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How safe and effective is transcutaneous electrical nerve stimulation for primary dysmenorrhea?
High-frequency TENS showed evidence of pain reduction compared with placebo or no treatment. There appeared to be no increase in adverse events, though evidence was sparse. Low-frequency TENS may also reduce pain compared with placebo or no treatment and was not associated with an increase in reported adverse events.
No significant difference was found between high and low-frequency TENS. The effects of high and low-frequency TENS compared with other treatments remain uncertain, with few trials and no reported adverse events.
The majority of the included participants were in their 20s, with little evidence for women in their 30s and 40s. Overall, the evidence was considered to be of low or very low quality, with many of the trials not reporting enough methodological detail to enable robust critical appraisal.
Primary dysmenorrhea is characterised by lower abdominal pain during menstruation, affecting 50–90% of women, with half experiencing moderate to severe pain. The most common treatment is NSAIDs.
TENS is a non-pharmacological alternative for those who cannot use drugs due to side effects or contraindications. It uses electrodes to deliver electrical currents to the pain site and offers high-frequency (over 50Hz) and low-frequency (under 10Hz) options. Mild adverse effects, such as skin irritation, can occur.
Han S, et al. Transcutaneous electrical nerve stimulation (TENS) for pain control in women with primary dysmenorrhoea. Cochrane Database Syst Rev 2024;7:CD013331. This review contains 20 trials and 585 people.
Pharmacist prescribers Linda Bryant and Leanne Te Karu discuss positive polypharmacy for heart failure. Current evidence shows the intensive implementation of four medications offers the greatest benefit to most patients with heart failure, with significant reductions in cardiovascular mortality, heart failure hospitalisations and all-cause mortality
