Impact of Probiotic Supplementation and High-Intensity Interval Training on Primary Dysmenorrhea: A Double-Blind, Randomized Controlled Trial Investigating Inflammation and Hormonal Modulation

Background: Dysmenorrhea, categorized as primary (PD) or secondary (SD), significantly affects females during their reproductive years, impairing quality of life, performance, and social relationships. Alongside medical treatment, exercise and probiotics are complementary measures for managing PD and promoting health. This study examined the impact of probiotic supplementation and high-intensity interval training (HIIT) on PD severity, physiological modulation, and physical fitness. Methods: Participants, recruited according to the primary dysmenorrhea criteria, were divided into non-PD (control) and PD groups, with the PD group further classified into dysmenorrhea (Dysmen), dysmenorrhea with probiotics (DysmenPro), dysmenorrhea with exercise (DysmenEx), and dysmenorrhea with both (DysmenExPro). Interventions included 10 weeks of HIIT and probiotics. Pre- and post-intervention assessments included questionnaires on premenstrual and menstrual symptoms, physical fitness evaluations, and blood sample analyses for biochemical, hormonal, and prostaglandin levels. Results: HIIT significantly reduced premenstrual symptoms, menstrual distress, and pain severity, likely due to hormone (estradiol, prolactin, progesterone, cortisol) modulation and decreased inflammation (high-sensitivity C-reactive protein, PGE2, PGF2&alpha:). Cardiovascular endurance and explosive strength showed improvement through high-intensity interval training (HIIT), whereas probiotics had no significant effect on these aspects of physical fitness. While probiotics reduced premenstrual and menstrual distress symptoms, they had no notable impact on pain, inflammation, or hormone levels. Dysmenorrhea-related discomforts were correlated significantly with inflammation and hormones. Conclusions: The intervention strategy involving probiotics and HIIT exercise may be utilized as an alternative and complementary treatment to alleviate PD symptoms. Furthermore, this strategy could also be incorporated into educational health plans to promote women&rsquo:s health and potentially prevent gynecological disorders in the adolescent population.