The Iranian Journal of Obstetrics, Gynecology and Infertility

The Iranian Journal of Obstetrics, Gynecology and Infertility

Effect of Calcium with and Without Magnesium on Amount and Duration of Menstrual Bleeding in Students with Primary Dysmenorrhea

Document Type : Original Article

Authors
Sakineh Mohammad Alizadeh Charandabi 1
Mojgan Mirghafourvand 2
Yousef Javadzadeh 2
Salimeh Nezamivand Chegini 3
1 Ph.D. of Reproductive Health, Associate Professor, Department of Midwifery, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
2 Ph.D. of Pharmacy, Associate Professor, Department of Pharmacy, School of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran.
3 M.Sc. of Midwifery, International Branch of Aras, Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.
10.22038/ijogi.2014.2263
Abstract
Introduction: Calcium and magnesium deficiency have been mentioned as a risk factors for increasing amount of menstrual bleeding with dysmenorrhea. Given that no study was found in this field, the aim of this study was aimed determining the effect of calcium with and without magnesium on amount and duration of menstrual bleeding.
Methods: This double blind randomized controlled trial was carried out on 63 students with moderate or severe dysmenorrhea in Tabriz, Iran in 2012. Participants were divided into three groups: receiving tablets of calcium, calcium combined magnesium and placebo. Amount and duration of menstrual bleeding was assessed during two months before and two months after starting intervention using the Higham chart. Data were analyzed using SPSS software version 13, Kolmogorov-Smirnov, Levene, One Way ANOVA, ANCOVA, paired t-test. P value less than 0.05 was considered significant.
Results: The calcium-magnesium group compared to placebo had significantly lower amount of menstrual bleeding (p=0.009) and shorter duration of menstrual bleeding (p=0.006). In the calcium group compared to placebo group, there was no statistically significant difference on the mean amount of menstrual bleeding (p=0.029), but duration of bleeding was significantly less in the calcium group (p=0.017).
Conclusion: The combination of calcium and magnesium is beneficial in reducing the amount and duration of menstrual bleeding in women with primary dysmenorrhea. This study could not show significant effect of calcium only, on amount of menstrual bleeding.
Keywords
Calcium
Dysmenorrhea
Hemorrhage
magnesium
Menstrual cycle
Randomized controlled trial
  1. Rapkin AJ, Howe C. Pelvic pain and dysmenorrhea. In: Berek JS. Berek & Novak's gynecology. 14th  ed. Philadelphia:Lippincott Williams & Wilkins;2007:505-40.
  2. Muto MG. The vulva. In: Rayan KJ, Berkowitz RS, Barbieri RL, Dunaif AE. Kistner's gynecology & women's health.7th ed. St. Louis:Mosby;1999:58-80.
  3. Janssen CA, Scholten PC, Heintz AP. A simple visual assessment technique to discriminate between menorrhagia and normal menstrual blood loss, Obstet Gynecol 1995 Jun;85(6):977-82.
  4. Thys-Jacobs S. Micronutrients and the premenstrual syndrome: the case for calcium. J Am Coll Nutr 2000 Apr;19(2):220-7.
  5. London RS, Bradley L, Chiamori NY. Effect of a nutritional supplement on premenstrual symptomatology in women with premenstrual syndrome: a double-blind longitudinal study. J Am Coll Nutr 1991 Oct;10(5):494-9.
  6. Seifert B, Wagler P, Dartsch S, Schmidt U, Nieder J. [Magnesium--a new therapeutic alternative in primary dysmenorrheal] [Article in German]. Zentralbl Gynakol 1989;111(11):755-60.
  7. Thys-Jacobs S, McMahon D, Bilezikian JP. Cyclical change in calcium metabolism across the menstrual cycle in women with premenstrual dysphoric disorder. J Clin Endocrinol Metab 2007 Aug;92(8):2952-9.
  8. Muneyvirci-Delale O, Nacharaju VL, Altura BM, Altura BT. Sex steroid hormones modulate serum ionized magnesium and calcium levels through the menstrual cycle in women. Fertil Steril 1998 May;69(5):958-62.
  9. Ogunfowokan AA, Babatunde OA. Management of primary dysmenorrhea by school adolescents in ILE-IFE, Nigeria. J Sch Nurs 2010 Apr;26(2):131-6.
  10. Lethaby A, Farquhar C. Treatments for heavy menstrual bleeding. BMJ 2003 Nov 29;327(7426):1243-4.
  11. Monga A. Gynecology by ten teachers. 18th ed. London:Edward Arnold;2006:132.
  12. Ziaei S, Zakeri M, Kazemnejad A. A randomised controlled trial of vitamin E in the treatment of primary dysmenorrhoea. BJOG 2005Apr;112(4):466-9.
  13. Rahimi M, Ziyaei S, Babai Gh, Rabiei M. [Effect of vitamin E in treatment of menorrhagia in patients with dysfunctional uterine bleeding] [Article in Persian]. Daneshvar Med 2009 Nov;16(88):59-66.
  14. Rasekh A, Farahmand M, Zahedi Asl S, Abbaspour Z. [Efects of vitamin E and Ibuprofen on amount, duration and interval of menstruation period bleeding in primary dysmenorrheal] [Article in Persian]. Kowsar Med J 2009 Jan;14(1):49-52.
  15. Mirbagher Ajorpaz N, Hafezi M, Salehi S, Tayebi A, Shenasa F, Zahtabchi S. [Comparing the effect of pure and impure honey on severity of pain, amount of bleeding, and duration and interval of menstrual cycles in female students with primary dysmenorrheal] [Article in Persian]. EBCJ 2012 Jan;2(2):23-33.
  16. Babazadeh R, Keramat A. [Premenstrual syndrome complementary medicine in Iran: a systematic review] [Article in Persian]. Feyz 2011;15(2):174-87.
  17. Damghanian M, Mortazavi F, Mottagh Z, Keramat A. [Systematic review on treatment of primary dysmenorrhea in Iran] [Article in Persian]. J Mashhad School Nues Midwifery 2010;10(3-4):32-46.
  18. 18. Proctor ML, Murphy PA. Herbal and dietary therapies for primary and secondary dysmenorrhoea. Cochrane Database Syst Rev 2009;(3):CD002124.
  19. Thys-Jacobs S, Ceccarelli S, Bierman A, Weisman H, Cohen MA, Alivery J. Calcium supplementation in premenstrual syndrome: a randomized crossover trial. J Gen Intern Med 1989 May-Jun;4(3):183-9.
  20. Thys-Jacobs S, Starkey P, Bernstein D, Tian J. Calcium carbonate and the premenstrual syndrome: effects on premenstrual and menstrual symptoms. Premenstrual Syndrome Study Group. Am J Obstet Gynecol 1998 Aug;179(2):444-52.
  21. Akhlaghi F, Hamedi A, Javadi Z, Hosseinipour F. [Effect of calcium in premenstrual syndrome] [Article in Persian]. J Iran Univ Med Sci 2003 Winter;10(37):669-75.
  22. Ghanbari Z, Haghollahi F, Shariat M, Rahimi Foroshani A, Ashrafi M. [Effect of calcium supplement therapy in women with premenstrual syndrome] [Article in Persian]. Taiwanese J Obstet Endocrinol 2009;48(2):124-9.
  23. Pourmohsen M, Zoneamat Kermani A, Taavoni S, Hosseini AF. [Effect of combined calcium and vitamin E consumption on premenstrual syndrome] [Article in Persian]. Iran J Nurs 2010;23(65):8-14.
  24. Facchinetti F, Borella P, Sances G, Fioroni L, Nappi RE, Genazzani AR. Oral magnesium successfully relieves premenstrual mood changes. Obstet Gynecol 1991 Aug;78(2):177-81.
  25. Ebrahimi E, Jalali H, Jamshidi-Manesh M. [The effect of magnesium on premenstrual syndrome in the women go to medical-health centers of Esfahan University of Medical Sciences] [Article in Persian]. Complement Med J Fac Nurs Midwifery 2013 Spring;3(1):12-9.
  26.  Walker AF, De Souza MC, Vickers MF, Abeyasekera S, Collins ML, Trinca LA. Magnesium supplementation alleviates premenstrual syndroms of fluid retention. J Womens Health 1998 Nov;7(9):1157-65.
  27. Benassi L, Barletta FP, Baroncini L, Bertani D, Filippini F, Beski L, et al. Effectiveness of magnesium pidolate in the prophylactic treatment of dysmenorrhea. Clin Exp Obstet Gynecol 1992;19(3):176-9.
  28. Fontana-Klaiber H, Hogg B. [Therapeutic effects of magnesium in dysmenorrheal] [Article in German]. Schweiz Rundsch Med Prax 1990 Apr 17;79(16):491-4.
  29. Tarighat Esphanjani A, Mahdavi R, Ghaem Maghami J, Safaeean A. [Comparing nutritional status  of college female students living on and off campus in Ardabil] [Article in Persian]. J Ardabil Univ Med Sci 2003;9(3):44-51