Dysmenorrhea characterized by menstrual pain is classified into two types: primary dysmenorrhea without an underlying disease and primary dysmenorrhea without an underlying disease. Secondary dysmenorrhea is caused by conditions such as endometriosis.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are usually the first-line treatment but have been associated with kidney damage, gastrointestinal bleeding, and high rates of hypersensitivity reactions.
Evidence suggests that vitamin D inhibits pain-sensing signals in the dorsal root ganglion and reduces inflammatory factors, so supplementation with this nutrient may be an alternative treatment option for dysmenorrhea. there is.
However, the influence on pain intensity in different types of dysmenorrhea remains unclear.
A group of Taiwanese researchers sought to evaluate the effectiveness of vitamin D supplementation in reducing dysmenorrhea-related pain through a systematic review and meta-analysis of randomized controlled trials (RCTs).
They searched for RCTs published in: cochrane library, Embase, Google Scholar, medline,and ScopusFrom commencement until December 30, 2023. A total of 11 studies involving 687 participants were included.
The primary and secondary outcomes were measured by change in pain intensity and emergency analgesic (painkiller) use, respectively.
Vitamin D supplementation was found to significantly reduce pain intensity in patients with dysmenorrhea compared to controls (pooled mean difference -1.64, 95% confidence interval, -2.27 to -1, p<0.001).
The I2 statistic was 79.43% (p < 0.001), which highlights the substantial heterogeneity among the included studies.
Additionally, trial sequential analysis (TSA) was conducted to assess the statistical power and precision of the meta-analysis and to identify the “true” intervention effect.
The TSA results showed that RCTs provided sufficient information. In subgroup analysis, vitamin D supplementation significantly reduced pain in primary dysmenorrhea but not in secondary dysmenorrhea.
Furthermore, daily (pooled MD of -1.06, 95% CI, -1.86 to -0.26, p < 0.001) and monthly (pooled MD of -2.29, 95% CI, -2.82 to -1.77, p < 0.001 ) was administered in both cases. Vitamin D supplementation has been shown to be effective.
Only two of the 11 studies compared the number of events related to emergency analgesic use between groups with and without vitamin D supplementation.
A meta-analysis showed a trend toward reduced emergency analgesic use among people receiving vitamin D supplementation, but it did not reach statistical significance to draw definitive findings and a larger sample size The need for further research was highlighted.
“We found that vitamin D supplementation was effective in reducing pain intensity in patients with dysmenorrhea, particularly in patients with primary dysmenorrhea. The cumulative power of the subgroup analysis was ‘true’. It supports treatment response.” The researchers repeated.
Effects of vitamin D deficiency
Vitamin D deficiency, a known risk factor for endometriosis, has been reported to induce or worsen symptoms of dysmenorrhea.
In this review, subgroup analysis showed that vitamin D supplementation effectively alleviates dysmenorrhea in people with vitamin D deficiency.
Of note, seven of the included studies were conducted in Iran, where the prevalence of vitamin D deficiency among Iranian women was reported to be as high as 64%.
Other studies did not specifically target patients with vitamin D deficiency, but baseline serum 25-hydroxyvitamin D (25(OH)D) levels were relatively low.
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“Subgroup analyzes and meta-regression showed that vitamin D supplements reduce dysmenorrhea pain, independent of baseline vitamin D deficiency status, but the effectiveness of supplements in correcting vitamin D deficiency It is unclear whether this is due to physical or pharmacological effects.
In three studies of patients with secondary dysmenorrhea, including those with endometriosis, vitamin D supplementation was effective in reducing pain, although this was not statistically significant.
“Further research is essential to understand the effectiveness of vitamin D supplementation in patients with secondary dysmenorrhea.”
Among the included studies, various frequencies of vitamin D intake appear to all be effective in reducing pain associated with dysmenorrhea. However, the optimal frequency of vitamin D supplementation to treat dysmenorrhea remains to be determined.
We note that this review has some limitations, including the small number of RCTs available in this area, which may not adequately address potential research bias.
“Nevertheless, meta-regression confirmed that risk of bias was not a modifier of effect. Furthermore, excluding studies with open-label methods and funded or unclear placebo designs, A sensitivity analysis showed similar results to our primary analysis, suggesting the robustness of our findings.”
Source: Nutrients
https://doi.org/10.3390/nu16071089
“Vitamin D supplementation for patients with dysmenorrhea: A meta-analysis using trial sequential analysis of randomized controlled trials.”
Author: Kan-Chu Lin et al.
