# Impact of Probiotic Supplementation and High-Intensity Interval Training on Primary Dysmenorrhea: A Double-Blind, Randomized Controlled Trial Investigating Inflammation and Hormonal Modulation

PMID: 40004951
Journal: Nutrients
Published: 2025 Feb 9
Authors: Yang MY, Chen HY, Ho CH, Huang WC

## Question

Do probiotic supplementation and supervised cycling HIIT improve symptoms, inflammation, hormones, and physical fitness in women with primary dysmenorrhea?

## Summary

In female students with primary dysmenorrhea, 10 weeks of supervised spin-bike HIIT, with or without probiotic supplementation, was associated with reduced premenstrual symptoms, menstrual distress, pain severity, inflammatory/prostaglandin markers, and hormone changes. The study used a clinical menstrual-pain population, small subgroups, and combined exercise and probiotic arms.

## Population

- Female students including non-dysmenorrhea controls and primary dysmenorrhea groups allocated to placebo, HIIT plus placebo, probiotics, or HIIT plus probiotics.
- Sample size: 65
- Age: 18-40 years
- Sex: Female
- Fitness level: Female students with primary dysmenorrhea or non-dysmenorrhea controls
- Health status: Female students with primary dysmenorrhea in intervention arms plus non-dysmenorrhea controls

## Methodology

- Randomized double-blind controlled trial with probiotic and exercise arms
- 10 weeks
- University faculty student setting with supervised spinning classes
- Randomized and controlled study design.

## Protocol

- Supervised spinning HIIT.
- Modality: Stationary cycling/spinning bike.
- Work intervals: 20 seconds all-out sprint in weeks 1-6, progressing to 25 seconds from week 7 onward.
- Recovery: 40 seconds active recovery.
- Sets or repetitions: 15 sprint intervals.
- Intensity: All-out sprints monitored with Borg scale and heart-rate belt.
- Session duration: 5-minute warm-up, 15-20 minutes HIIT, and 5-minute cool-down/stretching.
- Frequency: 2 sessions per week with recovery days between classes.
- Program length: 10 weeks.
- Progression: All-out sprint duration increased from 20 to 25 seconds from week 7 onward while recovery stayed at 40 seconds.
- Placebo or probiotic arms without HIIT.
- Modality: Daily capsule supplementation or placebo without supervised HIIT.
- Frequency: Daily capsule intake for probiotic/placebo arms.
- Program length: 10 weeks.
- Progression: No exercise progression in non-HIIT arms.

## Outcomes

### Main reported result
Status: mixed
HIIT significantly reduced premenstrual symptoms, menstrual distress, and pain severity in the primary dysmenorrhea groups.

### Main reported result
Status: mixed
HIIT decreased inflammatory and prostaglandin markers including hsCRP, PGE2, and PGF2alpha.

### Main reported result
Status: unclear
HIIT modulated estradiol, prolactin, progesterone, and cortisol.

### Main reported result
Status: mixed
HIIT improved cardiovascular endurance and explosive strength.

### Main reported result
Status: no clear change
Probiotics reduced premenstrual and menstrual distress but did not show notable effects on pain, inflammation, hormones, or physical fitness.

## Practical Insights

- A 2-day-per-week cycling HIIT schedule may be feasible for menstrual-symptom research when recovery days are built in.
- Monitoring with Borg scale and a heart-rate belt was used to manage all-out cycling efforts.
- The findings are most relevant to supervised clinical wellness programming for primary dysmenorrhea.

## Limitations

- Small subgroup sizes.
- Clinical and sex-specific population limits generalizability.
- Exercise type, age, population, and probiotic strain may influence results.
- Microbiota and metabolite mechanisms were not analyzed.
- More detailed menstrual-cycle prostaglandin validation was recommended.

## Safety And Adherence

- Five participants were excluded or dropped out because of eligibility, attendance below 80%, or loss to follow-up; no adverse events were reported in the extracted full text.

## Original Sources

- [PubMed](https://pubmed.ncbi.nlm.nih.gov/40004951/) (pubmed)
- [DOI](https://doi.org/10.3390/nu17040622) (doi)
- [PMC full text](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11858197/) (full text)

## Agent Guidance

Preserve the paper-level scope of this note. Do not generalize beyond the population, protocol, measured outcomes, and limitations above.