Effect of core strengthening exercises on pain and quality of life in females with primary dysmenorrhea: a scoping review.

backgroundDysmenorrhea is characterized by recurrent lower abdomen or pelvic pain that may radiate to the legs, inner thighs, and lower back. It is divided into two categories: primary dysmenorrhea (PD) and secondary dysmenorrhea (SD). When the ovulatory cycle is established, which usually happens in the first two years following menarche, PD is defined as menstrual discomfort without any visible pelvic disease. Many teenage girls suffer from primary dysmenorrhea, or excruciating period cramps, which can seriously interfere with their everyday activities, social contacts, and attendance at school. By engaging intrinsic musculature that supports spinal load and neuromuscular control, core strengthening aims to improve lumbar stability. Deep stabilizing muscles are isolated and conditioned by core strength training, which enhances functional stability. Strong core muscles are more resilient to everyday biomechanical strains, such as those brought on by menstruation.

objectiveTo map and synthesize the existing evidence regarding the effectiveness of core strengthening exercises on pain intensity and quality of life in females with primary dysmenorrhea. ELIGIBILITY CRITERIA: This scoping review included randomized controlled trials, experimental studies, and quasi-experimental studies published in English between 2019 and 2025 that investigated the effects of core strengthening or lumbopelvic stabilization exercises in females with primary dysmenorrhea. Studies primarily focusing on pharmacological management or unrelated physiotherapy modalities were excluded. SOURCES OF EVIDENCE: Electronic databases including PubMed, Scopus, MEDLINE, Google Scholar, and ClinicalKey were searched. CHARTING

methodsData were charted using a predefined extraction framework including study design, participant characteristics, intervention details, outcome measures, and key findings.

methodsA comprehensive literature search was conducted between January 2019 and March 2025 using keywords including "primary dysmenorrhea," "core strengthening," "core stability," "lumbopelvic exercises," and "exercise therapy" with Boolean operators ("AND," "OR"). Eleven studies met the inclusion criteria, comprising randomized controlled trials, comparative studies, and quasi-experimental designs, with a total sample size of 445 participants. The most commonly used outcome measures were the Visual Analog Scale (VAS), Numerical Pain Rating Scale (NPRS), WaLIDD scale, and quality of life questionnaires.

resultsMost included studies demonstrated significant reductions in pain intensity following core strengthening interventions lasting between 6 and 12 weeks. Several studies also reported improvements in quality of life, functional ability, sleep quality, and psychological well-being. Comparative studies showed that core strengthening exercises were more effective than stretching exercises alone in reducing dysmenorrhea symptoms. Studies incorporating lumbopelvic stabilization and pressure biofeedback reported enhanced neuromuscular control and superior pain reduction outcomes. Despite generally positive findings, heterogeneity in study design, exercise protocols, outcome measures, and limited long-term follow-up reduced the overall strength of evidence.

conclusionThe findings of this scoping review suggest that core strengthening exercises may be an effective non-pharmacological intervention for reducing pain intensity and improving quality of life in females with primary dysmenorrhea. Core stabilization programs appear to enhance lumbopelvic stability and functional outcomes while presenting minimal adverse effects. However, further high-quality randomized controlled trials with standardized protocols and long-term follow-up are required to strengthen the current evidence base.