Understanding the Benefits of Probiotics for Menstrual Health: Insights from the PERIOD Study
Health LibraryLatest Research in Women's Health
Understanding the Benefits of Probiotics for Menstrual Health: Insights from the PERIOD Study

Menstrual health is a crucial aspect of women's well-being, yet it often goes under-discussed. Among the various conditions affecting menstrual health, primary dysmenorrhea—commonly known as painful periods—is particularly prevalent. This condition not only causes significant discomfort but also impacts the quality of life, productivity, and mental health of many women worldwide. Traditional treatments typically include NSAIDs (non-steroidal anti-inflammatory drugs) and hormonal therapies, which, while effective, can have adverse effects with long-term use.

In search of alternative treatments that are both effective and have fewer side effects, recent research has turned to probiotics—live microorganisms known for their health benefits, particularly in immunomodulatory and inflammatory conditions. The PERIOD study, a randomized, double-blind, placebo-controlled trial conducted by Izyan Atiqah Zakaria and colleagues, explores the potential of probiotics to improve the lives of women suffering from primary dysmenorrhea.

Study Design and Methodology

The study enrolled 72 women with primary dysmenorrhea, randomly assigning them to either a probiotics group or a placebo group. Over three months, participants took oral sachets twice daily containing either a mixture of several strains of probiotics or a placebo. The primary outcomes measured were changes in pain severity, quality of life, mental health scores, and the frequency of NSAID usage. Additionally, the study assessed levels of inflammatory markers such as interleukin-6, interleukin-8, and tumor necrosis factor alpha, before and after the treatment period.

Key Findings

Interestingly, the study found that while probiotics did not significantly change the overall quality of life scores or inflammatory markers, they did show potential in several specific areas:

  • Mental Health Improvement: Participants in the probiotic group reported better mental health scores, suggesting that probiotics may help alleviate some of the emotional and psychological burdens associated with menstrual pain.
  • Reduced NSAID Use: There was a trend towards reduced NSAID consumption among those in the probiotic group. This is particularly significant given the side effects associated with long-term NSAID use, such as gastrointestinal issues and cardiovascular risks.

Interpretation of Results

The improvement in mental health scores and the reduction in NSAID use are promising indications that probiotics could play a role in managing primary dysmenorrhea. However, the lack of significant changes in inflammatory markers and the overall quality of life scores suggests that probiotics may not address all aspects of menstrual pain or that the effects may be more subtle.

The Broader Implications

This study contributes to a growing body of research suggesting that gut health is linked to a wide range of health conditions, including those related to reproductive health. By potentially reducing the need for NSAIDs and improving mental well-being, probiotics could offer a complementary approach to managing menstrual pain, especially for those looking for alternatives to traditional pharmaceuticals.

Looking Ahead

Despite the encouraging findings, the study's authors acknowledge that further research is needed, particularly studies with larger sample sizes and possibly different probiotic strains or formulations. Additionally, exploring the effects of probiotics over longer periods and in diverse populations could help clarify their role in managing menstrual health.


The PERIOD study opens up new conversations about the role of probiotics in women's health, particularly for those suffering from primary dysmenorrhea. While not a panacea, probiotics offer a promising avenue for improving menstrual health with minimal side effects. As research continues to unfold, it holds the potential to revolutionize the way we approach menstrual health and pain management, making it an exciting time for advancements in women's health care.

  • Zakaria IA, Mohammed Zain NA, Teik CK, Abu MA, Zainuddin AA, Abdul Aziz NH, Safian N, Mohd Mokhtar N, Raja Ali RA, Beng Kwang N, Mohamed Ismail NA, Hamizan MR, Ab Razak WS, Nur Azurah AG. The role of probiotics in improving menstrual health in women with primary dysmenorrhoea: A randomized, double-blind, placebo-controlled trial (the PERIOD study). Womens Health (Lond). 2024 Jan-Dec;20:17455057241234524. doi: 10.1177/17455057241234524. PMID: 38444064; PMCID: PMC10916465.
  • Becker CM, Johnson NP, As-Sanie S, Arjona Ferreira JC, Abrao MS, Wilk K, Imm SJ, Mathur V, Perry JS, Wagman RB, Giudice LC. Two-year efficacy and safety of relugolix combination therapy in women with endometriosis-associated pain: SPIRIT open-label extension study. Hum Reprod. 2024 Mar 1;39(3):526-537. doi: 10.1093/humrep/dead263. PMID: 38243752; PMCID: PMC10905503.
  • Zaharuddin L, Mokhtar NM, Muhammad Nawawi KN, Raja Ali RA. A randomized double-blind placebo-controlled trial of probiotics in post-surgical colorectal cancer. BMC Gastroenterol. 2019 Jul 24;19(1):131. doi: 10.1186/s12876-019-1047-4. PMID: 31340751; PMCID: PMC6657028.
  • Brown J, Crawford TJ, Datta S, Prentice A. Oral contraceptives for pain associated with endometriosis. Cochrane Database Syst Rev. 2018 May 22;5(5):CD001019. doi: 10.1002/14651858.CD001019.pub3. PMID: 29786828; PMCID: PMC6494634.
  • Dennis-Wall JC, Culpepper T, Nieves C Jr, Rowe CC, Burns AM, Rusch CT, Federico A, Ukhanova M, Waugh S, Mai V, Christman MC, Langkamp-Henken B. Probiotics (Lactobacillus gasseri KS-13, Bifidobacterium bifidum G9-1, and Bifidobacterium longum MM-2) improve rhinoconjunctivitis-specific quality of life in individuals with seasonal allergies: a double-blind, placebo-controlled, randomized trial. Am J Clin Nutr. 2017 Mar;105(3):758-767. doi: 10.3945/ajcn.116.140012. Epub 2017 Feb 22. PMID: 28228426.
1.Study Design and Methodology
2.Key Findings
3.Interpretation of Results
4.The Broader Implications
5.Looking Ahead