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Primary dysmenorrhea (PD) is a pain that occurs in the menstrual period without pathological pelvic disorder. Excessive prostaglandin release causes uterine contraction and leads to uterine hypoxia and ischemia, which results in extreme abdominal cramps and pain. Music therapy is one of the complementary treatment methods in the management of pain for PD which is an intervention that is not expensive and has no side effects. Another complementary treatment method is for PD is chocolate. In the literature; there have a few studies about the effect of the music and dark chocolate on the primary dysmenorrhea but no studies have been conducted to evaluate the effects of the music and dark chocolate on PD.
The following is the protocol for a randomized controlled clinical trial, where an experimental group 1 listened to a 30-minute song, an experimental group 2 ate dark chocolate and a control group had no intervention for the same time and conditions. The aim of this study is to determine the effect of dark chocolate and music on PD. This pain measured through a 10 cm Visual Analogue Scale (VAS) in nursing students from the Faculty of Health Sciences at the Manisa Celal Bayar University, Manisa, Turkey. Additionally, State-Trait Anxiety Inventory (STAI) was used to assess the trait and state anxiety.
Primary Dysmenorrhea (PD) is defined as cramping pain in the lower abdomen, which occurs before or during menstruation without pelvic diseases. Contraceptive pills and non steroidal anti inflammatory drugs are commonly used in the treatment of PD. International (66.5% to 92.5%) and Turkey (87.7% to 80.1%) in the studies among university students show that a high percentage of dysmenorrhea. Dysmenorrhea negatively affects the school absenteeism of girls, their academic success and causes a lack of concentration. The rate of using pain medication due to dysmenorrhea is high among students. Music therapy has been shown to be effective in relaxing the mind and body, relieving anxiety, enhancing security, and increasing pain thresholds. Dark chocolate contains copper, which is used by the body to synthesize neurotransmitters called collagen and endorphins. Endorphin hormone is an analgesic and natural sedative to reduce pain intensity such as menstrual pain.
This randomized clinical trial was designed to determine the effect of eating dark chocolate and listening music on PD, compared to a control group that no intervention in women of 18 years or older from the the Faculty of Health Sciences at the Manisa Celal Bayar University, Manisa, Turkey.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Music group | Experimental | Participants listened a song with headphones that lasts 29 minutes and 32 seconds for four days (three days before menstruation and the first day of menstruation). The song was composed by Juan Martin Saavedra. In the first month, music group was filled the State Anxiety Inventory (SAI) between 10 and 20th of the menstruation that SAI consists of 20 statements that ask people to describe how they generally feel. In the second month, pain scores were measured on the first day of menstruation using a visual analogue scale (VAS) of 10 cm (0 no pain at all, and 10 the worst possible pain) and Trait Anxiety Inventory (TAI) was filled to assess the anxiety.In the third month, after the participants were listening the music in three days before menstruation and the first day of menstruation (during four days), pain scores were measured on the first day of menstruation using VAS and TAI was filled to assess the anxiety. |
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| Chocolate group | Experimental | Participants ate 40 mg of dark chocolate with 60% cocoa per day for four days (three days before menstruation and the first day of menstruation) that was given by researchers to them. In the first month, chocolate group was filled the SAI to assess state anxiety between 10 and 20th of the menstruation.In the second month, pain scores were measured on the first day of menstruation using VAS and TAI was filled to assess the trait anxiety.In the third month, after the participants were eating 40 mg of dark chocolate per day in three days before menstruation and the first day of menstruation (during four days/total 160 mg), pain scores were measured on the first day of menstruation using VAS and TAI was filled to assess the anxiety. |
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| Control group | No Intervention | Control group had no intervention. In the first month, control group was filled the SAI to assess state anxiety between 10 and 20th of the menstruation. In the second month, pain scores were measured on the first day of menstruation using VAS and TAI was filled to assess the trait anxiety. In the third month, pain scores were measured on the first day of menstruation using VAS and TAI was filled to assess the anxiety. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| music | Behavioral | Participants listened a song with headphones that lasts 29 minutes and 32 seconds for four days (three days before menstruation and the first day of menstruation). |
| Measure | Description | Time Frame |
|---|---|---|
| Description of the students' demographics and clinical backgrounds. | Questions about the sociodemographic characteristics and dysmenorrhea characteristics of the students were asked using the individual identification form developed by the researchers in line with the literature. | It was implemented on the first day of the study and it took approximately 10-15 minutes to fill out the form. |
| To evaluate pain severity secondary to dysmenorrhea in the first day of menstruation through a Visual Analogue Scale (VAS). | We asked them to determine the severest pain score they felt on the first day of menstruation according to the VAS scale. The highest pain score that can be obtained on the VAS scale is 10 and the lowest is 0. | The first day of the menstrual cycle 1 (each cycle is 28 days) and it is the baseline data. |
| To evaluate the effect of dark chocolate consumption in reducing the pain severity secondary to dysmenorrhea in the first day of menstruation through a Visual Analogue Scale (VAS). | We asked them to eat dark chocolate and determine the severest pain score they felt on the first day of menstruation according to the VAS scale. The highest pain score that can be obtained on the VAS scale is 10 and the lowest is 0. Participants ate 40 mg of dark chocolate per day for four days (three days before menstruation and the first day of menstruation) that was given by researchers to them. | The first day of the menstrual cycle 2 (each cycle is 28 days) and it is the post intervention data. |
| To evaluate the effect of music consumption in reducing the pain severity secondary to dysmenorrhea in the first day of menstruation through a Visual Analogue Scale (VAS). | We asked them listen to music and to determine the severest pain score they felt on the first day of menstruation according to the VAS scale. The highest pain score that can be obtained on the VAS scale is 10 and the lowest is 0. Students listened a song with headphones that lasts 29 minutes and 32 seconds for four days (three days before menstruation and the first day of menstruation). Participants were instructed to avoid using cellphones or other activities during the time of the intervention. |
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Inclusion Criteria:
Exclusion Criteria:
18-25 years old
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| Name | Affiliation | Role |
|---|---|---|
| EBRU BAYSAL, PhD | Manisa Celal Bayar University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ebru Baysal | Manisa | Turkey (Türkiye) |
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| Type | Date | Date Unknown |
|---|---|---|
| Release | Sep 7, 2022 | |
| Reset | Jul 27, 2023 |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Sep 7, 2022 | Jul 27, 2023 |
| ID | Term |
|---|---|
| D010146 | Pain |
| D004412 | Dysmenorrhea |
| ID | Term |
|---|---|
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D008599 | Menstruation Disturbances |
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| ID | Term |
|---|---|
| D009147 | Music Therapy |
| ID | Term |
|---|---|
| D026421 | Sensory Art Therapies |
| D000529 | Complementary Therapies |
| D013812 | Therapeutics |
| D012046 | Rehabilitation |
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The name of students were listed in alphabetical order. The researchers gave each students a number. Then, the odd numbers were determined as the experimental and the even numbers as the control group with the lottery method. Using the table of random numbers, the intervention groups were divided into intervention group 1 (music therapy) and intervention group 2 (chocolate group).
| Chocolate group | Dietary Supplement | Participants ate 40 mg of dark chocolate with 60% cocoa per a day for four days (three days before menstruation and the first day of menstruation) that was given by researchers to them. |
|
| The first day of the menstrual cycle 2 (each cycle is 28 days) and it is the post intervention data. |
| To evaluate anxiety level in the first day of first menstruation cycle through State Anxiety Inventory (SAI). | In the first day of first menstrual cycle, students was filled the State Anxiety Inventory (SAI) that SAI consists of 20 statements that ask people to describe how they generally feel. Each question is rated on a 4-point scale (not at all, somewhat, moderately so, very much so). The SAI varies from a minimum score of 20 to a maximum score of 80. SAI scores are commonly classified as "no or low anxiety" (20-37), "moderate anxiety" (38-44), and "high anxiety" (45-80). | The first day of the menstrual cycle 1 (each cycle is 28 days) and it is the baseline data. |
| To evaluate the effect of dark chocolate consumption in reducing the anxiety level of students with dysmenorrhea using State-Trait Anxiety Inventory (STAI). | We asked them to eat dark chocolate and filled the State Anxiety Inventory (SAI)in the first day of first menstrual cycle. The SAI consists of 20 statements that ask people to describe how they generally feel. Each question is rated on a 4-point scale (not at all, somewhat, moderately so, very much so). The SAI varies from a minimum score of 20 to a maximum score of 80. SAI scores are commonly classified as "no or low anxiety" (20-37), "moderate anxiety" (38-44), and "high anxiety" (45-80). | The first day of the menstrual cycle 2 (each cycle is 28 days) and it is the post intervention data. |
| To evaluate the effect of the music in reducing the anxiety level of students with dysmenorrhea using State-Trait Anxiety Inventory (STAI). | We asked them to listen the music and filled the State Anxiety Inventory (SAI)in the first day of first menstrual cycle. The SAI consists of 20 statements that ask people to describe how they generally feel. Each question is rated on a 4-point scale (not at all, somewhat, moderately so, very much so). The SAI varies from a minimum score of 20 to a maximum score of 80. SAI scores are commonly classified as "no or low anxiety" (20-37), "moderate anxiety" (38-44), and "high anxiety" (45-80). | The first day of the menstrual cycle 2 (each cycle is 28 days) and it is the post intervention data. |
| D010335 | Pathologic Processes |
| D017699 | Pelvic Pain |
| D000359 |
| Aftercare |
| D003266 | Continuity of Patient Care |
| D005791 | Patient Care |
| D011613 | Psychotherapy |
| D004191 | Behavioral Disciplines and Activities |