The Effectiveness of Fish Oil and Ginger Drink in Reducing Dysmenorrhea: A Meta Analysis

Isnaini Novitasari, Eti Poncorini Pamungkasari, Hanung Prasetya


Background: Dysmenorrhea causes 34-50% of women to be unable to work in the workplace and 40% of adolescent girls are absent from school. Fish oil and ginger are used as alter­natives to NSAIDs, because although the use of NSAIDs is effective in reducing dysmenorrhea pain, they have side effects that are harmful to health after long-term conventional therapy. This study aims to estimate the magnitude of the effect of fish oil and ginger in reducing dysmenorrhea in women of reproductive age.

Subjects and Method: This was a meta-analysis and systematic study. The articles used were obtained from PubMed, Science Direct, ProQuest, Springer Link, and Google Scholar. The inclusion criteria used were full text art­icles with Randomized Control Trial (RCT). The study subjects are women of pro­ductive age. The treatment given was the con­sumption of fish oil or ginger with a placebo comparison, dysmenorrhea assessment using standardized measuring instruments such as VAS, Cox, ques­tionnaires, etc. Articles published in English. The PICO Research Problem are population= women of reproductive age, inter­vention= fish oil or ginger, comparison= placebo, and out­come= dys­menorrhea. The study was assessed using an effect size (Standar­dized Mean Diffe­rence). Meta analysis was performed using RevMan 5.3 with Random Effect Model.

Results: A total of 14 articles were reviewed in a meta-analysis in this study. Meta-analysis of 6 articles showed that fish oil reduced dys­menorrhea pain in women of reproductive age higher than placebo (Standardized Mean Diffe­rence= -1.06; 95% CI= -1.76 to -0.36; p= 0.003). Meta-analysis of 8 articles showed that ginger reduced dysmenorrhea pain in women of childbearing age more than placebo (Standar­dized Mean Difference= -0.77; 95% CI= -1.26 to -0.27; p=0.002).

Conclusion: Fish oil and ginger are effective in reducing dysmenorrhea pain in women of reproductive age.

Keywords: fish oil, ginger, and dysmenorrhea

Correspondence: Isnaini Novitasari. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Su­tami 36A, Surakarta 57126, Central Java. Email: Mo­bile: 085921790588.

Journal of Maternal and Child Health (2021), 06(03): 353-364

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Anonim (2017). Standard for Fish Oils. Codex Alimentarium Comission 329: 1–6. /Codex Standard for Fish Oils CXS_329e_Nov 2017.pdf.

Behboudi-GS, Hariri FZ, Moghaddam-BL (2018). The effect of Omega 3 fatty acid supplementation on premenstrual syndrome and health-related quality of life: A randomized clinical trial. J Psychosom Obstet Gynaecol. 39(4): 266–72.

Charbel-AD, James R (2010). Drug interactions with garlic and ginger supplements. Herbal Supplements: efficacy, toxicity, interactions with western drugs, and effects on clinical laboratory tests. 333–50.

Chatterjee S, Judeh ZMA (2016). Micro-encapsulation of fish oil. Lipid Technology 28(1): 13–15.

Chen CX, Draucker CB, Carpenter JS (2018). What women say about their dysmenorrhea: A qualitative thematic analysis. BMC Women’s Health. 18(1): 1–8.

Christophersen P, Yang M, Mu H (2016). Effects of microencapsulation on bio-availability of fish oil Omega-3 fatty acids. Encapsulation and Controlled Release Technologies in Food Systems. Second Edition: 309–32.

Corte LD, Di FC, Gabrielli O, Rapuccia S, La VLS, Ragusa R, Fichera M, Commodari E, Bifulco G, Giampaolino P (2020). The burden of endometriosis on women’s lifespan: A narrative overview on quality of life and psychosocial wellbeing. Int J Environ Res Public Health. 17(13): 1–17.

Daily JW, Zhang X, Kim DS, Park S (2015). Efficacy of ginger for alleviating the symptoms of primary dysmenorrhea: A systematic review and meta-analysis of randomized clinical trials. Pain Med. 16(12): 2243–55.

Davaneghi S, Tarighat-EA, Safaiyan A, Fardiazar Z (2017). The effects of n-3 fatty acids and Rosa damascena extract on primary dysmenorrhea. 19(1): 34–40.

Durmuş M (2019). Fish oil for human health: Omega-3 fatty acid profiles of marine seafood species. Food Sci Technol. 39(2): 454–61.

Ernawati S, Nonon SS, Nailus S, Ummu S, Agusniar TSL (2017). Manajemen kesehatan menstruasi (Menstrual health management). Universitas Nasional IWWASH Global One.

Ferries-RE, Corey E, Archer JS (2020). Primary dysmenorrhea: Diagnosis and therapy. Obstetrics and gynecol. 136(5): 1047–58.

Fletcher J (2020). Why is ginger good for you? Medical News Today. Accessed from Content

Gow R (2020). Cycle of salmon. Columbia Journal. Retrieved from http://colum biajournal. org /cycle-of-salmon/

Harel Z (2008). Dysmenorrhea in adolescents and young adults: from pathophysiology to pharmacological treatments and management strategies. Expert Opin Pharmacother. 9(15): 2661–72.

Hawker GA, Mian S, Kendzerska T, and Hawker GA, Mian S, Kendzerska T, French M (2011). Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res (Hoboken). 63(11): 240–52.

Hernandez EM (2015). Omega 3 Oils and Blends. Trait-Modified Oils in Foods: 169–97.

Hilleman DE, Teply R, Packard KA (2020). Knowledge, perceptions, and patterns of fish oil use in cardiac patients. J Pharm Pract. 33(5): 580–85.

Hosseinlou A, Alinejad V, Alinejad M, Aghakhani N (2014). The effects of fish oil capsules and vitamin B1 tablets on duration and severity of dysmenorrhea in students of high school in Urmia-Iran. Glob J Sci. 6(7): 124–29.

Jacobsen C (2014). Omega-3 Fatty Acid-Enriched Foods: Health Benefits and Challenges. Wiley-Blackwell. 8: 153-172.

Jenabi E (2013). The effect of ginger for relieving of primary dysmenorrhoea. J Pak Med Assoc. 63(1):8-10. PMID: 23865123.

Kashefi F, Khajehei M, Tabatabaeichehr M, Alaviniam M, Asili J (2014). Comparison of the effect of ginger and zinc sulfate on primary dysmenorrhea: a placebo-controlled randomized trial. Pain Manage Nurs. 15(4): 826–33.

Khayat S, Kheirkhah M, Behboodi M, Fanaei H, Kasaeian A, Javadimehr M (2014). Effect of treatment with ginger on the severity of premenstrual syndrome symptoms. ISRN Obstetrics and Gynecology, 2014, 1–5. /2014/792708.

Kheirkhah M, Gholami R, Ghare-SSY, Hanieh A (2016). Comparison of the effect of omega-3 fatty acids and perforan (Hypericum perforatum) on severity of premenstrual syndrome (PMS): A randomized trial. Int J Med Res Health Sci. (1): 333–340.

Keogh MK, O'Kennedy BT, Kelly J, Auty MA, Kelly PM, Fureby A, Haahr AM (2001). Stability of oxidation of spraydried fish oil powder micro-encapsulated using milk ingredients. J Food Sci. 66(2): 217-224.

Mehrpooya M, Eshraghi A, Rabiee S, Larki-HA, Ataei S (2017). Comparison the effect of fish-oil and calcium supple-mentation on treatment of primary dysmenorrhea. Rev Recent Clin Trials. 12(3): 1–6.

Najafi N, Khalkhali H, Tabrizi FM, Zarrin R (2018). Major dietary patterns in relation to menstrual pain: A nested case control study. BMC Women’s Health 18(1): 1–7.

Nodler JL, Divasta AD, Vitonis AF, Karevicius S, Malsch M, Sarda V, Fadayomi A, Harris HR, Missmer, Stacey A (2020). Supplementation with Vita-min D or ω-3 fatty acids in adolescent girls and young women with endometriosis (SAGE): A double-blind,

randomized, placebo-controlled trial. Am J Clin Nutr. 112(1): 229–36.

Novitasari E, Soemanto RB, Prasetya H (2020). Effect of acupuncture therapy on pain reduction in dysmenorrhea patients: A meta-analysis. J Matern Child Health. 05(6): 705–714.

Pagano E, Souto EB, Durazzo A, Sharifi‐RJ, Lucarini M, Souto SE, Salehi B, et al. (2020). Ginger (Zingiber Officinale Roscoe) as a Nutraceutical: Focus on the metabolic, analgesic, and anti-inflammatory effects. Phytother Res. 1–15.

Pakniat H, Chegini V, Ranjkesh F, Hosseini MA (2019). Comparison of the effect of vitamin E, vitamin D and ginger on the severity of primary dysmenorrhea: A single-blind clinical trial. Obstet Gynecol Sci. 62(6): 462–468.

Petraglia F, Bernardi M, Lazzeri L, Perelli F, Reis FM (2017). Dysmenorrhea and Related Disorders. F1000Res. 6: 1–7.

Pratap SRV, Gangadharappa HV, Mruthun-jaya K (2017). Ginger: A potential neutraceutical, an updated review. Int J Pharmacogn Phytochem Res. 9(9): 1227–38.

Rahbar N, Asgharzadeh N, Ghorbani R (2012). Effect of Omega-3 fatty acids on intensity of primary dysmenorrhea. Int J Gynecol Obstet. 117(1): 45–47.

Rahnama P, Montazeri A, Huseini HF, Kianbakht S, Naseri M (2012). Effect of Zingiber Officinale R. Rhizomes (ginger) on pain relief in primary dysmenorrhea: A placebo randomized trial. BMC Complement Altern Med. 12: 92.

Richards L (2020). Are sardines good for you? Medical news today. tersedia di

Sadeghi N, Paknezhad F, Rashidi NM, Kavianpour M, Jafari RS, Khade HH (2018). Vitamin E and fish oil, separately or in combination, on treatment of primary dysmenorrhea: A double-blind, randomized clinical trial. Gynecol Endocrinol. 34(9): 804–8.

Saha SN, Tiwari A, Patel YK, Bihari A, Vishwavidyalaya V, Ghasida (2020). Ginger physico chemical properties and it’s consumer products processing: A review. Int Archive of Applied Sciences and Technology. 11(2): 159–69.

Schaultz H (2016). Despite Generally Good Reputation Peruvian Anchovy Fishery Still Not MSC Certified. News Analysis on Supplement Health and Nutrition–North America EU Edition Tersedia di https://www.nutraingre

Shirooye P, Hashem-DF, Hamzeloo-MM, Afrakhteh M, Bioos S, Mokaberinejad R (2017). A clinical comparative study of oral and topical ginger on severity and duration of primary dysmenor-rhea. Res J Pharmacogn. 4(1): 23–32.

Shirvani MA, Motahari-Tabari N, Alipour A (2014). The effect of mefenamic acid and ginger on pain relief in primary dysmenorrhea: A randomized clinical trial. Arch Gynecol Obstet. 291(6): 1277–81.

Shirvani MA, Motahari-Tabari N, Alipour A (2017). Use of ginger versus stretching exercises for the treatment of primary dysmenorrhea: a randomized controlled trial. J Integr Med. 15(4): 295–301.

Sinaga E, Nonon S, Suprihatin, Sa’adah YAMN, Salamah U, Trisnamiati SLA (2017). Manajemen Kesehatan Menstruasi. Universitas Nasional IWWASH Global One.

Smithers R (2018). Good fish guide calls for consumers to move away from cod, haddock, salmon and prawn in favour of sustainable choice. The Guardian. Tersedia di https://www.

Sohrabi N, Kashanian M, Ghafoori SS, Malakouti SK (2013). Evaluation of the effect of Omega-3 fatty acids in the treatment of premenstrual syndrome: A pilot trial. Complement Ther Med. 21(3): 141–46.

Stepko B (2019). The Full Story on Fish Oil.” Retrieved from https://www. /info-2019/fish-oil.html

Sultan S, Ahmed Z, Afreen A, Rashid F, Majeed F, Khalid N (2020). Analgesic effect of ginger and peppermint on adolescent girls with primary dysmenorrhea. Food Sci Technol. 2061: 1–7.

Sutapa P, Alagh P, Rana M (2017). Experimental study to compare the effectiveness of progressive muscle relaxation versus oral intake of ginger powder on the selected symptoms of dysmenorrhoea among the nursing students. Nurs J India. 6(4): 2049–2052.PMID: 23534170.


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