Online Pain Neuroscience Education for Women With Primary Dysmenorrhea

Efficacy of an Online Pain Neuroscience Education Intervention in Women With Primary Dysmenorrhea: A Randomized Controlled Trial

Primary dysmenorrhea is a highly prevalent condition characterized by recurrent menstrual pain in the absence of identifiable pelvic pathology. It affects up to 95% of menstruating women and often interferes with quality of life. Pain neuroscience education (PNE) has shown positive effects in musculoskeletal conditions but has not yet been studied in women with primary dysmenorrhea. This study aims to evaluate the effect of an online PNE intervention combined with lifestyle recommendations, compared to lifestyle recommendations alone

This randomized controlled trial will compare an online pain neuroscience education (PNE) program plus lifestyle recommendations with lifestyle recommendations alone in women with primary dysmenorrhea. Participants will be randomized (1:1) to either the intervention group (4-week online PNE modules plus lifestyle recommendations) or the control group (lifestyle recommendations only). The program is based on Butler and Moseley's pain neuroscience principles, adapted to menstrual pain. Outcomes will be assessed at baseline and at 6 months. The primary outcome is pain intensity. Secondary outcomes include anxiety, depression, kinesiophobia and pain catastrophizing,

Inclusion Criteria:

• Nulliparous women aged 18 to 35 years.
• Clinical diagnosis of primary dysmenorrhea.
• History of moderate to severe menstrual pain for at least six consecutive menstrual cycles.
• Pain intensity score greater than 5 on a numerical rating scale (0-10).
• No prior use of pain neuroscience education (PNE).
• No history of pregnancy.

Exclusion Criteria:

• History of lower abdominal surgery.
• Presence of severe mental health disorders.
• Current use of hormonal contraceptives.