Effects of Structured Exercise Interventions on Menstrual Pain Intensity in Primary Dysmenorrhea: A Systematic Review and Meta-Analysis

Primer Dismenorede Yapılandırılmış Egzersiz Müdahalelerinin Menstrual Ağrı Şiddeti Üzerine Etkileri: Sistematik Derleme ve Meta-Analiz

Engin GEZER, Hatice GEZER

Doi: https://doi.org/10.5281/zenodo.23672742

https://www.ijoss.org/Archive/v3-i3/ijoss-Volume3-issue3-03.pdf

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Received / Gönderim: 02.09.2026 Accepted / Kabul: 18.10.2026 Published / Yayın: 25.10.2026

Öz

Primer dismenore, günlük işlevselliği ve yaşam kalitesini olumsuz etkileyebilen menstrual ağrı ile karakterize yaygın bir durumdur. Bu sistematik derleme ve meta-analizin amacı, primer dismenoreli kadınlarda yapılandırılmış egzersiz müdahalelerinin menstrual ağrı şiddeti üzerindeki etkisini değerlendirmektir. Derleme PRISMA 2020 bildirimi doğrultusunda yürütülmüş ve PROSPERO’ya prospektif olarak kaydedilmiştir (CRD420261282619). MEDLINE, PubMed, Science Citation Index, Social Sciences Citation Index ve Scopus veri tabanlarında, yapılandırılmış egzersiz müdahalelerini egzersiz içermeyen kontrol koşullarıyla karşılaştıran randomize kontrollü çalışmalar taranmıştır. Yanlılık riski Cochrane Risk of Bias 2 aracıyla, kanıt kesinliği ise GRADE yaklaşımıyla değerlendirilmiştir. Primer meta-analiz için yeterli nicel veri sağlayan 17 randomize kontrollü çalışma analize dahil edilmiştir. Rastgele etkiler meta-analizinde, yapılandırılmış egzersiz grubunda egzersiz içermeyen kontrol koşullarına kıyasla menstrual ağrı şiddetinin anlamlı düzeyde daha düşük olduğu bulunmuştur (Hedges’ g = −2,18; %95 GA: −3,02 ila −1,33). Çalışmalar arasında yüksek düzeyde heterojenlik saptanmıştır (I² = %92,4; τ² = 2,92). Tek tek çalışmaların çıkarıldığı ve ek duyarlılık analizleri, havuzlanmış etkinin yönünü değiştirmemiştir. Huni grafiği asimetrisi ve Egger regresyon testi olası küçük çalışma etkilerine işaret etmiştir (intercept = −8,78; p = 0,003). Metodolojik kaygılar, yüksek tutarsızlık ve olası küçük çalışma etkileri nedeniyle kanıt kesinliği çok düşük olarak değerlendirilmiştir. Yapılandırılmış egzersiz primer dismenoreli kadınlarda menstrual ağrı şiddetini azaltabilir; ancak etkinin büyüklüğü dikkatle yorumlanmalıdır. Optimal egzersiz türü ve dozunu belirlemek için standartlaştırılmış egzersiz protokolleri ve sonuç raporlaması kullanan, metodolojik açıdan güçlü randomize kontrollü çalışmalara ihtiyaç vardır.

Anahtar Kelimeler: Primer dismenore; Egzersiz; Menstrual ağrı; Fiziksel aktivite; Meta-analiz; Sistematik derleme

Abstract

Primary dysmenorrhea is a common condition characterized by menstrual pain that may adversely affect daily functioning and quality of life. This systematic review and meta-analysis aimed to evaluate the effect of structured exercise interventions on menstrual pain intensity in women with primary dysmenorrhea. The review was conducted in accordance with PRISMA 2020 and prospectively registered in PROSPERO (CRD420261282619). MEDLINE, PubMed, Science Citation Index, Social Sciences Citation Index, and Scopus were searched for randomized controlled trials comparing structured exercise interventions with non-exercise control conditions. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool, and certainty of evidence was evaluated using the GRADE approach. Seventeen randomized controlled trials provided sufficient quantitative data for the primary meta-analysis. Random-effects meta-analysis showed significantly lower menstrual pain intensity with structured exercise compared with non-exercise control conditions (Hedges’ g = −2.18, 95% CI −3.02 to −1.33). Substantial between-study heterogeneity was observed (I² = 92.4%; τ² = 2.92). Leave-one-out and additional sensitivity analyses did not alter the direction of the pooled effect. Funnel plot asymmetry and Egger’s regression test indicated potential small-study effects (intercept = −8.78, p = 0.003). The certainty of evidence was rated as very low because of methodological concerns, substantial inconsistency, and suspected small-study effects. Structured exercise may reduce menstrual pain intensity in women with primary dysmenorrhea; however, the magnitude of benefit should be interpreted cautiously. Further well-designed randomized controlled trials with standardized exercise protocols and outcome reporting are needed to determine the optimal exercise modality and dose.

Keywords: Primary dysmenorrhea; Exercise; Menstrual pain; Physical activity; Meta-analysis; Systematic review

How to Cite This Article

APA 7

Gezer, E, & Gezer, H. (2026). Effects of Structured Exercise Interventions on Menstrual Pain Intensity in Primary Dysmenorrhea: A Systematic Review and Meta-Analysis. International Journal of Health, Exercise, and Sport Sciences (IJOSS), 3(3), 957–981.

Vancouver

Gezer E, Gezer H. Effects of Structured Exercise Interventions on Menstrual Pain Intensity in Primary Dysmenorrhea: A Systematic Review and Meta-Analysis. International Journal of Health, Exercise, and Sport Sciences (IJOSS). 2026;3(3):957-981.

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