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After reviewing the limited literature available for Vitamin E in the treatment of primary dysmenorrhoea, evidence suggests that it may reduce pain compared to placebo in adolescent Tehran girls with primary dysmenorrhoea when used at a dose of 200 IU twice daily or 500 IU once daily for 5 days starting two days before menstruation. A randomised placebo-controlled trial to determine the effect of vitamin E in treatment of primary dysmenorrhoea by Ziaei, et al in 2001 concluded that both vitamin E and placebo were effective in relieving symptoms due to primary dysmenorrhoea, although the effects of vitamin E are more marked, more research is warranted to be able to conclude this finding. Another randomised placebo-controlled trial to determine the effect of vitamin E in treatment of primary dysmenorrhoea by Ziaei, et al in 2005 concluded that vitamin E relieves the pain of dysmenorrhoea and reduces blood work. Systemic reviews and clinical guidelines agree that these trials have limitations and the quality of evidence is variable. Additional research is necessary, preferably with larger, more thorough reports on the adverse effects and a larger demographic of patient populations.
The Cochrane Collaboration performed a review on Herbal and dietary therapies for primary and secondary dysmenorrhoea and evaluated randomized control trials on a variety of therapies including vitamin E and concluded that there is insufficient evidence to recommend the use of vitamin E for the treatment of primary or secondary dysmenorrhoea.
Other tertiary resources available on vitamin E and its use in primary dysmenorrhoea referenced either one, two or the following three clinical trials by Ziaei (2001) and Ziaei (2005) and Butler & McKnight, 1955. A review done by Bandolier concluded that vitamin E had a benefit in treating primary dysmenorrhoea. The treatment was 200 IU BID for 5 days beginning 2 days prior to expected menses. However, again due to limitations of the studies and possible risk of all-cause mortality with chronic high dose antioxidant vitamins (including vitamin E) patients interested to self treat primary dysmenorrhoea should be advised to use small doses for only a few days.
Overall, adolescent patients suffering with primary dysmenorrhoea should consider Vitamin E if NSAIDs are contraindicated, ineffective therapy from NSAIDs or if the patient wishes to try a natural health product.
References:
1. Butler EB, McKnight E. Vitamin E in the treatment of primary dysmenorrhoea. Lancet. 1955; i:844-847.
2. Ziaei S, Faghihzadeh S, Sohrabvand F, Lamyian M, Emamgholy T. A randomised placebocontrolled trial to determine the effect of vitamin E in treatment of primary dysmenorrhoea. British Journal of Obstetrics and Gynaecology. 2001; 108(11):1181-1183.
3. Ziaei S, Zakeri M, Kazemnejad A. A randomised controlled trial of vitamin E in the treatment of primary dysmenorrhoea. British Journal of Obstetrics and Gynaecology. 2005;112(4): 466-469.
4. Proctor ML, Murphy PA. Herbal and dietary therapies for primary and secondary dysmenorrhoea. Cochrane Database Syst Rev. 2009;(3):CD002124.
5. Banikarim C. Primary dysmenorrhea in adolescents. In: UptoDate. Middleman AB, Geffner M,Hoppin AG, eds. UpToDate. Waltham, Mass: UpToDate; 2013. Available at: http://www.uptodate.com/contents/treatment-of-primarydysmenorrhea-in-adult-women. Accessed May 14, 2013.
After reviewing the limited literature available for Vitamin E in the treatment of primary dysmenorrhoea, evidence suggests that it may reduce pain compared to placebo in adolescent Tehran girls with primary dysmenorrhoea when used at a dose of 200 IU twice daily or 500 IU once daily for 5 days starting two days before menstruation. A randomised placebo-controlled trial to determine the effect of vitamin E in treatment of primary dysmenorrhoea by Ziaei, et al in 2001 concluded that both vitamin E and placebo were effective in relieving symptoms due to primary dysmenorrhoea, although the effects of vitamin E are more marked, more research is warranted to be able to conclude this finding. Another randomised placebo-controlled trial to determine the effect of vitamin E in treatment of primary dysmenorrhoea by Ziaei, et al in 2005 concluded that vitamin E relieves the pain of dysmenorrhoea and reduces blood work. Systemic reviews and clinical guidelines agree that these trials have limitations and the quality of evidence is variable. Additional research is necessary, preferably with larger, more thorough reports on the adverse effects and a larger demographic of patient populations.
The Cochrane Collaboration performed a review on Herbal and dietary therapies for primary and secondary dysmenorrhoea and evaluated randomized control trials on a variety of therapies including vitamin E and concluded that there is insufficient evidence to recommend the use of vitamin E for the treatment of primary or secondary dysmenorrhoea.
Other tertiary resources available on vitamin E and its use in primary dysmenorrhoea referenced either one, two or the following three clinical trials by Ziaei (2001) and Ziaei (2005) and Butler & McKnight, 1955. A review done by Bandolier concluded that vitamin E had a benefit in treating primary dysmenorrhoea. The treatment was 200 IU BID for 5 days beginning 2 days prior to expected menses. However, again due to limitations of the studies and possible risk of all-cause mortality with chronic high dose antioxidant vitamins (including vitamin E) patients interested to self treat primary dysmenorrhoea should be advised to use small doses for only a few days.
Overall, adolescent patients suffering with primary dysmenorrhoea should consider Vitamin E if NSAIDs are contraindicated, ineffective therapy from NSAIDs or if the patient wishes to try a natural health product.
References:
1. Butler EB, McKnight E. Vitamin E in the treatment of primary dysmenorrhoea. Lancet. 1955; i:844-847.
2. Ziaei S, Faghihzadeh S, Sohrabvand F, Lamyian M, Emamgholy T. A randomised placebocontrolled trial to determine the effect of vitamin E in treatment of primary dysmenorrhoea. British Journal of Obstetrics and Gynaecology. 2001; 108(11):1181-1183.
3. Ziaei S, Zakeri M, Kazemnejad A. A randomised controlled trial of vitamin E in the treatment of primary dysmenorrhoea. British Journal of Obstetrics and Gynaecology. 2005;112(4): 466-469.
4. Proctor ML, Murphy PA. Herbal and dietary therapies for primary and secondary dysmenorrhoea. Cochrane Database Syst Rev. 2009;(3):CD002124.
5. Banikarim C. Primary dysmenorrhea in adolescents. In: UptoDate. Middleman AB, Geffner M,Hoppin AG, eds. UpToDate. Waltham, Mass: UpToDate; 2013. Available at: http://www.uptodate.com/contents/treatment-of-primarydysmenorrhea-in-adult-women. Accessed May 14, 2013.