Effects of Herbal Balm on Pain Relief from Primary Dysmenorrhea in Nursing Students

Abstract

Introduction Dysmenorrhea is a prevalent gynecological problem among women of reproductive age, significantly impacting both physical and psychological quality of life. This condition is particularly problematic for nursing students, who already experience substantial academic stress from both coursework and clinical practice. Consequently, menstrual pain can severely disturb their learning capabilities and overall well-being during menstruation. Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed to alleviate these symptoms; however, they are frequently associated with adverse gastrointestinal side effects. Therefore, it is imperative to investigate the effects of a herbal balm containing Plai (Zingiber montanum) and ginger oils in reducing primary dysmenorrhea, thereby providing a safe and appropriate alternative intervention for nursing students.

Objectives This study aimed to investigate the effectiveness of an herbal balm in reducing dysmenorrhea, improving menstruation-related quality of life, and assessing the satisfaction levels among nursing students utilizing the herbal balm.

Design This study utilized a quasi-experimental with two-group pretest-posttest design, in which the experimental group received the herbal balm intervention and the control group received a placebo balm. The innovative herbal balm, designed to alleviate primary dysmenorrhea among nursing students, was developed based on Amabile’s health innovation framework. This development process comprised six distinct stages: 1) identifying the problems associated with managing dysmenorrhea; 2) reviewing relevant concepts, theories, and literature, as well as consulting experts regarding herbal balm formulation for primary dysmenorrhea; 3) formulating the herbal balm prototype; 4) conducting expert validation; 5) pilot-testing the intervention; and 6) refining the final herbal balm product. 

Methodology The sample comprised 70 undergraduate nursing students from a faculty of nursing at a university in southern Thailand. Participants were selected via simple random sampling based on the following inclusion criteria: 1) female students aged 18–25 years; 2) regular menstrual cycles; 3) presence of primary dysmenorrhea with a pain score of ≥ 3 and 4) voluntary willingness to participate fully in all program activities and adhere to continuous follow-up. Participants were purposively assigned to either the experimental group(n = 35) or the comparison group (n = 35). The sample size was determined using G*Power software. The research instruments included: 1) the innovative herbal balm for menstrual pain relief; 2) a demographic questionnaire; 3) a pain scale; 4) a menstrual quality of life scale; and 5) a satisfaction questionnaire regarding the herbal balm. Data collection was conducted between February and April 2025. Data were analyzed using descriptive statistics and inferential statistics, including the Independent -test and Two-way repeated measures ANOVA, with Bonferroni post-hoc test for pairwise comparisons.

Results The experimental group had a mean age of 20.49 years (SD=1.25), while the comparison group had a mean age of 20.37 years (SD=1.35). The average duration of dysmenorrhea was 3.68 days and 2.88 days, respectively. The average daily menstrual flow (measured by sanitary pad usage) was 2.71 pads for the experimental group and 2.94 pads for the comparison group. As for physical and mental discomfort that occurred during menstruation (apart from menstrual pain), the experimental group primarily reported back pain (74.29%), followed by irritability (65.71%) and fatigue (54.29%). Conversely, the comparison group most frequently experienced irritability (71.42%), followed by back pain and fatigue (both at 68.57%). Two-way repeated measures ANOVA revealed that on days 1 and 2 of both the first and second menstrual cycles, primary dysmenorrhea severity differed significantly across the measured time points before application, and at 15 minutes, 30 minutes, and 1 hour post-application (F = 144.22,p<.001; F = 189.69, p <.001; F = 193.43, p <.001; and F = 127.04, p <.001, respectively). The effect sizes were 0.68, 0.74, 0.74, and 0.65. Furthermore, a statistically significant interaction effect between time and treatment group was observed (F = 23.02, p <.001; F = 9.19, p <.001; F = 24.22, p <.001; and F = 11.74, p <.001). Between-group analysis demonstrated that pain significantly differed between the experimental and comparison groups across all specified intervals (F =4.02, p = .049; F =5.73, p =.019; F =4.24, p =.043; and F =5.28, p =.025). Bonferroni post-hoc pairwise comparisons confirmed these differences were significant (p <.001). Post-intervention results indicated that the experimental group achieved a significantly higher menstruation-related quality of life than the comparison group (t = 3.79, p <.001). In the experimental group, overall satisfaction with the herbal balm was highest. In terms of sub-dimensions, satisfaction with the balm texture was high, while satisfaction with the packaging was highest. 

Recommendations The study findings support the integration of herbal balm as a complementary intervention for reducing mild-to-moderate dysmenorrhea among nursing students. Nevertheless, certain limitations must be acknowledged. First, the precise dosage of the applied herbal balm was not strictly quantified. Second, the high-temperature manufacturing process utilized during production may have inadvertently degraded the therapeutic properties of the volatile essential oils. Finally, because the sample was drawn from undergraduate nursing students at a single institution, the generalizability of these findings to other populations may be limited.