REGISTRO DOI: 10.69849/revistaft/os102411271312
Adriana Moreira¹
Juliana Gomes Teixeira¹
Márcia Maria Oliveira Lima²
Adriane Viapiana Bossa3
Angela Mara Rambo Martini4
ABSTRACT
Dysmenorrhea, or menstrual cramps, are pelvic pains, felt by some women before, during or after menstruation, and may be associated with various symptoms, both physical and emotional and behavioral. The prevalence is from 17% to 90% in women at some stage of life, and in 15% of them the cramps are intense interfering with daily and work activities. Non-pharmacological therapeutic resources are an option to alleviate this situation by reducing adverse pharmacological effects. Medicinal Biomagnetism (MB) is based on the correction of distortions of homeostasis, through the use of static magnetic fields of medium intensity (magnets), which collaborate to reduce pain, edema and inflammation through the restoration of the vibrational and energetic pattern of organs or tissues. The aim of the study is to suggest a therapeutic protocol for the self-application of a Double Magnet in women in this clinical condition, aiming at the sedation of menstrual cramps. The present exploratory qualitative study conducted from bibliographic research observed both the need for therapies to alleviate or treat dysmenorrhea and its repercussions, as well as the possibility of exploring the use of BM tools. The suggestion of the protocol with a double magnet tool, easy to self-apply, simple, and low cost, used in any environment, aims to meet these demands. After being tested by systematized clinical studies, the use of the protocol may improve quality of life and restore social and work activities.
Keywords: Biomagnetism, Medicinal; Menstrual cramps; Complementary and Integrative Therapy; Double Magnet; Magnetic Fields, Static; Self-application.
1 INTRODUCTION
The woman’s menstrual cycle lasts about a month, and is marked by a period of three to seven days of uterine bleeding, when the egg has not been fertilized, which may cause pain in some women before, during or after menstruation(1).
Dysmenorrhea is a pelvic pain, better known as menstrual cramps, and is the most common gynecological condition affecting women of childbearing age (2,3). It can be related to many other symptoms, such as: diarrhea; constipation; headaches; nausea; Vomiting; Sweating; frequent urge to urinate; pain in the lower limbs, sinuses, lumbosacral region, lower abdomen, of variable intensity, sometimes disabling, which radiates to the back and lower limbs with short periods of relief(3). Associated with these, psychological and behavioral symptoms may also appear, such as episodes of nervousness, fatigue, fainting and vertigo(2).
The symptoms of dysmenorrhea usually appear a few months after menarche, in ovulatory cycles, occurring in women without proven organic lesions and the determination of causes and origins is not well understood(1,4). The reported prevalence ranges from 17% to 90%(2,5) and in 15% the cramps are intense enough to interfere with daily activities, which can lead to absences from school or work, incurring indirect costs related to productivity(1,3).
Dysmenorrhea may be primary, which is the most common; and secondary, due to pelvic alterations, with degrees ranging from mild to accentuated(2,6). Primary dysmenorrheas are typically observed in women who ovulate, and since diseases that justify the symptoms are not usually found, historically the causes were associated with “psychosomatic factors”(1). Some other factors that may contribute to primary dysmenorrhea are: passage of menstrual tissue through the cervix; poorly positioned uterus; narrow cervical ostium; anxiety about the menstrual period; and lack of exercise. There are risk factors for severe symptoms in situations where there is an early age of first menstruation, heavy or long menstrual periods, family history of dysmenorrhea, and smoking. Symptoms tend to decrease with age and after pregnancy(7,8).
Secondary dysmenorrhea has its onset at any time after the first menstruation, especially in women over the age of 25. It happens by the occurrence of disorders or problems caused by adjacent diseases such as: endometriosis, considered the most common cause; Fibroid; physiological changes of the uterus or ovaries; pelvic inflammatory disease; irregular cycles; abnormalities and processes affecting the pelvic viscera; and even problems with the use of intrauterine devices (IUDs), especially with copper or levonorgestrel releasers. Included are some less common causes of secondary dysmenorrhea, some examples are: congenital malformations such as bicornuate uterus; intrauterine adhesions; ovarian tumors and cysts; and cervical stenosis. Both severe and primary secondary dysmenorrhea have the same risk factors(7).
The diagnosis to differentiate between primary and secondary dysmenorrhea should be clinical, based on a careful anamnesis that includes general and complementary physical examinations. The age of the woman at the time the tests are being done should be taken into account, considering that younger women (adolescents) have different pain from adult women. The onset of symptoms and their duration, the characteristics of menstrual flow, history of infection, previous surgeries and the main complaints of the patient should be carefully investigated(1,9,10).
Menstrual cramps, when they manifest in a mild degree, do not usually interfere in the daily activities of women, however, when the degree is moderate or accentuated, it can generate relevant social impacts(1,9,10) such as a decrease in productivity during this period(3,11). A fact so evident that in Brazil, the Chamber of Deputies analyzed a proposal that allows women to take time off work for up to three days a month during the menstrual period. In these cases, compensation for hours not worked may be required, so that there is no loss to the company. The measure is provided for in Bill 6784/16, by Deputy Carlos Bezerra (PMDB-MT), which adds an article to the Consolidation of Labor Laws (CLT – Decree-Law 5452/53), in the part that deals with women’s work (Agência Câmara de Notícias)(12).
Thus, there is an urgency in the search for resources involved in the treatment or improvement of pain resulting from this dysfunction, and complementary integrative therapies are options that should be considered(13). These therapies treat the most diverse pathologies and disorders, through products or manual practices, with the advantage of causing little or no adverse effects to the patient(14). It is important to emphasize that such therapies did not emerge to replace traditional medicine, but to live in harmony with it, in a complementary way and bringing well-being and relief to patients(13).
Among the complementary integrative therapies, Medicinal Biomagnetism (MB), a therapeutic technique developed by a Mexican physician and physiotherapist, Dr. Isaac Goiz Durán, in 1988, based on the studies of Dr. Richard Broeringmeyer, a physician at the American Space Agency, aims to correct distortions of homeostasis, which tend to acidity (excess of H+) and alkalinity (excess of OH-), at two specific points of the organism, which are in resonance with each other. It consists of the use of static magnetic fields (SMF), generated by magnets of medium intensity (from 1,000 to 7,000 Gauss). It confronts the charges of equal polarity, that is, it impacts the same polarity of the magnet in the corresponding polarity in the organism, both at a point that tends to greater alkalinity, and at another that tends to higher acidity. The application of medium intensity magnets promotes the induction of charges that are in vibrational and energetic relation, aiming to correct or avoid distortions of the hydrogen potential (pH) of organs or tissues(15,16,17,18,19,20).
Among the MSCs, there is the double neodymium magnet of medium intensity (1000 to 7500 Gauss), composed of the two polarities (north, called negative for the BM and south, called positive) both on the upper and lower faces. Since the North polarity is represented by the color black, while the South Pole is represented by the color red, one next to the other, and when applied in a small region or organ, it performs the function of local analgesia (Figure 1)(21).
Figure 1: Double Magnet
MSCs, including those used by the BM, contribute to reduce pain, edema and inflammation(18,19,22). They assist the body in restoring the electrical pattern, through depolarization, which occurs when the region is impacted with the south pole of the magnet. The impacted region receives electromotive force, which potentiates the impulses conducted by the nervous system, generating an immediate stimulation that results in energy to the organ in dysfunction, balancing and normalizing the existing condition. When applying the magnetic field of the north pole, the effect of sedation occurs in the impacted regions, consequently there is a decrease in painful stimuli. Theoretically, the use of the north pole of the magnetic field, in addition to sedation, could help in the return of the ideal cellular pH, without prejudice to toxicity to healthy cells. Thus, the purpose of magnetic therapy is to restore integral health(18,20).
A study using MSC through magnets was conducted by Mayrovitz et al. (2021), and a positive response was observed in pain in women with dysmenorrhea, which leads us to suggest that the double magnet may have an analgesic effect for women with this condition(14,18,20,22).
Thus, from the above, a magnetic or electrical stimulation of the organs could exert effects in different areas of the systems, through the nerves or organs, producing a toning or sedative effect, according to the need, so that the dysfunction can be corrected(22).
Considering that dysmenorrhea can interfere with the normal performance of usual and work activities, generating relevant social and personal impacts, it is imperative to search for therapies that can minimize, improve or even treat such dysfunctions(1).
In the expectation of assisting in the challenge of seeking therapeutic resources of easy applicability, low cost and that can be self-administered, the objective of the present study is to present in a simplified, direct and didactic way, a therapeutic protocol for self-application of the double magnet in women of childbearing age, for sedation of menstrual colic(23).
2 METHODOLOGY
Through the methodology of bibliographic research, an exploratory study of qualitative character was carried out to substantiate the suggestion of the application of a protocol, which provides sedation of pain, arising from dysmenorrhea, in women who present this dysfunction.
In the elaboration of this study, a bibliographic survey was made, where ideas and concepts of other authors were sought, in line with the proposed objectives, thus aiming to build a protocol on the object of study and justifying the use of the technique of Medicinal Biomagnetism.
Qualitative research aims to make the researcher familiar with a subject of little knowledge in people’s daily lives, and should not be translated into numbers, nor does it require statistical techniques, since it establishes a dynamic relationship between natural and human phenomena, in order to reject or prove hypotheses suggested by bibliographic research(24).
To carry out this qualitative study, on the topic of menstrual cramps, articles were searched in the period from 2012 to 2022, in the electronic databases PubMed, Scientific Electronic Library Online (SCIELO), Virtual Health Library (VHL) and Portal of Scientific Journals in Health Sciences. Articles in Portuguese, Spanish and English were selected and priority was given to those with DOI Digital Object Identifier.
The criteria of accessibility, criticality and scientific veracity determined the choice of databases. In the articles with the theme “dysmenorrhea”, priority was given to subjects related to concepts, semiology, epidemiology and non-pharmacological treatment. Among the selected studies, those that were not related to the proposed theme, such as diagnosis, were excluded; pharmacological, surgical and related treatment.
In order to search for the articles, the following health science descriptors were used: dysmenorrhea, menstrual cramps and Medicinal Biomagnetism. In addition to using the descriptors double magnet and self-application.
As for Medicinal Biomagnetism, which has few publications, for research we used the books and handouts of the graduate program in “Biomagnetism and Bioenergetics applied to Health”, excluding contents not consistent with the research.
3 RESULTS
Searches were conducted in electronic media based on the descriptors selected for this research and 3,146 publications related to dysmenorrhea were identified, 26 related to menstrual cramps were selected. Associated with the themes related to BM, Static Magnetic Fields and Double Magnet, 14 publications were selected. Of the total number of selected publications, six have a DOI.
Based on the bibliographic survey carried out, information was gathered to guide the elaboration of the protocol such as: the most appropriate anatomotopographic region for the impaction of the double magnet, the positioning of the double magnet respecting the polarities (+ and -), the time and the appropriate number of impactations.
After studies of the selected articles, the following proposal was elaborated for a protocol, painless, non-invasive, low cost, in a simple and practical way, with easy applicability, with the tool “Double Magnet”.
3.1 Protocol for treatment of menstrual cramps
This protocol proposal was structured to be used during episodes of menstrual cramps, for self-application of a tool called double magnet, aiming at the sedation of pain from dysmenorrhea.
The process of applying the protocol consists of three sequenced steps: sample, composed of women eligible to use the protocol; selection of the material to be used and methodology with the implementation of the suggested protocol.
SAMPLE
The protocol to be proposed may be applied to women in the fertile period, in the age group between puberty (after menarche) and before menopause, who are experiencing menstrual colic, excluding those who are in the process of pregnancy(1,14).
MATERIAL
The application of aDouble Magnet, which is a tool composed of two neodymium magnets that are arranged side by side, inside a cover that covers them, of non-toxic, flexible and sanitizable PVC, one with the north polarity facing up, while the other with the south polarity. The external structure that holds both magnets represents a unit of the Double Magnet, containing on its two faces, the two polarities, north and south(23) as previously mentioned in Figure 1.
METHOD
Regarding the form of application, it is suggested that the negative pole, called the north pole of the magnet, be in contact with the body, facing towards the right side of the same and, in counterposition, the south pole, or positive pole, be in contact with the body facing the left of the same, as shown in Figure 2(25). It is worth mentioning that the positive pole in the Double Magnet is usually expressed in red, while the negative pole expressed in black.
Figure 2: Application of the Double Magnet in Menstrual Colic
The women will be instructed to self-apply the double magnet in the uterus region, according to Figure 2, for a minimum duration of 40 minutes, in a period of 3 to 7 days during the acute phase of pain, that is, for the days that follow the events related to dysmenorrhea(23).
The minimum time stipulated for this technique is based on a convention already used by the WB when seeking the depolarization of the pairs, aiming at sedation(23).
The self-application of this protocol can be performed, both during work activities (in motion), as well as associated with relaxation activities or meditation techniques, in any environment, home, work, not requiring a specific place to use this tool(23).
4 DISCUSSION
This study found important theoretical bases that support the need to create complementary therapeutic alternatives, easy to apply, low cost and that can mitigate the consequences of dysmenorrhea. The suggestion of the present therapeutic protocol, in addition to the expected analgesia, aims to ensure the permanence of women in their daily activities, work or not, considering that it is the same self-applicable in any environment.
The treatment of dysmenorrhea, conventionally, is performed with pharmacological therapy, however this treatment is usually associated with adverse effects such as nausea, intermenstrual bleeding, mastalgia. In addition, pain relief is not always satisfactory in many women, which is why non-pharmacological therapies should be encouraged to avoid such effects and help reduce pain intensity(26).
For this purpose, some studies have shown favorable results, with different modalities of non-pharmacological therapies, alone or associated with drug therapy, in the treatment of dysmenorrhea. Among them, the most used therapies are essential oils; medicinal plants; acupuncture; aromatherapy; reflexology; massages and exercises(14,26,27,28,29,30,31).
Transcutaneous Nerve Stimulation (TENS) therapy involves the use of electrodes to stimulate the skin at various frequencies and intensities in an attempt to decrease pain perception. TENS can be classified as high or low frequency. A recent single-blind randomized clinical trial demonstrated results that favor the application of high-frequency TENS in combination with heat therapy(29).
A study by Kannam & Claydon (2014), a systematic review of clinical trials and meta-analysis, investigated the effect of diverse therapies such as heat, TENS, yoga, acupuncture and acupressure, on pain relief, and on the impact on the quality of life of women with primary dysmenorrhea. They observed significant improvement in some therapeutic modalities, but in others the improvement was not significant, but they concluded that they were the same important as a clinical effect(26).
A Canadian Consensus published a Guidelines for clinical practice in primary dysmenorrhea, and among the various recommendations, it refers to integrative and complementary therapies, with varying degrees of recommendation. Regarding exercise and TENS did not observe harm, and it is reasonable to recommend even without evidence from clinical trials. Acupuncture results were inconsistent in the studies considered. In acupressure, they concluded that this modality brought benefits, but recognized that many studies were of low methodological quality. In behavioral therapies such as hypnotherapy, relaxation techniques, supplemental diet, among others, their use should be associated with pharmacological therapy. The local heat had better recommendation. Regarding dietary supplements, the result was less consistent, due to the lack of safety in the methodology of the studies consulted. This concludes from the need for more robust studies for a more careful analysis of the action of these therapies(2).
Regarding the use of therapies using MSC in the control of dysmenorrhea, only one study was found in the databases searched. In the aforementioned study, Mayveritz & col (2021), through a randomized pilot study with parallel groups, evaluated the effect of the application of a rare earth concentric magnet versus simulated magnet, in two groups of women (N=36, active group=19 and control=17) between 18 and 22 years old, with menstrual cramps, whose pain level was verified by the analog pain scale, before and after treatment. The women could not receive drug analgesia. They remained for 40 minutes with the magnet in the abdominal region, and in their normal activities. The results showed a significant decrease in the intragroup active pain score (4.16 ± 2.20, p=0.027), the same not verified within the control group (5.53± 1.50). The difference between the groups showed a reduction of 41.8% ± 31.1% for the active group and 20.8% ± 16.1% for the control group (p<0.05). The authors conclude that the significant improvement in pain observed with a minimum time of use of the device can be better explored with other application times, which can be performed by new studies(14).
According to Tejedas et al. (2011), the biostimulatory capacity resulting from the biomagnetic effect on the cells, produces anti-inflammatory and analgesic results, with the advantage of not being invasive. According to numerous studies developed in Cuba, it has been described that magnetic energy produces potential changes in cellular tissue and nerves, inducing potential changes in the central and peripheral nervous system, promoting regeneration of the compromised tissue(32).
Advances are observed, even if very incipient in the exploration of therapy with some magnets for analgesic and anti-inflammatory effects in various clinical conditions. The hypothesis of this effect is based on the studies of Dr. Richard Broeringmeyer, where it is reported that the human body produces fluctuating magnetic fields in its organs, as a result of the different chemical activities performed by the organism, where each body cell has a specific magnetic function. In this sense, the human body is controlled by electromagnetic energy fields, with the nervous system acting through electrical impulses, which have charges, with the ability to reestablish the normal functioning of the tissue(20).
The use of magnetism for therapeutic purposes has occurred in various parts of the world for centuries(32). However, research involving the use of the tools used in Medicinal Biomagnetism is scarce, although the number of Biomagnetists is increasing worldwide and the demand for less invasive and easy-to-apply treatments is increasing(18). Thus, it is expected that more studies involving this tool will be carried out.
Another aspect raised in the studies evaluated refers to the impact of dysmenorrhea on women’s quality of life, which often reflects on absenteeism from daily activities. In the study by Nunes et al. (2013), numerous limitations of the daily activities of women affected by dysmenorrhea were mentioned. In a sample of 65.7% of these women, 24.8% demonstrated decreased concentration during classes; 26.6% had sleep disturbances; 20.4% reported staying in bed for long periods; 19.5% had interference in sports activities; 17.7% reported interference in the relationship with friends; 11.5% changes in study and homework achievements; 2.7% changes in work activities and 1.8% worse results in school evaluations(33).
Yonglitthipagon et al. (2017), demonstrated the improvement in quality of life and menstrual pain, in addition to physical conditioning, in women with primary dysmenorrhea, after twelve weeks of a yoga program, which suggests that integrative and complementary therapeutic measures can help reduce these diseases to the quality of life of these women(10).
Data reported by Passos et al. (2018), in a sample of 101 women, employees of a telemarketing company, demonstrated that 30% of these women were absent from work, evidencing a significant impact of primary dysmenorrhea on productivity(34).
We also emphasize that, because it has a painful, sometimes disabling, manifestation, dysmenorrhea ends up affecting emotional issues and reducing women’s energy during the painful cycle, which makes evident a decrease in quality of life during this period. A consequence of this is that many women at some stage of their lives, under the influence of dysmenorrhea, have already been absent from some commitment or from their work(1,9,10).
It is believed that dysmenorrhea is often underreported and undertreated, and its proper management can improve the overall quality of life, as well as relieve financial and academic burdens for many women(35).
It is known that manypatients cannot seek medical care and often do not make use of the therapies that are available(2). Effective treatment of dysmenorrhea requires a discussion of risks, benefits and alternatives, with a particular focus on finding a treatment modality that meets the patient’s goals within the context of their lifestyle and other medical conditions. In some cases, however, less effective modalities may meet the patient’s needs, and more than one therapy may be initiated to improve efficacy(3).
The proposal of a protocol arises from the need to structure techniques aimed at producing basic evidence that gives more credibility and accessibility to the WB. For this to happen in order to achieve the objectives, the idea that professional activities in any area, in order to be efficient, should be performed according to a protocol(36) must be taken into account.
Thus, the applicability of the present protocol can contribute to new research possibilities in the area, resulting in undeniable benefits for the affected population. It is urgent and relevant that science continues to evolve, always focusing on the health and quality of life of people around the world. Allied to allopathic treatments, complementary and integrative treatments should evolve in the same proportion. Research and investments need to reach all aspects aimed at better health conditions for all(1).
Based on this theoretical basis, it is evident the need to suggest therapeutic measures that can minimize the impact of dysmenorrhea on daily activities, with the reduction of painful manifestations, which can also affect the work activities of women affected by this syndrome.
5 CONCLUSION AND FUTURE PROSPECTS
Based on the studies analyzed in this investigation, we conclude that the proposed protocol can exert an analgesic effect on menstrual cramps, with a non-invasive, low-cost, simple and self-applicable technique. Considering that static magnetic fields are used for pain, inflammation and edema reduction and because they have no important contraindication, they result in a therapeutic possibility for this clinical condition (1,9,13).
The therapeutic effects of the use of magnets have been investigated and even incipient, some already present satisfactory results in response to the use of the technique(13,14). Medicinal Biomagnetism deserves to have investments in research that can evaluate its effects, thus stimulating more accurate studies recognized by the scientific community. Thus, for such effects to be investigated, randomized clinical trials are necessary.
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1 Graduate students in Biomagnetism and Bioenergetics Applied to Health, Par Magnético Institute– IPM/Faculdade de Governança, Engenharia e Educação – FGE, São Paulo, Brazil.
² Retired Co-Advisor Professor at the Federal University of the Jequitinhonha and Mucuri Valleys – UFVJM, Minas Gerais, Brazil.
3 Co-supervising Professor Program in Biomagnetism and Bioenergy Applied to Health, Par Magnético Institute – IPM / Faculty of Governance, Engineering and Education of São Paulo – FGE. SP, Brazil.
4 Advising Professor Program in Biomagnetism and Bioenergy Applied to Health, Par Magnético Institute – IPM / Faculty of Governance, Engineering and Education of São Paulo – FGE. SP, Brazil.