Premenstrual Syndromes : PMS and PMDD - Rutuja :: The site ...

Table 16.2 (Continued)
Name Description
COMPLEMENTARY AND ALTERNATIVE THERAPIES 143
Naturopathy An eclectic system of healthcare, which integrates elements of complementary and
conventional medicine to support and enhance self-healing processes
Osteopathy A form of manual therapy involving massage, mobilization, and spinal manipulation
Reflexology A therapeutic method that uses manual pressure applied to specific areas, or zones, of
the feet (and sometimes the hands or ears) that are believed to correspond to areas of the
body, in order to relieve stress and prevent and treat physical disorders
Relaxation therapy Techniques for eliciting the ‘relaxation response’ of the autonomic nervous system
Spiritual healing The direct interaction between one individual (the healer) and a second (sick) individual
with the intention of bringing about an improvement or cure of the illness
Yoga A practice of gentle stretching, exercises for breath control, and meditation as a mindbody
intervention
Table 16.3 Positive and negative motivations for
trying CAM
Positive motivations
● Hope for increased well-being and other positive
outcomes
● Philosophical congruence:
– spiritual dimension
– emphasis on holism
– active role of patient
– explanation intuitively acceptable
– natural treatments
● Personal control over treatment
● Good relationship with therapist:
– on equal terms
– time for discussion
– allows for emotional factors
● Accessibility
● Negative motivations
● Dissatisfaction with certain aspects of conventional
medicine:
– ineffective
– adverse effects
– poor communication with healthcare practitioner
– insufficient time with healthcare practitioner
● Total rejection of conventional medicine:
– antiscience or antiestablishment attitude
● Desperation
Much of the popularity of CAM amounts to a criticism
of conventional healthcare. This can be seen as a
backlash from the spirit of the mid-20th century when
science was expected to solve most problems. Reality
turned out to be different. Many consumers now feel
disappointed that many medical conditions (including
PMDD) cannot be cured or adequately alleviated (i.e.
without side effects); CAM, on the other hand, is ‘free’
of safety problems – at least this is what proponents
incessantly claim.
THE EVIDENCE FOR OR AGAINST CAM
Even though sometimes denied by proponents of CAM,
most therapies can be tested for efficacy/effectiveness
in randomized clinical trials (RCTs). Occasionally, the
standard RCT design requires adaptation to fit the
demands of CAM, 7 but there are no compelling reasons
why CAM should defy scientific testing in principle.
The following discussion regarding the effectiveness of
CAM to treat PMDD will therefore be based on evidence
from clinical trials and (where available) systematic
reviews of such studies.
Acupuncture/acupressure
A systematic review included four controlled clinical
trials (CCTs) of acupuncture or acupressure for dysmenorrhea
(not PMDD). 8 Even though they all generated
results suggesting that acupuncture does in fact