Transcutaneous electrical nerve stimulation (TENS) for the treatment of primary dysmenorrhea: a randomized crossover comparison with placebo TENS and ibuprofen

Article Abstract:

Although drug therapy for primary dysmenorrhea (severe pain associated with the onset of menstruation) can be effective for some women, many are not helped. Still others cannot take the drugs (such as nonsteroidal anti-inflammatory agents) that are usually prescribed. Transcutaneous electrical nerve stimulation (TENS), an approach that uses electrodes on the surface of the abdomen to stimulate sensory nerves, is used to treat other pain conditions; its effectiveness against the pain of primary dysmenorrhea was evaluated in 32 women. TENS was administered continuously during the first eight hours of the menstrual cycle, then as needed, for two cycles. The effects of TENS were compared with those of sham TENS (electrodes in place, but no stimulating current passed through them), and ibuprofen (a non-steroidal anti-inflammatory drug), both for one cycle. The order in which subjects experienced these treatments was varied randomly. Subjects rated 25 menstrual symptoms at specified times throughout their cycles, and were allowed to take ibuprofen as needed (pain rescue medication). The results revealed that 10 subjects had satisfactory pain control from TENS alone, while all except 4 needed ibuprofen during sham TENS treatment. Additional doses of ibuprofen were required by the subjects during the ibuprofen treatment cycle. Less ''rescue'' ibuprofen was required with TENS treatment than with either of the other approaches during almost all the intervals in the first 12 hours after the cycle began. TENS alone gave good to excellent subjective relief of pain for approximately 42 percent of the subjects, while sham TENS provided relief to only 3 percent. In addition, TENS delayed the need for ibuprofen by an average of almost six hours from the onset of pain, while the delay when ibuprofen only was offered was less than one hour. TENS also improved diarrhea and fatigue/lethargy, as compared with ibuprofen, and several other symptoms, as well, as compared with sham TENS. A discussion is provided of how TENS might work to produce its effect. The approach seems safe and effective for treating primary dysmenorrhea, especially when used with low doses of ibuprofen. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Ibuprofen, Dysmenorrhea, Transcutaneous electrical nerve stimulation

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No evidence of hearing loss due to fetal acoustic stimulation test

Article Abstract:

One method of assessing the condition of the fetus is the fetal acoustic stimulation test, in which a vibration and sound producing device is used to stimulate the fetus during pregnancy. Movement of the fetus and an increase in fetal heart rate in response to the vibroacoustic stimulation indicates good fetal health. However, vibroacoustic stimulation of the fetus may have adverse effects, such as the release of catecholamines, interference with cycles of rest and activity of the fetus, or hearing loss. The relationship between the fetal acoustic stimulation test during gestation and subsequent hearing loss was assessed by examining 465 children at four years of age. Thirty-one children did not have normal hearing. Further evaluation of hearing showed that hearing loss resulted from blockage by ear wax in 12 cases; impaired function of the eustachian tube and fluid accumulation in the middle ear in 15 children; and ear infection with fluid accumulation in the middle ear in two children. Hearing loss in both ears was also detected in two children, but subsequent treatment resulted in recovery of hearing. Thus, it is concluded that testing the fetus with acoustic stimulation during pregnancy does not increase the risk of hearing loss in early childhood. (Consumer Summary produced by Reliance Medical Information, Inc.)

Testing, Causes of, Hearing loss, Prenatal influences, Audiometry, Fetal movement, Fetal movements

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Fetal responses to different intensity levels of vibroacoustic stimulation

Article Abstract:

Acoustic stimulation of the fetus is thought to exert positive effects, and this was tested by applying vibroacoustic stimuli to the abdomens of 275 pregnant women between 32 and 42 weeks' gestation. The mother's perception of fetal movements and fetal heart rate (FHR) increases were recorded during stimulation. Stimulation lasted between one and two seconds and was performed at loudness intensities of 92, 103, and 109 decibels (dB). Of particular interest was the fetal response at different levels of stimulation, and at different fetal ages. A second study measured the same data in 10 women on four consecutive days and used sham (not real) stimulation over the abdomen, while performing genuine stimulation on the mother's leg. Results showed that stimulation at 103 or 109 dB (the more intense stimuli) resulted in fetal movement more often than stimulation at 92 dB. FHR accelerated more often than the mother perceived movement, at all sound levels. Thus, it appears that vibroacoustic stimulation induces different fetal responses at different levels. This is important to recall in evaluating results from studies of the effects of sound on fetuses. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Fetus, Sound pressure

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