Comparison of the effect of calcium and vitamin B1 supplementations on menstrual distress symptoms: a randomized, triple-blind, controlled trial

BACKGROUND: Menstrual distress is a prevalent condition that considerably compromises the well-being and daily functioning of women across the globe. While both calcium and vitamin B1 have demonstrated promise in influencing pain pathways and neurological function, their relative effectiveness in mitigating menstrual distress remains inadequately explored. This study was therefore designed to directly compare the therapeutic impact of calcium and vitamin B1 supplementation on the severity of this condition. METHODS: A triple-blind, randomized, placebo-controlled clinical trial was conducted in Iran in 2024. One hundred and twenty-three university students experiencing mild to moderate menstrual distress were randomly allocated into three groups: a calcium group (n=40), a vitamin B1 group (n=37), and a placebo group (n=46). Over a two-month period, all participants received 60 identically encapsulated, coded supplements. The primary outcome, the severity of menstrual distress, was evaluated using the Moos Menstrual Distress Questionnaire (MMDQ) during the menstrual cycle preceding and following the two-month intervention. Statistical analyses, performed in SPSS version 26, included Chi-square, ANOVA, and Tukey's tests, with a significance threshold set at p < 0.05. RESULTS: Following the intervention, both supplementation groups exhibited a marked and statistically significant reduction in overall symptom severity-including pain, concentration difficulties, behavioral changes, and negative affect-compared to the placebo group (p 0<0.001). A notable between-group difference emerged specifically in the pain domain, where the reduction in pain intensity was significantly greater in the calcium group than in the vitamin B1 group (4.13 ± 0.4 vs. 2.6 ± 0.9, P = 0.042). CONCLUSIONS: The findings indicate that both calcium and vitamin B1 are effective interventions for reducing the multifaceted symptoms of menstrual distress. However, calcium demonstrated superior efficacy specifically for alleviating menstrual pain compared to vitamin B1. These results support the inclusion of these specific nutritional supplements in clinical management strategies to ameliorate menstrual distress.