Effect of Exercise on Pain and Core Endurance in Women with Primary Dysmenorrhea: A Literature Review

Abstract

Background: Primary dysmenorrhea is a prevalent gynaecological condition characterized by painful menstrual cramps in the absence of pelvic pathology, significantly affecting quality of life, academic performance, and daily functioning. Exercise-based physiotherapy interventions, particularly core strengthening exercises, have emerged as effective non-pharmacological strategies for symptom management.
Objective: To systematically evaluate the effectiveness of core strengthening and core endurance exercises in reducing menstrual pain and improving functional outcomes among women with primary dysmenorrhea.
Methods: A systematic review was conducted following the PRISMA 2020 guidelines. Electronic databases including PubMed/MEDLINE, Google Scholar, and ResearchGate were searched for studies published between January 2016 and December 2022. Eligible studies included randomized controlled trials, quasi-experimental studies, controlled clinical trials, and cross-sectional studies evaluating core strengthening, core stability, or core endurance exercises in adolescents and young women with primary dysmenorrhea. Methodological quality was assessed using the PEDro Scale, Joanna Briggs Institute Critical Appraisal Checklist, and AXIS Tool according to study design. Data were synthesized narratively because of methodological heterogeneity.
Results: Ten studies met the inclusion criteria. Five studies demonstrated that core strengthening exercises significantly reduced menstrual pain while improving functional performance and core muscle endurance. Three studies reported beneficial effects of stretching and aerobic exercises on pain intensity and quality of life. One study supported deep breathing exercises for pain relief, whereas another identified impaired abdominopelvic muscle endurance in women with primary dysmenorrhea, emphasizing the importance of core stabilization. Overall, core strengthening consistently produced greater clinical improvements than stretching alone.
Conclusion: Current evidence supports core strengthening exercises as a safe, effective, and evidence-based conservative intervention for primary dysmenorrhea. Incorporating structured core exercise programs into routine physiotherapy practice may reduce menstrual pain, enhance core endurance, improve functional capacity, and decrease dependence on pharmacological management. Further high-quality randomized controlled trials with longer follow-up are warranted.