Effectiveness of pain neuroscience education in women with dysmenorrhea: controlled clinical trial

BACKGROUND: Dysmenorrhea is a highly prevalent gynecological condition that negatively affects menstrual pain experience, daily activities, and overall quality of life. Pain neuroscience education (PNE) is a non-pharmacological intervention designed to reshape maladaptive pain beliefs and promote a more adaptive understanding of pain mechanisms. This study aimed to examine the effects of PNE on pain beliefs, menstrual pain intensity, and the functional impact of dysmenorrhea among women reporting symptoms consistent with primary dysmenorrhea. METHODS: This prospective controlled clinical trial included 74 women aged ≥18 years who reported dysmenorrhea symptoms consistent with primary dysmenorrhea. Participants were allocated consecutively to either a PNE group (n = 37) or a control group (n = 37). The PNE group received three weekly online educational sessions, whereas the control group continued their routine activities without intervention. The primary outcomes were pain intensity assessed using the Short-Form McGill Pain Questionnaire (SF-MPQ) and pain-related beliefs assessed using the Pain Beliefs Questionnaire (PBQ). The secondary exploratory outcome was functional impact assessed using the Scale for Assessing the Impact of Dysmenorrhea on Daily Life (SAIDDL). All outcomes were collected using standardized self-reported online questionnaires before the intervention and during the first menstrual cycle following the intervention. RESULTS: Compared with the control group, the PNE group showed greater reductions in sensory, affective, and total pain scores on the SF-MPQ. The PNE group also demonstrated greater improvement in psychological pain beliefs, while total PBQ findings were more modest and should be interpreted cautiously. Greater improvement in functional impact was also observed in the PNE group, as reflected by lower SAIDDL scores. CONCLUSION: PNE was associated with short-term improvements in self-reported pain intensity, psychological pain beliefs, and daily functioning in women with dysmenorrhea. These findings suggest that PNE may represent a promising complementary non-pharmacological approach. Future studies with randomized designs, larger samples, and longer follow-up periods are needed to confirm these findings. TRIAL REGISTRATION: ClinicalTrials.gov NCT06732778, Registration date: September 12, 2024.