14th ed. Churchill Livingstone, London2008: 128-129
        • Kisner C.
        • Colby L.
        Therapeutic Exercise: Foundations and Techniques.
        5th ed. FA Davis, Philadelphia, PA2007: 454-469
        • Patel V.
        • Tanksale V.
        • Sahasrabhojanee M.
        • et al.
        The burden and determinants of dysmenorrhoea: a population-based survey of 2262 women in Goa, India.
        BJOG. 2006; 113: 453
        • Aykut M.
        • Günay O.
        • Gün I.
        • et al.
        The impact of some biological, socio-demographic and nutritional factors on the prevalence of dysmenorrhoea.
        Erciyes Med J. 2007; 29: 393
        • Unsal A.
        • Ayranci U.
        • Tozun M.
        • et al.
        Prevalence of dysmenorrhea and its effect on quality of life among a group of female university students.
        Ups J Med Sci. 2010; 115: 138
        • Field T.
        • Diego M.
        • Hernandez-Reif M.
        • et al.
        Yoga and massage therapy reduce prenatal depression and prematurity.
        J Bodywork Movement Therapies. 2012; 16: 204
        • Keville K.
        • Green M.
        Aromatherapy: A Complete Guide to the Healing Art.
        2nd ed. Crossing Press, Berkeley, CA2008: 218-222
        • Calvert I.
        Ginger: an essential oil for shortening labour?.
        Pract Midwife. 2005; 8: 30
        • Burns E.E.
        • Blamey C.
        • Ersser S.J.
        • et al.
        The use of aromatherapy in intrapartum midwifery practices an observational study.
        Complement Ther Nurs Midwifery. 2000; 6: 33
        • Noorbakhsh M.
        • Alijani E.
        • Kohandel M.
        • et al.
        The effect of physical activity on primary dysmenorrhea of female university students.
        World Appl Sci J. 2012; 17: 1246
        • Mirbod S.M.
        • Sarami H.
        • Martazi F.
        • et al.
        Effects of isometric exercise on the alleviation of lumbar and pelvic pain in pregnant women resident in Isfahan.
        J Res Rehabil Sci. 2011; 7: 621
        • Mastrangelo M.A.
        • Galantino M.L.
        • House L.
        Effects of yoga on quality of life and flexibility in menopausal women: a case series.
        Explore. 2007; 3: 42
        • Umeda M.
        • Newcomb L.W.
        • Ellingson L.D.
        • et al.
        Examination of the dose–response relationship between pain perception and blood pressure elevations induced by isometric exercise in men and women.
        Biol Psychol. 2010; 85: 90
        • Ou M.C.
        • Hsu T.F.
        • Lai A.C.
        • et al.
        Pain relief assessment by aromatic essential oil massage on outpatients with primary dysmenorrhea: a randomized, double-blind clinical trial.
        J Obstet Gynaecol Res. 2012; 38: 817
        • Daley A.J.
        Exercise and primary dysmenorrhoea: a comprehensive and critical review of the literature.
        Sports Med. 2008; 38: 659
        • Warburton D.E.
        • Nicol C.W.
        • Bredin S.S.
        Health benefits of physical activity: the evidence.
        Can Med Assoc J. 2006; 174: 801
        • Strin T.W.
        • Chapman D.P.
        • Ahluwalia I.B.
        Menstural-related problems and psychological distress among women in the United States.
        J Womens Health. 2005; 14: 316
        • Tillett J.
        • Ames D.
        The uses of aromatherapy in women's health.
        J Perinat Neonatal Nurs. 2010; 24: 238
        • Dhany A.L.
        • Mitchell T.
        • Foy C.
        Aromatherapy and massage intrapartum service impact on use of analgesia and anesthesia in women in labor: a retrospective case note analysis.
        J Altern Complement Med. 2012; 18: 932
        • Israel R.G.
        • Sutton M.
        • O’Brien K.F.
        Effects of aerobic training on primary dysmenorrhea symptomatology in college females.
        J Am Coll Health. 1985; 33: 241
        • Joshua J.
        • Broman-Fulks A.
        • Rabian B.
        • et al.
        Effects of aerobic exercise on anxiety sensitivity.
        Behav Res Ther. 2004; 42: 125