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EVİDENCE-BASED TRADİTİONAL AND COMPLEMENTARY TREATMENT PRACTİCES İN THE MANAGEMENT OF PREMENSTRUAL SYMPTOMS

Yıl 2024, Cilt: 2 Sayı: 2, 172 - 186, 30.10.2024

Öz

EVİDENCE-BASED TRADİTİONAL AND COMPLEMENTARY TREATMENT PRACTİCES İN THE MANAGEMENT OF PREMENSTRUAL SYMPTOMS
ABSTRACT
Premenstrual syndrome is a complex chain of syndromes where multiple symptoms can occur together. To manage these symptoms that can affect a significant portion of a woman's life, various pharmacological (such as antidepressants, diuretics, progesterone, estrogen implants, oral contraceptive pills, pyridoxine, or gonadotropin hormone agonists) and non-pharmacological (such as nutrition, surgery, psychotherapy, etc.) treatments can be used. Complementary and alternative treatment methods are also frequently used in treating premenstrual symptoms. The most important reason for using GETAT in the management of PMS symptoms is that the methods are safer and less costly. Among these methods are lifestyle changes, herbal supplements, acupuncture, cognitive behavioral therapies, and others. This review aims to examine the levels of evidence for complementary and alternative practices used in premenstrual syndrome. The studies included in the review were accessed through a search covering the last 15 years using keywords such as 'premenstrual syndrome,' 'complementary and alternative medicine,' and 'evidence-based practices' in multiple databases. The classification system defined by the Joanna Briggs Institute was utilized to assess the levels of evidence of the articles."
Practices that have been proven with a high level of evidence to be effective in reducing the symptoms and severity of premenstrual syndrome; It has been found that there is the use of acupuncture/acupuncture, which is one of the alternative treatments, as well as the use of the vitex agnus, which is one of the biologically based practices. When the evidence levels are examined, it is seen that more studies with a high level of evidence regarding GETAT methods are needed.
Keywords: Nursing, Evidence-based practices; Complementary treatment practices; Premenstrual syndrome

Kaynakça

  • 1. Yamamoto K, Okazaki A, Sakamoto Y, Funatsu M. The relationship between premenstrual symptoms, menstrual pain, irregular menstrual cycles, and psychosocial stress among Japanese college students. J Physiol Anthropol. 2009;28(3):129-36.
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  • 3. American College of Obstetricians & Gynecologists. ACOG, 2023. https://www.acog.org/womens-health/faqs/premenstrual-syndrome Erişim Tarihi: 26.10.2023.
  • 4. Akdeniz, F., Gönül, A. S. Kadınlarda üreme olayları ile depresyon ilişkisi. Klinik Psikiyatri Dergisi. 2004;7(2):70-74.
  • 5. Gudipally PR, Sharma GK. Premenstrual syndrome. In: StatPearl. Treasure Island (FL): StatPearls, Los Angeles, 2024. https://www.ncbi.nlm.nih.gov/books/NBK560698/ Erişim Tarihi: 25.04.2024.
  • 6. Royal College of Obstetricians and Gynaecologits,2020. https://www.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/premenstrual-syndrome-management-green-top-guideline-no-48/ Erişim Tarihi: 17.10.2024
  • 7. Shehadeh, J. H., & Hamdan-Mansour, A. M. (2018). Prevalence and association of premenstrual syndrome and premenstrual dysphoric disorder with academic performance among female university students. Perspect Psychiatr Care, 54(2), 176-184.
  • 8. Acikgoz, A., Dayi, A., & Binbay, T. (2017). Prevalence of premenstrual syndrome and its relationship to depressive symptoms in first-year university students. Saudi medical journal, 38(11), 1125.
  • 9. Göker A, Artunç-Ülkümen B, Aktenk F, İkiz N. Premenstrual syndrome in Turkish medical students and their quality of life. J Obstet Gynaecol. 2015 Apr;35(3):275-8.
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PREMENSTRÜEL SEMPTOMLARININ YÖNETİMİNDE KANITA DAYALI GELENEKSEL VE TAMAMLAYICI TEDAVİ UYGULAMALARI

Yıl 2024, Cilt: 2 Sayı: 2, 172 - 186, 30.10.2024

Öz

PREMENSTRÜEL SEMPTOMLARININ YÖNETİMİNDE KANITA DAYALI GELENEKSEL VE TAMAMLAYICI TEDAVİ UYGULAMALARI
ÖZET
Premenstrüel sendrom birçok semptomun bir arada görülebildiği komplike bir sendromdur. Dünya’da ve Türkiye’de premenstrüel semptomların görülme sıklığı oldukça yaygındır. Kadın yaşam döneminin büyük bir kısmını etkileyebilen bu semptomlar ile baş edebilmek için çeşitli farmakolojik (antidepresanlar, diüretikler, progesteron, östrojen implantları, oral kontraseptif haplar ve piridoksin veya gonadotropin hormon agonistleri vb.) ve farmakolojik olmayan (beslenmenin düzenlenmesi, cerrahi yöntemler ve psikoterapi vb.) tedaviler kullanılabilmektedir. Premenstrüel semptomların tedavisinde geleneksel ve tamamlayıcı tedavi uygulamaları da kullanılmaktadır. PMS semptomlarının yönetiminde GETAT kullanımının en önemli nedeni yöntemlerin daha güvenli ve daha az maliyetli olmasıdır. Kullanılan bu yöntemler arasında yaşam tarzı değişiklikleri, bitkisel takviyeler, akupunktur, yoga, kahkaha yogası vb. yer alır. Bu derleme çalışması, premenstrüel sendromda kullanılan geleneksel ve tamamlayıcı tedavi uygulamalarının kanıt düzeylerini incelemek amacıyla hazırlanmıştır. Derlemenin hazırlanmasında kullanılan çalışmalara, veri tabanlarında yer alan ve son 15 yıl içinde yayınlanmış makaleler taranarak ulaşılmıştır. Makalelerin kanıt düzeylerinin değerlendirilmesinde Joanna Briggs Enstitüsü tarafından belirlenmiş sınıflandırma sisteminden faydalanılmıştır. Bu derleme çalışması, premenstrüel sendrom üzerine çalışması yapılmış, kanıtı bulunan GETAT uygulamaları ile sınırlandırılmıştır.
Premenstrüel sendrom semptomlarını, şiddetini azaltmada etkili olduğu yüksek düzeyde kanıtlarla saptanmış uygulamalar; alternatif tedavilerden olan akupunktur/akupröser kullanımı ve bunun yanında biyolojik temelli uygulamalardan hayıt bitkisinin kullanımı olduğu bulunmuştur. Kanıt düzeyleri incelendiğinde GETAT yöntemleriyle ilgili yüksek kanıt düzeyine sahip daha çok çalışmaya ihtiyaç duyulduğu görülmektedir.
Anahtar Kelimeler: Hemşirelik; Kanıt temelli uygulamalar; Tamamlayıcı tedavi uygulamaları; Premenstrüel sendrom

Kaynakça

  • 1. Yamamoto K, Okazaki A, Sakamoto Y, Funatsu M. The relationship between premenstrual symptoms, menstrual pain, irregular menstrual cycles, and psychosocial stress among Japanese college students. J Physiol Anthropol. 2009;28(3):129-36.
  • 2. American Psychiatric Association Diagnostic and Statistical Manual of Mental Health Disorders, 5th Edition. Washington D.C., 2013. https://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425596 Erişim Tarihi: 29.04.2024.
  • 3. American College of Obstetricians & Gynecologists. ACOG, 2023. https://www.acog.org/womens-health/faqs/premenstrual-syndrome Erişim Tarihi: 26.10.2023.
  • 4. Akdeniz, F., Gönül, A. S. Kadınlarda üreme olayları ile depresyon ilişkisi. Klinik Psikiyatri Dergisi. 2004;7(2):70-74.
  • 5. Gudipally PR, Sharma GK. Premenstrual syndrome. In: StatPearl. Treasure Island (FL): StatPearls, Los Angeles, 2024. https://www.ncbi.nlm.nih.gov/books/NBK560698/ Erişim Tarihi: 25.04.2024.
  • 6. Royal College of Obstetricians and Gynaecologits,2020. https://www.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/premenstrual-syndrome-management-green-top-guideline-no-48/ Erişim Tarihi: 17.10.2024
  • 7. Shehadeh, J. H., & Hamdan-Mansour, A. M. (2018). Prevalence and association of premenstrual syndrome and premenstrual dysphoric disorder with academic performance among female university students. Perspect Psychiatr Care, 54(2), 176-184.
  • 8. Acikgoz, A., Dayi, A., & Binbay, T. (2017). Prevalence of premenstrual syndrome and its relationship to depressive symptoms in first-year university students. Saudi medical journal, 38(11), 1125.
  • 9. Göker A, Artunç-Ülkümen B, Aktenk F, İkiz N. Premenstrual syndrome in Turkish medical students and their quality of life. J Obstet Gynaecol. 2015 Apr;35(3):275-8.
  • 10. Cheng SH, Shih CC, Yang YK, Chen KT, Chang YH, Yang YC. Factors associated with premenstrual syndrome a survey of new female university students. Kaohsiung J Med Sci. 2013 Feb;29(2):100-5.
  • 11. Abdelmoty HI, Youssef MA, Abdallah S, Abdel-Malak K, Hashish NM, Samir D, Abdelbar M, Hosni et al. Menstrual patterns and disorders among secondary school adolescents in Egypt. A cross-sectional survey. BMC Womens Health. 2015 Sep; 15:70.
  • 12. Erbil, N., & Yücesoy, H. (2023). Premenstrual syndrome prevalence in Turkey: a systematic review and meta-analysis. Psychology, Health & Medicine, 28(5), 1347-1357.
  • 13. Uçak, H., & Özkan, F. S. (2022). Traditional and complementary medicine practices used by women with premenstrual syndrome. Konuralp Medical Journal, 14(1), 23-29.
  • 14. Joanna Briggs Institute. 2014. https://jbi.global/sites/default/files/2019-05/JBI-Levels-of-evidence_2014_0.pdf Erişim Tarihi: 29.04.2024.
  • 15. Armour M, Ee CC, Hao J, Wilson TM, Yao SS, Smith CA. Acupuncture and acupressure for premenstrual syndrome. Cochrane Database Syst Rev. 2018 Aug 14;8(8):CD005290.
  • 16. Jang, S. H., Kim, D. I., Choi, M. S. Effects and treatment methods of acupuncture and Herbal Medicine for premenstrual syndrome/premenstrual dysphoric disorder: systematic review. BMC Complementary and Alternative Medicine. 2014;14(1):1-13.
  • 17. Zhang, J., Cao, L., Wang, Y., Jin, Y., Xiao, X., & Zhang, Q. (2019). Acupuncture for Premenstrual Syndrome at Different Intervention Time: A Systemic Review and Meta‐Analysis. Evidence‐Based Complementary and Alternative Medicine, 2019(1), 6246285.
  • 18. Choung, H. M., & Song, J. S. (2013). The ear acupressure therapy on premenstrual syndrome and dysmenorrhea on female college Students. Journal of The Korea Society of Computer and Information, 18(5), 87-94.
  • 19. Küçükkelepce, D. S., Ünver, H., Nacar, G., Tashan, S. T. The effects of acupressure and yoga for coping with premenstrual syndromes on premenstrual symptoms and quality of life. Complementary Therapies in Clinical Practice. 2021;42, 101282.
  • 20. Bazarganipour, F., Taghavi, S. A., Allan, H., Beheshti, F., Khalili, A., Miri, F., et al. The effect of applying pressure to the lıv3 and lı4 on the symptoms of premenstrual syndrome: a randomized clinical trial. Complementary Therapies in Medicine. 2017;31:65-70.
  • 21. Kaewrudee, S., Kietpeerakool, C., Pattanittum, P., Lumbiganon, P. Vitamin or mineral supplements for premenstrual syndrome. The Cochrane Database of Systematic Reviews. 2018;18(1):CD012933.
  • 22. Bertone-Johnson, E. R., Chocano-Bedoya, P. O., Zagarins, S. E., Micka, A. E., Ronnenberg, A. G. Dietary Vitamin D intake, 25-Hydroxyvitamin D3 levels and premenstrual syndrome in a college-aged population. The Journal of Steroid Biochemistry And Molecular Biology. 2010;121(1-2), 434-437.
  • 23. Dadkhah, H., Ebrahimi, E., & Fathizadeh, N. Evaluating The effects of Vitamin D and Vitamin E supplement on premenstrual syndrome: a randomized, double-blind, controlled trial. Iranian Journal of Nursing and Midwifery Research. 2016;21(2), 159.
  • 24. Bahrami, A., Avan, A., Sadeghnia, H. R., Esmaeili, H., Tayefi, M., Ghasemi, F., et al. High dose Vitamin D supplementation can improve menstrual problems, dysmenorrhea, and premenstrual syndrome in adolescents. Gynecological Endocrinology. 2018;34(8):659-663.
  • 25. Abdi, F., Ozgoli, G., Rahnemaie, F. S. A systematic review of the role of Vitamin D and Calcium in premenstrual syndrome. Obstetrics & Gynecology Science. 2019;62(2):73-86.
  • 26. Moslehi, M., Arab, A., Shadnoush, M. et al. The association between serum magnesium and premenstrual syndrome: a systematic review and meta-analysis of observational studies. Biological Trace Element Research. 2019;192:145–152.
  • 27. Kia, A. S., Amani, R., Cheraghian, B. The association between the risk of premenstrual syndrome and Vitamin D, calcium, and magnesium status among university students: a case control study. Health Promotion Perspectives. 2015;5(3), 225.
  • 28. Ozolinya, L. A., Overko, A. V., Bakhodurova, K. A. The role of magnesium in the treatment of premenstrual syndrome. VF Snegirev Archives of Obstetrics and Gynecology. 2020;7(2):102-107.
  • 29. Bahrami, A., Bahrami-Taghanaki, H., Khorasanchi, Z., Timar, A., Jaberi, N., Azaryan, E., et a. Menstrual problems in adolescence: relationship to serum Vitamins A and E, and systemic inflammation. Archives of Gynecology and Obstetrics. 2020;301(1), 189-197.
  • 30. Siminiuc R, Ţurcanu D. Impact of nutritional diet therapy on premenstrual syndrome. Front Nutr. 2023 Feb 1;10:1079417. doi: 10.3389/fnut.2023.1079417. PMID: 36819682; PMCID: PMC9928757.
  • 31. Abdollahifard S, Rahmanian Koshkaki A, Moazamiyanfar R. The effects of vitamin B1 on ameliorating the premenstrual syndrome symptoms. Glob J Health Sci. 2014;29(6):144-53.
  • 32. Evrianasari, N., Tuasela, S. V. Pengaruh Alpukat Terhadap Gejala Premenstrual Syndrome (Pms) Pada Mahasiswa Kebidanan Tingkat I Di Prodi Kebidanan Universitas Malahayati Bandar Lampung Tahun. Jkm (Jurnal Kebidanan Malahayati). 2019;4(2).
  • 33. Masoumi SZ, Ataollahi M, Oshvandi K. Effect of combined use of Calcium and Vitamin B6 on premenstrual syndrome symptoms: a randomized clinical trial. J Caring Sci. 2016 Mar 1;5(1):67-73.
  • 34. Sayehmiri, K., Asadi-Samani, M., Bahmani, M. (2016). Effects of vitamin B6 on premenstrual syndrome: A systematic review and meta-analysis. Journal of Chemical and Pharmaceutical Science, 2016;9(3), 1346-53.
  • 35. Knecht, K., Kinder, D., & Stockert, A. (2020). Biologically-based complementary and alternative medicine (CAM) use in cancer patients: the good, the bad, the misunderstood. Frontiers in nutrition, 6, 196.
  • 36. Dietz, B. M., Hajirahimkhan, A., Dunlap, T. L., Bolton, J. L. Botanicals and their bioactive phytochemicals for women’s health. Pharmacological Reviews, 2016;68(4):1026-1073.
  • 37. Rahnama P, Montazeri A, Huseini HF, Kianbakht S, Naseri M. Effect of Zingiber officinale R. rhizomes (ginger) on pain relief in primary dysmenorrhea: a placebo randomized trial. BMC Complement Altern Med. 2012 Jul;12:92.
  • 38. Daily JW, Zhang X, Kim DS, Park S. Efficacy of Ginger for Alleviating the Symptoms of Primary Dysmenorrhea: A Systematic Review and Meta-analysis of Randomized Clinical Trials. Pain Med. 2015 Dec;16(12):2243-55.
  • 39. Khayat, S., Kheirkhah, M., Behboodi Moghadam, Z., Fanaei, H., Kasaeian, A., Javadimehr, M. Effect of Treatment with Ginger on The Severity of Premenstrual Syndrome Symptoms. International Scholarly Research Notices. 2014.
  • 40. Azmoudeh, B. E., Habibian, M., Askari, B. The effectiveness of the combination of cinnamon and Ginger with exercise training in the treatment of dysmenorrhea and premenstrual syndrome. Iran Journal of Nursing. 2019;32(121), 68-81.
  • 41. Shoaee, F., Pouredalati, M., Dadshahi, S. ve ark. Evaluation of non-pharmacological strategies, therapeutic and cognitive-behavioral interventions in the treatment of premenstrual syndrome: a review study. International Journal of Pediatrics. 2020;8(2), 10929-10939.
  • 42. Kamranpour, S. B., Farzad, L., Rahbar, T., Alizadeh, S. The effect of valerian on the severity of premenstrual syndrome symptoms. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2015;18(161), 1-9.
  • 43. Moghadam, Z. B., Rezaei, E., Gholami, R. S., Kheirkhah, M., Haghani, H. The Effect of Valerian Root extract on the severity of premenstrüel syndrome symptoms. Journal of Traditional and Complementary Medicine. 2016;6(3), 309-315.
  • 44. Shankar, P., Priya, J., Devi, G., Arivarasu, L. Effects of valerian root on menstrual disorders. Annals of the Romanian Society for Cell Biology. 2021;2675-2684.
  • 45. Çetin, H. S., Erbil, N. Premenstrüel Sendromda Ağrı Yönetimi. Ordu Üniversitesi Hemşirelik Çalışmaları Dergisi. 2020;3(2), 202-210.
  • 46. Verkaik, S., Kamperman, A. M., Van Westrhenen, R., & Schulte, P. F. The treatment of premenstrual syndrome with preparations of Vitex Agnus Castus: a systematic review and meta-analysis. American Journal of Obstetrics and Gynecology. 2017;217(2), 150-166.
  • 47. Cerqueira, R. O., Frey, B. N., Leclerc, E., Brietzke, E. Vitex agnus castus for premenstrual syndrome and premenstrual dysphoric disorder: a systematic review. Archives of Women's Mental Health. 2017; 20:713-719.
  • 48. Bilgiç, Ş. Hemşirelikte holistik bir uygulama; aromaterapi. Namık Kemal Tıp Dergisi. 2017;5(3), 134-141.
  • 49. Uzunçakmak, T., & Alkaya, S. A. (2018). Effect of aromatherapy on coping with premenstrual syndrome: A randomized controlled trial. Complementary therapies in medicine, 36, 63-67.
  • 50. Ayu, N. S. The effectiveness of Cananga aromatherapy with warm compress in reducing premenstrual syndrome (pms) amongst teenage girls. Jurnal Keperawatan Soedirman. 2019;14(3).
  • 51. Geethanjali, S., Venugopal, V., Poonguzhali, S., Maheshkumar, K. Effect of clary sage oil as an aromatherapy on cardiac autonomic function among patients with premenstrual syndrome–a randomized controlled study. Obesity Medicine. 2020;18, 100193.
  • 52. Heydari, N., Abootalebi, M., Jamalimoghadam, N., Kasraeian, M., Emamghoreishi, M., Akbarzadeh, M. Investigation of the effect of aromatherapy with Citrus aurantium blossom essential oil on premenstrual syndrome in university students: A clinical trial study. Complementary Therapies in Clinical Practice. 2018;32, 1-5.
  • 53. Uzunçakmak, T., Alkaya, S. A. Effect of aromatherapy on coping with premenstrual syndrome: A randomized controlled trial. Complementary Therapies in Medicine. 2018;36, 63-67.
  • 54. Öztürk, S., Tanrıverdi, D. Premenstrüel sendrom ve baş etme. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi. 2010;13(3), 57-61.
  • 55. Sağlam, H. Y., Orsal, O. Effect of exercise on premenstrual symptoms: A systematic review. Complementary Therapies in Medicine. 2020;48:102272.
  • 56. Dehnavi, Z. M., Jafarnejad, F., Goghary, S. S. The effect of 8 weeks aerobic exercise on severity of physical symptoms of premenstrual syndrome: a clinical trial study. BMC Women's Health. 2018;18(1), 1-7.
  • 57. Maged, A. M., Abbassy, A. H., Sakr, H. R. ve ark., Effect of swimming exercise on premenstrual syndrome. Archives of Gynecology and Obstetrics. 2018;297(4):951-959.
  • 58. Lotfipur-Rafsanjani, S. M., Ravari, A., Ghorashi, Z. ve ark., Effects of geranium aromatherapy massage on premenstrual syndrome: A clinical trial. International Journal of Preventive Medicine. 2018;9.
  • 59. Ghaedi L, Moradi M. Assessment of the effects of massage therapy on premenstrual syndrome. Zahedan J Res Med Sci. 2011;13(2):94066.
  • 60. Çevik, K. Hemşirelikte tamamlayıcı ve alternatif tedavi: Refleksoloji. Ege Üniversitesi Hemşirelik Fakültesi Dergisi. 2013;29(2), 71-82.
  • 61. Hasanpour, M., Mohammadi, M. M., Shareinia, H. Effects of reflexology on premenstrual syndrome: a systematic review and meta-analysis. BioPsychoSocial Medicine, 2019;13(1), 1-12.
  • 62. Afifi, O. A. W., Fahmy, N. M., Omran, A. A., Abd-Elmoniem, S. O. Effect of self-feet reflexology on relieving premenstrual syndrome. Menoufia Nursing Journal. 2017;2(2), 1-16.
  • 63. Asgariani, Z., Barat, S., Moudi, S., Hamidia, A., Bijani, A. Comparing the efficacy of hypnosis and the muscle relaxation in the symptom-relief of premenstrual syndrome. Koomesh. 2018;20(3).
  • 64. Heydarpour, S., Dehghan, F. Comparing the effectiveness of relaxation by hypnotherapy and virtual reality technology in alleviation of the symptoms of premenstrual syndrome. Cogent Psychology. 2019;6(1), 1686962.
  • 65. Moghtader, L., Pakseresht, S. Comparison of the effectiveness of cognitive-behavioral group therapy with cognitive hypnosis on reducing depression in students with premenstrual syndrome. Journal of Clinical Nursing and Midwifery. 2019;8(2), 327-336.
  • 66. Vaghela, Nirav; Mishra, Daxa; Sheth, Maitri1; Dani, Vyoma Bharat. To compare the effects of aerobic exercise and yoga on Premenstrual syndrome. Journal of Education and Health Promotion 2019;8(1):p 199.
  • 67. Kılıç, N., Ünal H. 12 haftalık yoga egzersizinin PMS (premenstrüel sendrom) sorunu olan kadınların anksiyete düzeyleri ve yaşam kaliteleri üzerine etkilerinin araştırılması. Spormetre Beden Eğitimi ve Spor Bilimleri Dergisi. 2020;18(2), 126-135.
  • 68. Ghaffarilaleh, G., Ghaffarilaleh, V., Sanamno, Z., Kamalifard, M. Yoga positively affected depression and blood pressure in women with premenstrual syndrome in a randomized controlled clinical trial. Complementary Therapies in Clinical Practice. 2019;34, 87-92.
  • 69. Vaghela, N., Mishra, D., Sheth, M., Dani, V. B. To compare the effects of aerobic exercise and yoga on premenstrual syndrome. Journal of Education and Health Promotion, 2019;8.
Toplam 69 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Doğum ve Kadın Hastalıkları Hemşireliği
Bölüm Derlemeler
Yazarlar

Yeliz Ildır Altun 0000-0003-4901-7332

Merve Temel 0000-0001-7034-1175

Ozlem Can Gurkan 0000-0002-5608-6208

Yayımlanma Tarihi 30 Ekim 2024
Gönderilme Tarihi 9 Eylül 2024
Kabul Tarihi 22 Ekim 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 2 Sayı: 2

Kaynak Göster

AMA Ildır Altun Y, Temel M, Can Gurkan O. PREMENSTRÜEL SEMPTOMLARININ YÖNETİMİNDE KANITA DAYALI GELENEKSEL VE TAMAMLAYICI TEDAVİ UYGULAMALARI. Tusad. Ekim 2024;2(2):172-186.