Primary dysmenorrhea (aka menstrual cramps not caused by endometriosis or uterine fibroids or infections) is caused by an increase prostaglandin leakage of the endometrium (lining of the uterus), during menses. The most common conventional treatment is non-steroidal anti-inflammatory drugs (NSAIDS) which block an enzyme that causes the blockage of synthesis of the prostaglandins. Ginger is one such herb that has anti-spasmodic effects due to its ability to block cyclooxygenase as well as 5-lipoxygenase.
The current study was a randomized comparative cross-over clinical trial in 168 Iranian women aged 18-26. One group received Novafen (an NSAID) during the first menstrual cycle and ginger in the second, while the other croup consumed ginger first, then Novafen. Women were given capsules containing either 200 mg of ground ginger or the commercially available Novafen. Women started taking capsules on the first day of menses when the menstrual pain started and continued to take a capsule every 6 hours for a total of 48 hours.
All the women completed the trial with 48.8% experiencing grade II and 51.2% grade III dysmenorrhea. Both the treatments decreased the pain during the treatment period, especially during the first 24 hours. When taking Novafen, women reported a reduction in the mean pain score from 7.12 to 3.10 after the 48 hours; When taking ginger, the pain scores decreased from 7.6 to 2.69 after 48 hours. Satisfaction and bleeding were similar in both groups and the severity of symptoms before and after treatment were similar in both groups.
Commentary: In other studies, ginger has been shown to improve primary dysmenorrhea as well as heavy menstrual bleeding.
One study compared ginger to mefenamic acid, another NSAID, and ginger was shown to be as effective on pain relief. (Shirvani M, et al. The effect of mefenamic acid and ginger on pain relief in primary dysmenorrhea: a randomized clinical trial. Arch Gyneco.l Obstet 2015;291(6):1277-81.)
Ginger has also had better results than placebo. (Rahnama P, et al. Effect of Zingiber officinale R. rhizomes (ginger) on pain relief in primary dysmenorrhea: a placebo randomized trial. BMC Complement Akltern Med 2012;12(1):1).
Ginger is safe and with minimal side effects and at least as effective as two other NSAIDS for acute relief of primary dysmenorrhea.
Reference:
Rad H, Basirat Z, Bakouei F, et al. Effect of ginger and Novafen on menstrual pain: a cross-over trial. Taiwanese J Ob/Gyn 2018;806-809
