Cai Jingjie, Liu Mingyi, Jing Yan, Yin Zikang, Kong Nianxin, Guo Chenggen
College of Sports Training, Wuhan Sports University, Wuhan, China.
China Youth Sports and the Integration of Sports and Education Public Policy Research Center, Wuhan, China.
Acta Obstet Gynecol Scand. 2025 May;104(5):815-828. doi: 10.1111/aogs.15042. Epub 2025 Jan 30.
Aerobic exercise has been confirmed to alleviate primary dysmenorrhea (PD) in adolescents and young women. However, the effect of the aerobic exercise type and dosage on PD alleviation was unclear. This research aims to assess the effect of aerobic exercise on PD and investigate the dose-response relationships.
Systematic literature searches of Web of Science, Embass, Cochrane Library, PubMed, PsycNET, CINAHL, CNKI, Baidu Scholar, Google Scholar, and other Complimentary Medicine Database. PICOS standards were adopted in this research: participants were nonathlete women with PD; intervention was aerobic exercise of at least one menstruation cycle; comparator was any comparator; outcomes were pain intensity or pain duration; and study type was randomized controlled trials. The Cochrane Collaboration risk of bias tool was used to assess the quality of the research. Random-effect meta-analysis was conducted for pain intensity and pain duration, with prespecified subgroup analyses based on aerobic exercise components. The strength of the evidence was assessed using GRADE. This systematic review and meta-analysis was registered in PROSPERO (CRD42024533544).
The study identified 16 eligible studies, with 15 involving adolescents, totaling 918 participants aged 15 to 43, with an average age of 21.26 ± 13.15. The results confirmed that aerobic exercise can alleviate PD's pain intensity (standard mean difference (SMD) = -1.728 (p = 0.00), 95% CI [-2.26 to -1.31]) and pain duration (weighted mean difference (WMD) = -12.53 h, p = 0.01, 95% CI: -21.38 to -3.68). However, the heterogeneity of these two results was high. Subgroup analysis showed that Pilates (SMD = -3.17, 95% CI [-4.26 to -2.07]), low intensity (SMD = -1.64, 95% CI [-2.10 to -1.19]), 31-45 min duration (SMD = -3.05, 95% CI [-5.36 to -0.75]), ≤2 times per week frequency (SMD = -2.24, 95% CI [-3.36 to -1.12]), and a period cycle of 2 menstrual cycles (SMD = -2.21, 95% CI [-3.13 to -1.28]) had the maximum effect size.
Aerobic exercise was able to alleviate pain intensity and pain duration in adolescents and young women with PD. Moderate-quality evidence indicates that Pilates, low intensity, 46-60 min, ≤two times per week, or two menstrual cycles showed more efficiency in alleviating PD. Due to the limited data, future research should prioritize conducting randomized controlled trials of aerobic exercise interventions in younger age groups to develop personalized treatment strategies for adolescents.
有氧运动已被证实可缓解青少年和年轻女性的原发性痛经（PD）。然而，有氧运动类型和剂量对缓解PD的影响尚不清楚。本研究旨在评估有氧运动对PD的影响，并探究剂量反应关系。
对Web of Science、Embass、Cochrane图书馆、PubMed、PsycNET、CINAHL、CNKI、百度学术、谷歌学术以及其他补充医学数据库进行系统文献检索。本研究采用PICOS标准：参与者为患有PD的非运动员女性；干预为至少一个月经周期的有氧运动；对照为任何对照；结局为疼痛强度或疼痛持续时间；研究类型为随机对照试验。采用Cochrane协作偏倚风险工具评估研究质量。对疼痛强度和疼痛持续时间进行随机效应荟萃分析，并根据有氧运动成分进行预先设定的亚组分析。使用GRADE评估证据强度。本系统评价和荟萃分析已在PROSPERO（CRD42024533544）注册。
该研究确定了16项符合条件的研究，其中15项涉及青少年，共有918名年龄在15至43岁之间的参与者，平均年龄为21.26±13.1俯。结果证实，有氧运动可缓解PD的疼痛强度（标准平均差（SMD）=-1.728（p=0.00），95%CI[-2.26至-1.31]）和疼痛持续时间（加权平均差（WMD）=-12.53小时，p=0.01，95%CI：-21.38至-3.68）。然而，这两个结果的异质性较高。亚组分析表明，普拉提（SMD=-3.17，95%CI[-4.26至-2.07]）、低强度（SMD=-1.64，9%CI[-2.10至-1.19]）、持续时间31-45分钟（SMD=-3.05，95%CI[-5.36至-0.75]）、每周频率≤2次（SMD=-2.24，95%CI[-3.36至-1.12]）以及周期为2个月经周期（SMD=-2.21，95%CI[-3.13至-1.28]）的效果量最大。
有氧运动能够缓解患有PD 的青少年和年轻女性的疼痛强度和疼痛持续时间。中等质量证据表明，普拉提、低强度、46-60分钟、每周≤两次或两个月经周期在缓解PD方面显示出更高的效率。由于数据有限，未来研究应优先在较年轻年龄组中开展有氧运动干预的随机对照试验，以制定针对青少年的个性化治疗策略。
