The Efficacy of Zinc and Ginger for Dysmenorrhoea

Reputable for its anti-inflammatory properties, Zingiber officinale (ginger) has applications as an effective treatment for painful menstrual cramps (dysmenorrhoea), as confirmed by a recent meta-analysis.[1] Ginger is known to block the cyclooxygenase (COX) and lipoxygenase (LOX) pathways in prostaglandin synthesis. Gingerol and gingerdiones, two active constituents in ginger, are potent inhibitors of COX pathways, lending to the rhizome’s anti-inflammatory properties.[2,3]

Primary dysmenorrhoea is attributed to the production of uterine prostaglandins, and inflammation has been identified as a key player in the condition’s pathophysiology. Women with severe dysmenorrhoea have higher levels of prostaglandins, particularly in the first two days of menstruation.[4]

Several clinical studies have verified the efficacy of ginger in reducing pain associated with dysmenorrhoea when used in the first three to four days of menstruation at doses ranging from 250-2000mg per day.[5-9] It has been found to have a good safety profile, without the gastrointestinal and renal side effects seen in drugs commonly used for dysmenorrhoea such as non-steroidal anti-inflammatory drugs (NSAIDs).[1]

In a randomised controlled trial, zinc was found to have a similar effect to ginger (p<0.001) in relieving primary dysmenorrhoea when taken for a week from the four days prior to menstruation to the first three days of menstruation.[10] It is purported that zinc’s antioxidant and anti-inflammatory actions extend to the uterus where it may reduce the production of prostaglandins.[10] Zinc has also exhibited improvements in micro-vessel circulation, leading to reduced menstrual cramping.[11]

Dysmenorrhoea can result in poor quality of life due to difficulty in the functioning and performance of daily activities.[1,12] It is the most common gynaecological condition in women, with prevalence ranging up to 91% in women of reproductive age.[13] Complementary treatments such as ginger and zinc should be considered as efficacious as part of any treatment protocol for dysmenorrhoea.

References

1. Chen CX, Barrett B, Kwekkeboom KL. Efficacy of oral ginger (Zingiber officinale) for dysmenorrhoea: a systematic review and meta-analysis. Evid Based Complement Alternat Med 2016;2016:6295737. [Full text]
    
2. Ali BH, Blunden G, Tanira MO, et al. Some phytochemical, pharmacological and toxicological properties of ginger (Zingiber officinale Roscoe): a review of recent research. Food Chem Toxicol 2008;46(2):409-420. [Abstract]
    
3. Kim SO, Kundu JK, Shin YK, et al. [6]-Gingerol inhibits COX-2 expression by blocking the activation of p38 MAP kinase and NF-kappaB in phorbol ester-stimulated mouse skin. Oncogene 2005;24(15):2558-2567. [Full text]
    
4. Proctor M, Farquhar C. Diagnosis and management of dysmenorrhoea. BMJ 2006;332(7550):1134-1138. [Full text]
    
5. Daily JW, Zhang X, Kim DS, et al. Efficacy of ginger for alleviating the symptoms of primary dysmenorrhea: a systematic review and meta-analysis of randomized clinical trials. Pain Med 2015;16(12):2243-2255. [Full text]
    
6. Pattanittum P, Kunyanone N, Brown J, et al. Dietary supplements for dysmenorrhoea. Cochrane Database Syst Rev 2016;3:CD002124. [Full text]
7. Jenabi E. The effect of ginger for relieving of primary dysmenorrhoea. J Pak Med Assoc 2013;63(1):8-10. [Full text]
    
8. Rahnama P, Montazeri A, Huseini HF, Kianbakht S, Naseri M. Effect of Zingiber officinale R. rhizomes (ginger) on pain relief in primary dysmenorrhea: a placebo randomized trial. BMC Complement Altern Med 2012;12:92. [Full text]
    
9. Ozgoli G, Goli M, Moattar F. Comparison of effects of ginger, mefenamic acid, and ibuprofen on pain in women with primary dysmenorrhea. J Altern Complement Med 2009;15(2):129-132. [Abstract]
    
10. Kashefi F, Khajehei M, Tabatabaee C, et al. Comparison of the effect of ginger and zinc sulfate on primary dysmenorrhea: a placebo-controlled randomized trial. Pain Manag Nurs 2014;15(4):826-33. [Abstract]
     
11. Eby GA. Zinc treatment prevents dysmenorrhea. Med Hypotheses 2007;69(2):297-301. [Abstract]
     
12. Grandi G, Ferrari S, Xholli A, et al. Prevalence of menstrual pain in young women: what is dysmenorrhea? J Pain Res 2012;5:169-174. [Full text]
     
13. Ju H, Jones M, Mishra G. The prevalence and risk factors of dysmenorrhoea. Epidemiol Rev 2014;36:104-113. [Abstract]

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