***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: OBJECTIVES This is a controlled , prospect i ve study which compares the effects of a low-dose heat patch for self-medication on the reduction of pain symptoms in dysmenorrhea . METHODS The sample group included female sophomore students study ing at a university in Istanbul , Turkey , between 2007 and 2008 . These female participants completed the Dysmenorrhea Identification Form to determine the sample group , and a total of 193 female students possessed the eligible criteria . The research control group consisted of 66 patients , the analgesia group consisted of 61 , and the heat patch group consisted of 66 . The control group did not use any treatments , while the self-medication group used analgesic medication ( single dose ) , and the heat patch group applied a heat patch on the lower abdomen , against the skin , for an application period of 2 menstrual cycles . Using a visual analog scale ( VAS ) , the pain severity was recorded at the baseline , after 4 hours of intervention , and after 8 hours of intervention . The data were examined using ANOVA . RESULTS There were significant differences between the groups in terms of pain severity after 8 hours of application ( P < .001 ) . All groups had similar pain levels at baseline and during the fourth and eighth hours , with no significant differences between the groups during the first and the second menstrual cycles ( P > .05 ) . CONCLUSION The authors conclude that the heat patch is an effective method for reducing dysmenorrhea OBJECTIVES The aim of this study was to evaluate the effects of auricular acupressure on relieving menstrual symptoms and decreasing nitric oxide ( NO ) for women with primary dysmenorrhea . DESIGN This was a r and omized clinical trial comparing the effects of auricular acupressure by seed-pressure method and placebo adhesive patch . SETTING Setting s included colleges in northern and central Taiwan . SUBJECTS Serum CA-125 testing was used as a screening test for primary dysmenorrhea ( < 35 mg/dL ) . The study included 36 college females r and omized to acupressure group , 35 to control group . INTERVENTIONS The acupressure group received auricular acupressure by seed-pressure method on liver ( CO12 ) , kidney ( CO10 ) , and endocrine ( CO18 ) acupoints . The control group had a plain adhesive patch placed on the same acupoints with no seed attached . Acupressure protocol included massaging 15 times on each acupoint , 3 times a day , for a total of 20 days . OUTCOME MEASURES Primary : Short-form Menstrual Distress Question naire ( MDQs ) . Secondary : blood sample of NO . Assessment s of MDQs and NO were performed at baseline and within the first 2 days of their next menses ( after completion of 20 days of acupressure ) . RESULTS In the acupressure group , the overall menstrual symptoms ( 95 % confidence interval [ CI ] = -49.8 to -6.5 , effect size [ ES ] = 0.43 , p = 0.01 ) and two subscales , menstrual pain ( 95 % CI = -16.4 -to -2.2 , ES = 0.45 , p = 0.01 ) and negative affects ( 95 % CI = -11.9 - 2.0 , ES = 0.38 , p = 0.04 ) , revealed that menstrual symptoms decreased significantly after auricular acupressure by the seed-pressure method . The ES for the MDQs were in favor of the auricular acupressure by seed-pressure method . NO level increased in the acupressure group , although this difference did not achieve statistical significance ( p > 0.05 ) . CONCLUSIONS This study supports the effects of auricular acupressure by seed-pressure method in improving menstrual symptoms , and offers a noninvasive complementary therapy for women with primary dysmenorrhea OBJECTIVE We have evaluated the clinical efficacy of yoga for primary dysmenorrhea . Primary dysmenorrhea occurs in 50 % of female adolescents and is a common problem in women of reproductive age . We have assessed whether three yoga poses ( Cobra , Cat , and Fish Poses ) are able to reduce severity and duration of primary dysmenorrhea . METHODS To determine the effectiveness of yoga in adolescents with primary dysmenorrhea , 92 girl students,18 - 22 years old , were r and omly assigned to an experimental group ( n = 50 ) and a  control group ( n = 42 ) . The Visual Analog Scale for Pain was used to assess intensity of pain and the pain duration was calculated in terms of hours . Each group was evaluated for three menstrual cycles . At first cycle no method was presented ; the participants only were asked to complete the question naire of menstrual characteristics during their menstrual . Then the participants were asked by the experimental group to do yoga poses at luteal phase , and also to complete the menstrual characteristics question naire in during of menstruation . The control group did not receive any intervention except to complete menstrual characteristics question naire in during of menstruation . RESULTS There was a significant difference in the pain intensity and pain duration in the post-tests compared with the pretest in yoga group ( P < 0.05 ) . The results showed that compared with the Control group , there was a significant difference in the pain intensity and pain duration in the experimental group ( P < 0.05 ) . CONCLUSION Yoga reduced the severity and duration of primary dysmenorrhea . The findings suggest that yoga poses are safe and simple treatment for primary dysmenorrhea BACKGROUND : There are two types of primary dysmenorrhea ( spasmodic and congestive ) which differ from each other in terms of the occurrence time in menstrual cycle , pain quality and other symptoms . The present study aim ed to determine the effect of acupressure at the Sanyinjiao point ( SP-6 ) on severity of menstrual symptoms ( primary outcome ) and the duration of resting time as well as the number of ibuprofen  consumption ( secondary outcome ) in the two types of primary dysmenorrhea . METHODS : This was a clustered r and omized controlled trial on 72 eligible students residing in dormitories of public universities of Tabriz , Iran . Determining the type of primary dysmenorrhea using a Menstrual symptoms question naire ( MSQ ) , 36 participants which suffered from each type of dysmenorrhea were enrolled from the four dormitories . The dormitories were r and omly divided into intervention and control groups . No intervention was carried out at the first cycle . During the two next cycles , Sanyinjiao point of the subjects in the intervention group was pressed for twenty minutes at the time of pain . The subjects in both groups were allowed to consume ibuprofen , if needed . During these three cycles , the participants recorded and reported menstrual symptoms severity , duration of resting time and the number of the used ibuprofen . RESULTS : The severity of menstrual symptoms and duration of resting time in the 2nd and 3rd cycles were significantly reduced more than control groups for both spasmodic and congestive types of primary dysmenorrhea . In addition , the aver-age numbers of ibuprofen pills taken by both intervention groups was significantly less than the control groups . There was no significant difference between the two intervention groups in terms of any of the outcomes . CONCLUSIONS : Acupressure is effective on lowering the symptoms of dysmenorrhea and duration of resting time almost equally in both spasmodic and congestive types . Therefore , using this method either alone or along with other methods is recommended to treat dysmenorrhea OBJECTIVES Dysmenorrhea is a common gynecologic disorder . Although non-steroidal anti-inflammatory drugs are commonly used , due to their side effects and lack of response in some individuals , other approaches such as exercise have been considered . This study compared the effect of stretching exercises and mefenamic acid on the reduction of pain and menstruation characteristics in primary dysmenorrhea . METHODS In this r and omized clinical trial , 122 female students with moderate to severe dysmenorrhea were assessed and were placed in either the exercise or mefenamic acid group . The exercise program was performed for 15 minutes , three times a week and included a five-minute warm up and six belly and pelvic stretching exercises for 10 minutes . The mefenamic acid group received 250 mg capsules every eight hours from the onset of menstruation until pain relief . Both interventions were performed during two consecutive menstrual cycles . Pain intensity was measured using a 10 cm visual analog scale . RESULTS The mean pain intensity was significantly higher in the exercise group only in the first cycle ( p = 0.058 ) . In the second cycle , the mean difference in pain reduction in the exercise group was higher than the mefenamic group compared to the start of the study ( p = 0.056 ) and the first cycle ( p = 0.007 ) . There was no significant difference in the severity and duration of pain between the groups ( p > 0.050 ) . CONCLUSIONS Stretching exercises were as effective as mefenamic acid in the treatment of primary dysmenorrhea . Our results suggest that the effect of exercise on relieving menstruation pain increases over time The present study aims at comparing the effects of acupressure using new combination of acupoints , and Ibuprofen on the severity of  primary dysmenorrhea ( PD ) . 216 female high school students , aged between 14 to 18 years , were r and omly selected and divided into three groups . Each group underwent different treatment techniques : acupressure , Ibuprofen and sham acupressure as a placebo . The results indicated that the three therapeutic techniques were significantly effective in reducing the pain . However the therapeutic efficacies of acupressure and Ibuprofen were similar with no significant difference , and were significantly better than the placebo . Thus acupressure , with no complications , is recommended as an alternative and also a better choice in the decrease of the severity of PD Background Primary dysmenorrhea is a common and sometimes disabling condition . In recent years , some studies aim ed to improve the treatment of dysmenorrhea , and therefore , introduced several therapeutic measures . This study was design ed to compare the analgesic effect of iron chip containing heat wrap with ibuprofen for the treatment of primary dysmenorrhea . Methods In this r and omized ( I RCT 201107187038N2 ) controlled trial , 147 students ( 18–30 years old ) with the diagnosis of primary dysmenorrhea were enrolled considering the CONSORT guideline . Screening for primary dysmenorrhea was done by a two- question screening tool . The participants were r and omly assigned into one of the intervention groups ( heat Patch and ibuprofen ) . Data regarding the severity and emotional impact of the pain were recorded by a shortened version of McGill Pain Question naire ( SF-MPQ ) . Student 's t test was used for statistical analysis . Results The maximum and minimum pain severities were observed at 2 and 24 hours in both groups . The severity of sensual pain at 8 , 12 , and 24 hours was non-significantly less in the heat Patch group . There was also no significant difference between the groups regarding the emotional impact of pain at the first 2 , 4 , 8 , 12 and 12 hours of menstruation . Conclusions Heat patch containing Iron chip has comparable analgesic effects to ibuprofen and can possibly be used for primary dysmenorrhea . Trial registration I RCT OBJECTIVE To determine if pain relief provided by a wearable heat wrap ( continuous , low-level , topical heat therapy ) is superior to oral acetaminophen for primary dysmenorrhea .  STUDY DESIGN A r and omized , active-controlled , multisite , single-blind ( investigator ) , parallel- design study compared an abdominal wrap to an oral medication ( acetaminophen , 1000 mg ) over I day . Pain relief ( 0 - 5 ) and abdominal muscle tightness/cramping ( 0 - 100 ) were recorded at 12 time points . At 24 and 48 hours , menstrual symptom-based quality of life was assessed . RESULTS Three hundred sixty-seven subjects entered the study , with 344 subjects evaluable . The heat wrap was superior to acetaminophen for pain relief over an 8-hour period ( means of 2.48 and 2.17 , p = 0.015 ) and at t hours 3 , 4 , 5 and 6 ( p < or = 0.05 ) . Tightness/cramping was less for the heat wrap versus acetaminophen over 8 hours ( means of 40.4 and 44.5 , p = 0.04 ) and at hours 4 , 5 and 6 ( p < or = 0.05 ) . There was significantly decreased fatigue , fewer mood swings and less lower abdominal cramping ( p < or = 0.05 ) with heat therapy . CONCLUSION Continuous , low-level , topical heat therapy was superior to acetaminophen for the treatment of dysmenorrhea Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more OBJECTIVES This study aims to evaluate the effects of Sanyinjiao ( SP6 ) acupressure in reducing the pain level and menstrual distress  result ing from dysmenorrhea . METHODS Forty participants with dysmenorrhea were assigned to either the acupressure group ( n = 19 ) or the control group ( n = 21 ) . The acupressure group received 20 min of SP6 acupressure during the initial inter 
    Output:
    
Conclusion Exercise showed large effects , while acupressure and heat showed moderate effects in reducing menstrual pain compared to no treatment .
Both exercise and heat are potential alternatives to analgesic medication .