A single-blind randomized comparative study of Asafoetida vs Mefenamic acid in dysmenorrhea, associated symptoms and health-related quality of life

To compare the efficacy and safety of asafoetida (Ferula assafoetida L. oleo-gum-resin) with mefenamic acid (NSAID) to alleviate dysmenorrhea, associated systemic symptoms and improvement in health-related quality of life.Patients (n=60) were randomly allocated to receive asafetida (n=30) or mefenamic acid (n=30) in this single-blind, randomized, standard controlled trial. Test and control drug, 250mg was administered and given orally twice daily for 5days; 2days prior to and first three days of menstruation for two consecutive cycles. The primary outcomes included the severity of pain assessed with visual analogue scale, verbal multidimensional scale and safety assessment. Secondary outcomes included health-related quality of life (HRQoL) determined using SF-36 health survey questionnaire, pain duration, associated systemic symptoms and PBLAC (Pictorial Blood Loss Assessment Chart) score for menstrual blood loss. The data was statistically interpreted with 5% level of significance.Between the groups, at baseline, pain severity did not differ significantly (P>0.05) however, after the intervention, a significant decrease in pain severity was noted in both groups (P<0.001). At third menstrual cycle, asafetida showed a significant decrease in pain severity compared to mefenamic acid on day one (P<0.0004) however no significant difference was observed on day two and day three (P>0.05). At post-intervention improvement in HRQoL and decrease in pain duration was significantly higher in the test group compared with control group. Systemic symptoms decreased significantly in both groups after intervention. No side effects were reported.Asafoetida was effective and safe to relieve menstrual cramps and to improve HRQoL. Further, its effect was comparable with mefenamic acid.