***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 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Zingiber officinale R. rhizome ( ginger ) is a popular spice that has traditionally been used to combat the effects of various inflammatory diseases . The aim of this study was to evaluate the effects of ginger on pain relief in primary dysmenorrhea . Method This was a r and omized , controlled trial . The study was based on a sample of one hundred and twenty students with moderate or severe primary dysmenorrhea . The students were all residents of the dormitories of Shahed University . They were r and omly assigned into two equal groups , one for ginger and the other for placebo in two different treatment protocol s with monthly intervals . The ginger and placebo groups in both protocol s received 500 mg capsules of ginger root powder or placebo three times a day . In the first protocol ginger and placebo were given two days before the onset of the menstrual period and continued through the first three days of the menstrual period . In the second protocol ginger and placebo were given only for the first three days of the menstrual period . Severity of pain was determined by a verbal multidimensional scoring system and a visual analogue scale . Results There was no difference in the baseline characteristics of the two groups ( placebo n = 46 , ginger n = 56 ) . The results of this study showed that there were significant differences in the severity of pain between ginger and placebo groups for protocol one ( P = 0.015 ) and protocol two ( P = 0.029 ) . There was also significant difference in duration of pain between the two groups for protocol one ( P = 0.017 ) but not for protocol two ( P = 0.210 ) . Conclusion Treatment of primary dysmenorrhea in students with ginger for 5 days had a statistically significant effect on relieving intensity and duration of pain . Trial registration I RCT OBJECTIVE The objective of this study was to compare immediate effect of acupuncture at SP6 on uterine arterial blood flow in primary dysmenorrhea with that of GB39 . DESIGN This was a prospect i ve , r and omized clinical trial . SETTING Sixty-six ( 66 ) patients with primary dysmenorrhea from the Affiliated Hospital of Shangdong University of Traditional Chinese Medicine were recruited . INTERVENTIONS The SP6 group ( n = 32 ) was treated with manual acupuncture at bilateral SP6 for 5 minutes after obtaining needling sensation ( de qi ) during the period of menstrual pain , whereas the control group ( n = 34 ) was needled at GB39 of both sides for 5 minutes when they suffered menstrual pain . MAIN OUTCOME MEASURES Differences in pulsatility index ( PI ) , resistance index ( RI ) , and ratio of systolic peak and diastolic peak ( A/B ) in uterine arteries were the main outcome measures . RESULTS Highly significant reductions were observed in the SP6 treatment group 5 minutes after treatment in menstrual pain scores ( 8.17 ± 1.90 versus 11.20 ± 2.66 ; p < 0.001 ) , values of PI ( 1.75 ± 0.48 versus 2.32 ± 0.70 ; p < 0.001 ) , RI ( 0.72 ± 0.11 versus 0.78 ± 0.07 ; p < 0.001 ) , and A/B ( 4.33 ± 1.37 versus 5.23 ± 1.67 ; p < 0.001 ) . Compared with the GB39 control group , patients in the SP6 treatment group showed significant reductions in 5 minutes after treatment in the changes of menstrual pain scores ( 3.03 ± 2.36 versus 0.00 ± 0.29 ; p < 0.001 ) , values of PI ( 0.57 ± 0.42 versus -0.10 ± 0.58 ; p < 0.001 ) , RI ( 0.06 ± 0.08 versus -0.03 ± 0.15 ; p < 0.01 ) , and A/B ( 0.90 ± 0.87 versus 0.23 ± 1.02 ; p < 0.01 ) . There were no significant changes in menstrual pain scores , values of PI , RI , or A/B before and after treatment in the GB39 control group ( p > 0.05 ) . No adverse events from treatment were reported . CONCLUSIONS This study suggests that needling at SP6 can immediately improve uterine arterial blood flow of patients with primary dysmenorrhea , while GB39 does not have these effects Background The incidence of preadolescent acne among women is increasing . Acne deteriorates the quality of life ; conventional treatment options are limited and have not been effective against acne , particularly acne associated with menstruation . Despite evidence that acne associated with menstruation abnormalities naturally improves when menstruation recovers to normal , there have only been few studies on the effects of dysmenorrhea treatment on acne . Therefore- we design ed this study to assess the effects of gyejibokryung-hwan ( GBH ) and dangguijagyag-san ( DJS ) , which are widely used in dysmenorrhea treatment , on acne associated with menstruation cycle . Methods This is a protocol for a r and omized , double-blind , parallel-group , placebo-controlled and multicenter trial . One hundred and sixteen participants with dysmenorrhea accompanied by acne vulgaris will be recruited at three centers and r and omized into two groups , the herbal treatment group and placebo group . The participants will receive GBH or DJS based on pattern identification or placebo granules thrice daily for 8 weeks , with an 8-week follow up . The primary outcome will be the mean percentage change in the count of inflammatory acne lesions . The secondary outcomes would be based on dysmenorrhea numeric rating scale , verbal multidimensional scoring system for dysmenorrhea , acne numeric rating scale , investigator ’s static global assessment scale of facial acne vulgaris , and safety testing . Adverse events will also be reported . Discussion The effects of GBH or DJS used in dysmenorrhea treatment on acne associated with the menstrual cycle will be evaluated . The findings of this trial will provide evidence regarding the effect of herbal medicine in improving acne vulgaris associated with menstruation in women . Trial registration Korean Clinical Trial Registry ( http://cris.nih.go.kr ; registration number : KCT0002259 ) . Date of registration : March 10 , PURPOSE To examine the effect of auricular acupressure therapy on primary dysmenorrhea among female high school students in South Korea . DESIGN A r and omized controlled trial was employed . METHODS The study sample consisted of 91 female high school students , with 45 participants in the experimental group and 46 in the control group in two regions of South Korea . The average age of the participants was 16.7 years , and the average age of menarche was 12.2 years .  Auricular acupressure therapy including an auricular acupressure needle on skin paper tape was applied on an ear for 3 days during periods of extreme primary dysmenorrhea . The acupoint names were Jagung , Sinmun , Gyogam , and Naebunbi . For the placebo control group , only the skin paper tape without an auricular acupressure needle was applied on the same acupoints . Measures used were the Menstrual Distress Question naire to assess primary dysmenorrhea , and the visual analog scale to assess abdominal and back pain of participants . FINDINGS There were significant differences on abdominal pain ( t = 24.594 , p < .001 ) , back pain ( t = 22.661 , p < .001 ) , and primary dysmenorrhea ( t = 32.187 , p < .001 ) between the two groups . Auricular acupressure therapy decreased abdominal pain , back pain , and primary dysmenorrhea of female high school students in South Korea . CONCLUSIONS Auricular acupressure therapy was an effective intervention for alleviating abdominal pain , back pain , and primary dysmenorrhea of female high school students in South Korea . For feasibility of the auricular acupressure therapy in practice , it is needed to train and learn the exact positions of acupoints in ear . CLINICAL RELEVANCE Health providers should consider providing auricular acupressure therapy as an alternative method for reducing abdominal and back pain , and primary dysmenorrhea in female high school students in South Korea 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 STUDY OBJECTIVES To assess the effectiveness of fennel on  primary dysmenorrhea symptoms and menorrheal duration .  DESIGN Clinical trial study . SETTING Islamic Azad University , Toyserkan . PARTICIPANTS 80 female students were r and omly divided in to two groups of intervention ( n = 40 ) and control ( n = 40 ) . INTERVENTIONS The intervention group was given one soft capsule Fennel ( 30 mg ) every 4 hours , 3 days before menstruation till the 5th day and continued for 3 months . The control group received no medication . MAIN OUTCOME MEASURES The severity of sample s pain was grade d using a visual analogue scale . 5 st and ard question naires include of Visual analog scale pain ( VAS ) , McGill pain question naire , the range of stress about dysmenorrheal ( VASA ) , Perceived stress scale , Well being scale were filled out in intervals of before , during and after fennel capsule uptake . Data were analyzed by SPSS 17 software . P < .05 was considered to be statistically significant . RESULTS The mean of nausea intensity and weakness decreased to 1.93 , and 2.88 after 3 months , whereas they were 2.37 , 6.65 in control group which indicated a significant difference . Reduce the duration of menstrual period , a significant difference was found after two and three months of use . Concern in terms of quality and feelings of well-being after 1 and 3 months , was observed significant difference compared with before using . CONCLUSION Considering the safety of herbal medicines , this drug can use to relieve dysmenorrheal signs and menstrual duration Background : Dysmenorrhea is one of the most common medical problems in gynecology causing several problems in the personal and social life of women . This study was conducted to compare the effect of thymus vulgaris and ibuprofen on the treatment of primary dysmenorrhea Methods : This clinical study was conducted on 84 students of Babol University of Medical Sciences with primary dysmenorrhea . The students were r and omly assigned to three groups receiving thymus vulgaris , ibuprofen and placebo . In all three groups , with the beginning of pain , 200 mg capsules and 25 drops of essential oil were given every 6 hours for two consecutive cycles . Pain intensity used the visual scale before and one hour after each dose for 48 hour after starting medication . The data were collected and analyzed . This study was registered in the Iranian Registry of Clinical Trial ( www.i rct .ir ) with registration number ID : I RCT 201101245683N1 Results : The mean age of participants was 20.5±1.8 years . Both thymus vulgaris and ibuprofen were effective to reduce the pain severity of dysmenorrhea . Before treatment , the mean pain intensity in thymus vulgaris , ibuprofen and placebo groups were 6.57±2.02 , 5.30±2.23 and 6.18±1.78 , respectively and after treatment decreased to 1.21±1.06 , 1.48±1.62 and 3.54±2.26 , respectively . Reduction of pain severity was not statistically significant between the two medications , however it was significant for each drug compared with placebo ( p<0.001 ) . Conclusion : The results suggest that thymus vulgaris as well as ibuprofen can be effective in reducing the severity of pain and spasm in primary dysmenorrhea STUDY QUESTION Is a vaginal preparation of sildenafil citrate capable of alleviating acute menstrual pain in patients with primary dysmenorrhea ( PD ) ? SUMMARY ANSWER A vaginal preparation of sildenafil citrate is capable of alleviating 
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CONCLUSION Medicinal plants , drugs , and acupressure seem to suppress pain by reducing the level of prostagl and ins , mediating nitric oxide , increasing beta-endorphin levels , blocking the calcium channel , and enhancing circulatory flow through the uterine pathway .