Comparative effectiveness of non-pharmacological interventions for primary dysmenorrhea: A protocol for a systematic review and network meta-analysis

IntroductionPrimary dysmenorrhea (PD) is the most common gynecological condition among young women. Although several non-pharmacological interventions have proven effective in relieving pain in patients with PD, the optimal treatment remains unknown. This systematic review and network meta-analysis (NMA) will aim to compare and rank the analgesic effects of different non-drug interventions for PD. Methods and analysisRandomized controlled trials of non-pharmacological interventions for PD will be identified via a search of the PubMed, Cochrane Library, Web of Science, and Embase databases until May 2024. The primary outcome will be change in pain intensity among patients with PD, while the secondary outcomes include health-related quality of life and symptoms of depression and anxiety. Two independent reviewers will perform document screening, study selection, and data extraction. The methodological quality of the included studies will be assessed using the Cochrane Risk of Bias tool (V. 2). The RevMan, Stata, and Aggregate Data Drug Information System software will be used to perform a pairwise meta-analysis and Bayesian NMA in a random-effects model. The certainty of the evidence will be rated using the Grading of Recommendations, Assessment, Development, and Evaluation System. Ethics and disseminationEthical approval will not be required for this study because all data will be obtained from published research. The findings will be published in a peer-reviewed journal. STRENGTHS AND LIMITATIONS OF THIS STUDYO_LIThis will be the first study to comprehensively compare the efficacy of non-pharmacological interventions for primary dysmenorrhea using network meta-analysis. C_LIO_LIThe study will assess both short- and long-term efficacies of various non-pharmacological interventions in mitigating pain intensity among patients with primary dysmenorrhea. C_LIO_LIThis systematic review will be conducted in compliance with the Cochrane Handbook guidelines, which will ensure methodological rigor. C_LIO_LIOnly trials from English databases will be included, which may lead to omission of eligible studies in other languages. C_LIO_LIThe efficacy of different regimens of the same non-pharmacological intervention will not be investigated in this study. C_LI