Background: In various research, vitamin E and mefenamic supplementation has been suggested as a viable treatment for primary dysmenorrhea.

Objective: To see the effects of Vitamin E and mefenamic acid in primary dysmenorrhoea.

Methods: Sheikh Sayera Khatun Medical College and Hospital, Gopalganj conducted this observational type of prospective study. Where information was gathered between 1st April 2019 to 31st March 2020. During the research, a total of 40 Female OPD patients in Sheikh Sayera Khatun Medical College and Hospital, Gopalganj, who fulfilled the selection criteria were the study sample. Purposive sampling was used to acquire the samples according to the inclusion criteria. All data were coded and entered into SPSS-23 for further analysis. The statistics used were both descriptive and inferential. Statistics used to describe data included frequency distribution, percent, mean, and standard deviation; graphs; tables; and figures; and inferential statistics.

Results: VAS score was significantly decreased from baseline to end of treatment at 3rd cycle (7.40 ± 0.98 to 3.70 ± 0.72) for vitamin E group and (7.05 ± 0.75 to 3.52 ± 0.55) for mefenamic acid group. The percentage reduction of VAS was 49.60% and 49.51% at 3rd cycle. The Cox Menstrual Symptom Scale score significantly decreased from baseline to end of treatment at 3rd cycle (3.88 ± 0.40 to 1.25 ± 0.44).The percentage reduction of CMSS score was 67.50% and 65.83% at 3rd cycle.

Conclusion: As both Vitamin E and Mefenamic acid shows significant reduction in pain intensity in primary dysmenorrhoea without any difference between two treatment groups. So, in clinical practice, Vitamin E may be a useful alternative to Mefenamic acid in primary dysmenorrhoea.

Keywords: Primary dysmenorrhoea, Mefenamic acid, Vitamin E.

1. Kaur S, Sheoran P, Sarin J. Assessment and comparison of dysmenorrhoea in terms of severity of pain and utilization of non steroid anti-inflammatory drugs among unmarried and married women, International Journal of Caring Sciences, 2015; 8(3): 737–745.
2. Vilvapriya S, Vinodhini S. Vitamin E in the treatment of primary dysmenorrhoea, International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2018; 7(6): 2257-2261.
3. Gebeyehu MB, Mekuria AB, Tefera YG, Andarge DA, Debay YB, Bejiga GS, et al.. Prevalence, Impact, and Management Practice of Dysmenorrhoea among University of Gondar Students, Northwestern Ethiopia: A Cross-Sectional Study, International Journal of Reproductive Medicine, 2017: 1-8. [ DOI: 10.1155/2017/3208276 ]
4. Malhotra N, Kumar P, Malhotra J, Bora NM, Mittal P. Jeffcoate’s Principle of Gynaecology, Eighth Edition, Jaypee Brothers Medical Publications, New Delhi, 2014: 579.
5. Shirvani MA, Motahari-Tabari N, Alipour A. The effect of Mefenamic Acid and Ginger on Pain Relief in Primary Dysmenorrhoea: A Randomized Clinical Trial, Archives of Gynecology and Obstetrics, 2015; 291(6): 1277-1281.
6. Marjoribanks J, Ayeleke RO, Farquhar C, Proctor M. 2015. Nonsteroidal anti-inflammatory drugs for dysmenorrhoea, The Cochrane Database of Systematic Reviews, 2015 July 30;2015(7), CD001751: 1-137 [doi: 10.1002/14651858.CD001751.pub3]
7. Iacovides S, Baker FC, Avidon I. The 24-h progression of menstrual pain in women with primary dysmenorrhoea when given diclofenac potassium: a randomized, double-blinded, placebo-controlled crossover study, Archives of Gynecology and Obstetrics, 2014;289(5): 993-1002.
8. Farahani ËLA, Hasanpoor-Azghdy SB, Kasraei H, Heidari T. 2017. Comparison of the effect of honey and Mefenamic acid on the severity of pain in women with primary dysmenorrhoea. Archives of Gynecology and Obstetrics, 296(2): 277-283. 18. Mutalip SSM, Ab-Rahim S and Rajikin MH. Vitamin E as an Antioxidant in Female Reproductive Health, Antioxidants, 2018 February;7(22):2-15. [doi:10.3390/antiox7020022]
9. Hayes EC, Rock JA. 2002. Cox-2 inhibitors and their role in gynecology, Obstetrics and Gynecology, 57(11): 768-780.
10. Nayeban S. Jafarnejad F, Nayeban S, Sefidgaran A. A Comparison of the Effects of Vitamin E and Vitamin B1 on the Severity and Duration of Pain in Primary Dysmenorrhoea, Journal of Midwifery and Reproductive Health, 2014; 2(2): 143-146.
11. Kashanian M, Lakeh MM, Ghasemi A, Noori S. Evaluation of the effect of vitamin E on pelvic pain reduction in women suffering from primary dysmenorrhoea, Journal of Reproductive Medicine, 2013; 58(1-2): 34-38.
12. Ziaei S, Zakeri M, Kazemnejad A. A randomised controlled trial of vitamin E in the treatment of primary dysmenorrhoea, British Journal of Obstetrics and Gynaecology, 2005; 112(4): 466–469
13. Satyanarayan U, Chakrapani U. Biochemistry, Fourth Edition, Reed Elsevier India Private Limited and Books and Allied (P) Ltd, 8/1 Chintamoni Das Lane, Kolkata 700009, India, ISBN: 9788131236017, 9788131237137,15 June 2013; 129.
14. Azlin MIN, Maryasalwati I, Norzilawati MN, Mahdy ZA, Jamil MA, Rashid MRZ. The efficacy of etoricoxibvsMefenamic acid in the treatment of primary dysmenorrhoea: A randomised comparative trial, Journal of Obstetrics and Gynaecology, 2008; 28(4): 424–426.
15. Azlin MIN, Maryasalwati I, Norzilawati MN, Mahdy ZA, Jamil MA, Rashid MRZ. 2008. The efficacy of etoricoxibvs Mefenamic acid in the treatment of primary dysmenorrhoea: A randomised comparative trial. Journal of Obstetrics and Gynaecology, Vol. 28, No. 4, pp. 424–426.
16. Safari A, Shah Rezaei GR, Damavandi A. Comparison of the effects of vitamin E and Mefenamic acid on the severity of primary dysmenorrhoea. Annals of Military and Health Sciences Research, Vol. 4, No. 1, pp. 735-738.
17. Masoumi SZ, Asl HR, Poorolajal J, Panah MH, Oliaei SR. Evaluation of Mint Efficacy Regarding Dysmenorrhoea in Comparison with Mefenamic Acid: A Double Blinded Randomized Crossover Study, Iranian Journal of Nursing Midwifery Research, 2016; 21(4): 363-367
18. Asif M. Study of Anthranylic Acid Derivatives: Mefenamic Acid and Its Various Analogues, American Journal of Medicine Studies, 2014; 2(1): 24-30.
19. Ziaei S, Zakeri M, Kazemnejad A. 2005. A randomised controlled trial of vitamin E in the treatment of primary dysmenorrhoea. British Journal of Obstetrics and Gynaecology, Vol. 112, No.4, pp. 466–469.
20. Masoumi SZ, Asl HR, Poorolajal J, Panah MH, Oliaei SR. 2016. Evaluation of mint efficacy regarding dysmenorrhoea in comparison with Mefenamic acid: A double blinded randomized crossover study. Iranian Journal of Nursing Midwifery Research, Vol. 21, No. 4, pp. 363-367.
21. Asif M. 2014. Study of Anthranylic Acid Derivatives: Mefenamic Acid and Its Various Analogues. American Journal of Medicine Studies, 2, No. 1, pp. 24-30.

Dr Kanika Roy

Senior Consultant, Department of Gynae and Obstetrics, 100 Bedded Upazila Health Complex, Kashiani, Gopalgonj, Bangladesh