Comparison of the Effect of Ginger and Zinc Sulfate on Primary Dysmenorrhea: A Placebo-Controlled Randomized Trial

Published:February 21, 2014DOI:


      Primary dysmenorrhea is common among young women and results in their incapacitation; it can be accompanied by various symptoms that can disrupt their lives. The aim of this randomized trial was to compare the effect of ginger, zinc sulfate, and placebo on the severity of primary dysmenorrhea in young women. One hundred and fifty high school students were recruited. The participants were divided into three groups. The first group received ginger capsules, the second group received zinc sulfate capsules, and the third group received placebo capsules. All participants took the medications for four days, from the day before the commencement of menstruation to the third day of their menstrual bleeding. The severity of dysmenorrhea was assessed every 24 hours by the pain visual analog scale. The severity of pain was significantly different between, before, and after the intervention in both the ginger and the zinc sulfate groups (p < .001). Compared with the placebo receiving group, participants receiving ginger and zinc sulfate reported more alleviation of pain during the intervention (p < .05). Ginger and zinc sulfate had similar positive effects on the improvement of primary dysmenorrheal pain in young women.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Pain Management Nursing
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Abdali K.
        • Khajehei M.
        • Tabatabaee H.R.
        Effect of St John's wort on severity, frequency, and duration of hot flashes in premenopausal, perimenopausal and postmenopausal women: A randomized, double-blind, placebo-controlled study.
        Menopause. 2010; 17: 326-331
        • Abdul-Razzak K.K.
        • Ayoub N.M.
        • Abu-Taleb A.A.
        • Obeidat B.A.
        Influence of dietary intake of dairy products on dysmenorrhea.
        Journal of Obstetrics and Gynaecology Research. 2010; 36: 377-383
        • Ajith T.A.
        • Hema U.
        • Aswathy M.S.
        Zingiber officinale roscoe prevents acetaminophen-induced acute hepatotoxicity by enhancing hepatic antioxidant status.
        Food and Chemical Toxicology. 2007; 45: 2267-2272
        • Altman R.D.
        • Marcussen K.C.
        Effects of a ginger extract on knee pain in patients with osteoarthritis.
        Arthritis & Rheumatism. 2001; 44: 2531-2538
        • Bailey R.L.
        • Gahche J.J.
        • Miller P.E.
        • Thomas P.R.
        • Dwyer J.T.
        Why US adults use dietary supplements.
        JAMA Internal Medicine. 2013; 173: 355-361
        • Bijur P.E.
        • Silver W.
        • Gallagher E.J.
        Reliability of the visual analog scale for measurement of acute pain.
        Academic Emergency Medicine. 2001; 8: 1153-1157
        • Boonstra A.
        • Schiphorst Preuper H.R.
        • Reneman M.F.
        • Posthumus J.B.
        • Stewart R.E.
        Reliability and validity of the visual analogue scale for disability in patients with chronic musculoskeletal pain.
        International Journal of Rehabilitation Research. 2008; 31: 165-169
        • Cho G.S.
        • Han M.W.
        • Lee B.
        • Roh J.L.
        • Choi S.H.
        • Cho K.J.
        • Nam S.Y.
        • Kim S.Y.
        Zinc deficiency may be a cause of burning mouth syndrome as zinc replacement therapy has therapeutic effects.
        Journal of Oral Pathology & Medicine. 2010; 39: 722-727
        • Christian P.
        • Morgan M.E.
        • Murray-Kolb L.
        • LeClerq S.C.
        • Khatry S.K.
        • Schaefer B.
        • Cole P.M.
        • Katz J.
        • Tielsch J.M.
        Preschool iron-folic acid and zinc supplementation in children exposed to iron-folic acid in utero confers no added cognitive benefit in early school-age.
        The Journal of Nutrition. 2011; 141: 2042-2048
        • Daniels S.E.
        • Torri S.
        • Desjardins P.J.
        Valdecoxib for treatment of primary dysmenorrhea.
        Journal of General Internal Medicine. 2005; 20: 62-67
        • Drozdov V.N.
        • Kim V.A.
        • Tkachenko E.V.
        • Varvanina G.G.
        Influence of a specific ginger combination on gastropathy conditions in patients with osteoarthritis of the knee or hip.
        The Journal of Alternative and Complementary Medicine. 2012; 18: 583-588
        • Durain D.
        Primary dysmenorrhea: Assessment and management Update.
        The Journal of Midwifery & Women’s Health. 2004; 49: 520-528
        • Eby G.A.
        Zinc treatment prevents dysmenorrhea.
        Medical Hypotheses. 2007; 69: 297-301
        • Edwards J.E.
        • Moore R.A.
        • Mcquay H.J.
        Rofecoxib for dysmenorroea: Meta-analysis using individual patient data.
        BMC Womens Health. 2004; 4: 5
        • Eryilmaz G.
        • Ozdemir F.
        • Pasinlioglu T.
        Dysmenorrhea prevalence among adolescents in eastern Turkey: Its effects on school performance and relationships with family and friends.
        Journal of Pediatric and Adolescent Gynecology. 2010; 23: 267-272
        • Gardiner P.
        • Whelan J.
        • White L.F.
        • Filippelli A.C.
        • Bharmal N.
        • Kaptchuk T.J.
        A systematic review of the prevalence of herb usage among racial/ethnic minorities in the United States.
        Journal of Immigrant and Minority Health. 2013; 15: 817-828
        • Gray D.C.
        • Rutledge C.M.
        Herbal supplements in primary care: Patient perceptions, motivations, and effects on use.
        Holistic Nursing Practice. 2013; 27: 6-12
        • Haghighi M.
        • Khalvat A.
        • Toliat T.
        • Jallaei S.
        Comparing the effects of ginger (zingiber officinale) extract and ibuprofen on patients with osteoarthritis.
        Archives of Iranian Medicine. 2005; 8: 267-271
        • Harel Z.
        Dysmenorrhea in adolescents and young adults: An update on pharmacological treatments and management strategies.
        Expert Opinion on Pharmacotherapy. 2012; 13: 2157-2170
        • Jang I.
        • Kim M.
        • Lee S.
        • Jeong K.
        • Chung H.
        Factors related to dysmenorrhea among Vietnamese and Vietnamese marriage immigrant women in South Korea.
        Obstetrics & Gynecology Science. 2013; 56: 242-248
        • Kashefi F.
        • Ziyadlou S.
        • Khajehei M.
        • Ashraf A.
        • Reza Fadaee A.
        • Jafari P.
        Effect of acupressure at the Sanyinjiao point on primary dysmenorrhea: A randomized controlled trial.
        Complementary Therapies in Clinical Practice. 2010; 16: 198-202
        • Kelly R.
        • Abel M.
        Copper and zinc inhibit the metabolism of prostaglandin by the human uterus.
        Biology of Reproduction. 1983; 28: 883-889
        • Khajehei M.
        • Abdali K.
        • Parsanezhad M.
        • Tabatabaee H.
        Effect of treatment with dydrogesterone or calcium plus vitamin D on the severity of premenstrual syndrome.
        International Journal of Gynecology & Obstetrics. 2009; 105: 158-161
        • Khajehei M.
        • Abdali K.
        • Tabatabaee H.
        A comparison between the efficacy of dydrogesterone and calcium plus vitamin D in improving women's general health.
        African Journal of Psychiatry. 2010; 13: 218-224
        • Kim T.
        • Park H.
        • Lee H.
        • Chung S.
        Premenstrual syndrome and dysmenorrhea in the career women at Bucheon City.
        Korean Journal of Obstetrics & Gynecology. 2011; 54: 523-528
        • Kizhakkayil J.
        • Sasikumar B.
        Diversity, characterization and utilization of ginger: A review.
        Plant Genetic Resources. 2011; 9: 464-477
        • Kotani N.
        • Oyama T.
        • Sakai I.
        • Hashimoto H.
        • Muraoka M.
        • Ogawa Y.
        • Matsuki A.
        Analgesic effect of a herbal medicine for treatment of primary dysmenorrhea—A double-blind study.
        The American Journal of Chinese Medicine. 1997; 25: 205-212
        • Lang C.
        • Murgia C.
        • Leong M.
        • Tan L.
        • Perozzi G.
        • Knight D.
        • Ruffin R.
        • Zalewski P.
        Anti-inflammatory effects of zinc and alterations in zinc transporter mRNA in mouse models of allergic inflammation.
        American Journal of Physiology Lung Cellular and Molecular Physiology. 2007; 292: L577-L584
        • Lefebvre G.
        • Pinsonneault O.
        • Antao V.
        • Black A.
        • Burnett M.
        • Feldman K.
        • Lea R.
        • Robert M., SOGC.
        Primary dysmenorrhea consensus guideline.
        Journal of Obstetrics & Gynaecology. 2005; 169: 1117-1130
        • Marchini M.
        • Tozzi L.
        • Bakshi R.
        • Pistai R.
        • Fedele L.
        Comparative efficacy of diclofenac dispersible 50 mg and ibuprofen 400 mg in patients with primary dysmenorrhea: A randomized, double-blind, within-patient, placebo-controlled study.
        International Journal of Clinical Pharmacology and Therapeutics. 1995; 33: 491-497
        • Nozaki C.
        • Vergnano A.
        • Filliol D.
        • Ouagazzal A.
        • Goff A.
        • Carvalho S.
        • Reiss D.
        • Gaveriaux-Ruff C.
        • Neyton J.
        • Paoletti P.
        • Kieffer B.
        Zinc alleviates pain through high-affinity binding to the NMDA receptor NR2A.
        Nature Neuroscience. 2011; 14: 1017-1022
        • Ortiz M.
        • Rangel-Flores E.
        • Carrillo-Alarcón L.
        • Veras-Godoy H.
        Prevalence and impact of primary dysmenorrhea among Mexican high school students.
        International Journal of Gynecology & Obstetrics. 2009; 107: 240-243
        • Ozgoli G.
        • Goli M.
        • Moattar F.
        Comparison of effects of ginger, mefenamic acid, and ibuprofen on pain in women with primary dysmenorrhea.
        The Journal of Alternative and Complementary Medicine. 2009; 15: 129-132
        • Parker M.
        • Sneddon A.
        • Arbon P.
        The menstrual disorder of teenagers (MDOT) study: Determining typical menstrual patterns and menstrual disturbance in a large population-based study of Australian teenagers.
        British Journal of Obstetrics & Gynaecology. 2010; 117: 185-192
        • Penna S.
        • Medeiros M.
        • Aimbire F.
        • Faria-Neto H.
        • Sertié J.
        • Lopes-Martins R.
        Anti-inflammatory effect of the hydralcoholic extract of zingiber officinale rhizomes on rat paw and skin edema.
        Phytomedicine. 2003; 10: 381-385
        • Phan N.Q.
        • Blome C.
        • Fritz F.
        • Gerss J.
        • Reich A.
        • Ebata T.
        • Augustin M.
        • Szepietowski J.C.
        • Ständer S.
        Assessment of pruritus intensity: Prospective study on validity and reliability of the visual analogue scale, numerical rating scale and verbal rating scale in 471 patients with chronic pruritus.
        Acta Dermato-Venereologica. 2012; 92: 502-507
        • Prasad A.
        Clinical, immunological, anti-inflammatory and antioxidant roles of zinc.
        Experimental Gerontology. 2008; 43: 370-377
        • Proctor M.
        • Farquhar C.
        Diagnosis and management of dysmenorrhoea.
        British Medical Journal. 2006; 332: 1134-1138
        • Rahnama P.
        • Montazeri A.
        • Huseini H.
        • Kianbakht S.
        • Naseri M.
        Effect of zingiber officinale R. rhizomes (ginger) on pain relief in primary dysmenorrhea: A placebo randomized trial.
        BMC Complementary and Alternative Medicine. 2012; 12: 92
        • Rosenwaks Z.
        • Seegar-Jones G.
        Menstrual pain: Its origin and pathogenesis.
        Journal of Reproductive Medicine. 1980; 25: 207-212
        • Salmon C.
        • Bailey-Shaw Y.
        • Hibbert S.
        • Green C.
        • Smith A.
        • Williams L.
        Characterisation of cultivars of Jamaican ginger (Zingiber officinale Roscoe) by HPTLC and HPLC.
        Food Chemistry. 2012; 131: 1517-1522
        • Santos L.
        • Feres C.
        • Melo F.
        • Coelho M.
        • Nothenberg M.
        • Oga S.
        • Tagliati C.
        Anti-inflammatory, antinociceptive and ulcerogenic activity of a zinc-diclofenac complex in rats.
        Brazilian Journal of Medical and Biological Research. 2004; 37: 1205-1213
        • Srivastava K.
        • Mustafa T.
        Ginger (zingiber officinale) in rheumatism and musculoskeletal disorders.
        Medical Hypotheses. 1992; 39: 342-348
        • Van Breemen R.
        • Tao Y.
        • Li W.
        Cyclooxygenase-2 inhibitors in ginger (zingiber officinale).
        Fitoterapia. 2011; 82: 38-43
        • Vendruscolo A.
        • Takaki I.
        • Bersani-Amado L.
        • Dantas J.
        • Bersani-Amado C.
        • Cuman R.
        Antiinflammatory and antinociceptive activities of zingiber officinale roscoe essential oil in experimental animal models.
        Indian Journal of Pharmacology. 2006; 38: 58-59
        • Vinick M.
        The therapeutic properties and usages of five common spices: Coriander, cumin, fennel, ginger and turmeric.
        California College of Ayurveda, California2009 (Retrieved from)
        • Wong C.L.
        • Lai K.Y.
        • Tse H.M.
        Effects of SP6 acupressure on pain and menstrual distress in young women with dysmenorrhea.
        Complementary Therapies in Clinical Practice. 2010; 16: 64-69
        • Wong L.P.
        • Khoo E.
        Dysmenorrhea in a multiethnic population of adolescent Asian girls.
        International Journal of Gynecology & Obstetrics. 2010; 108: 139-142
        • Yip Y.
        • Tam A.
        An experimental study on the effectiveness of massage with aromatic ginger and orange essential oil for moderate-to-severe knee pain among the elderly in Hong Kong.
        Complementary Therapies in Medicine. 2008; 16: 131-138
        • Zhu X.
        • Proctor M.
        • Bensoussan A.
        • Smith C.
        • Wu E.
        Chinese herbal medicine for primary dysmenorrhoea.
        Cochrane Database Systematic Review. 2007; 17: CD005288