CLINICAL QUESTION

Is transcutaneous electrical nerve stimulation (TENS) effective and safe in the treatment of primary dysmenorrhea compared with placebo, no treatment, or other treatments?

EVIDENCE-BASED ANSWER

TENS, regardless of frequency (low = less than 10 Hz; high = more than 50 Hz), seems to reduce pain associated with primary dysmenorrhea compared with placebo or no treatment. It is uncertain whether TENS has a better analgesic effect than acupressure, acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), and interferential current therapy. The evidence is uncertain about whether there are more or fewer adverse effects with the use of TENS compared with other treatment options.¹ (Strength of Recommendation: B, inconsistent or limited-quality patient-oriented evidence.)

PRACTICE POINTERS

Primary dysmenorrhea is a common concern of menstruating individuals. It is characterized by painful cramps in the lower abdomen, which start shortly before or at the onset of menses, in the absence of pelvic pathology.² Primary dysmenorrhea negatively affects quality of life and tends to be one of the main reasons for absenteeism from school and work in this population.