An Evidence based review of effectiveness of TENS on women with primary dysmenorrhea

Background: Primary dysmenorrhea, marked by painful menstrual cramps without pelvic pathology, is prevalent among menstruating youth. It results from increased uterine contractions and ischemia due to elevated prostaglandin levels. Common treatments like NSAIDs and hormonal contraceptives may be ineffective or have adverse effects. Transcutaneous Electrical Nerve Stimulation (TENS), a non-pharmacological method delivering low-voltage electrical currents to the skin, offers a potential alternative. TENS is believed to relieve pain through gate control theory and the stimulation of endogenous opioid release. Despite growing interest, existing studies offer mixed results on its effectiveness and application parameters. Methods: A systematic literature review was conducted using databases such as PubMed, Scopus, CINAHL, and Google Scholar, targeting studies from 2014 to 2024. Keywords included "TENS," "transcutaneous electrical nerve stimulation," "primary dysmenorrhea," and "non-pharmacological pain management." Studies selected included randomized controlled trials, quasi-experimental studies, and systematic reviews. Results: Ten studies met inclusion criteria. Most found that TENS significantly reduced menstrual pain compared to placebo, no treatment, or conventional care. High-frequency TENS (80–100 Hz) applied to the lower abdomen or lumbosacral region showed the most benefit. Some studies also reported reduced analgesic use and improved daily functioning. Conclusion: TENS appears to be a safe, well-tolerated, and potentially effective non-pharmacological treatment for primary dysmenorrhea. It offers pain relief and improves quality of life, making it a viable alternative to medication-based options.