Comment on Dysmenorrhea, a Narrative Review of Therapeutic Options

We commend the authors of the recent systematic review on dysmenorrhoea treatment, which provides a comprehensive overview of various pharmacologic and non-pharmacologic interventions. Dysmenorrhoea remains a prevalent and However, the review had certain limitations related to study heterogeneity and the rigor of inclusion criteria, which may influence the reliability and applicability of the findings. The article included a variety of studies covering a wide range of pharmacological, non-pharmacological, and surgical interventions. These studies exhibited heterogeneity due to the variety of participants, designs, interventions, and assessment criteria. For example, different types of NSAIDs exhibited variation in effectiveness for the treatment of dysmenorrhoea, but the article as a whole did not discuss in detail the impact of this heterogeneity on the results.2 Although the effects of the various types of treatments are summarised, the variability between studies is not analysed in depth, which may lead readers to misunderstand the generalisability of the overall conclusions. Another significant concern is the varying quality of the studies included in the review. Whereas some studies, such as Cochrane reviews and large randomized controlled trials, provide high-quality evidence, others-particularly those The review acknowledges these issues but does not provide detailed inclusion criteria, which raises concerns about the the section on behavioural interventions and non-pharmacologic treatments discusses a variety of approaches, from exercise to the use of cannabinoids, yet many of the included studies lack rigorous control groups or sufficient sample with weaker evidence.