Effectiveness of Reflexology for Premenstrual Syndrome (PMS) and

Other Health Difficulties Specific to Women

Ayame Inoue

, Yukie Majima

, Seiko Masuda

and Takeshi Matsuda

Graduate School of Humanities and Sustainable System Sciences, Osaka Prefecture University, Sakai, Osaka, Japan

Graduate School of Informatics, Osaka Metropolitan University, Sakai, Osaka, Japan

Graduate School of Management and Information Technology, Hannan University, Matsubara, Osaka, Japan

Keywords: Bowel Sounds, PMS Symptoms, Reflexology.

Abstract: Reflexology is said to be effective for regulating physical discomfort and relieving pain, but it is also expected

to be effective for improving PMS symptoms, which are common among many women. However, few

researchers have examined its effects for PMS symptoms, so few women use reflexology and most of them

still rely on drugs such as oral contraceptives and chemical therapies. For this study, we examined reflexology

effects on PMS symptoms and the body, devoting particular attention to bowel sounds. This paper presents

results of experiments which treat reflexology for three women who have each PMS symptoms and other

health difficulties. As results of bowel sounds, frequency spectrums of three women have been consolidated

into a single curve. one after treatment. In the future, we increase the number of data and clarify the relation

among reflexology, bowel sounds, PMS symptoms and other health difficulties.

1 INTRODUCTION

Many women in Japan have premenstrual syndrome

(PMS) symptoms such as constipation, diarrhea, and

abdominal pain. A survey conducted by the Japan

Society of Obstetrics and Gynecology in 2018 found

that 70–80% of menstruating women have PMS

symptoms, and that about 5.4% of them have

difficulties in daily life (The Japan Society of

Obstetrics and Gynecology, 2018). The annual

economic loss attributable to medical expenditures

and lost productivity of women working with

gynecological disorders, including PMS symptoms,

is calculated as at least 6.37 trillion yen. To resolve

these difficulties and losses, femtec-related services

(femtec: The coined word of female and technology.

Items and services that solve health problems of

women (Hitachi Consulting, 2021).) and products

have been increasing in recent years, but many people

still rely on drugs such as oral contraceptives and

chemical therapies.

Reflexology, a non-chemical therapy, is aimed at

producing health without reliance on chemicals. It

was introduced into medical treatment as a

complementary therapy in Europe the United States.

The soles of the feet have reflex points corresponding

to internal organs throughout the body, which are

stimulated by pressing them with fingers or sticks to

activate the internal organs, thereby improving

metabolism and immunity (Embong, 2015). Studies

examining the effects of reflexology include one

which found effectiveness for lowering blood

pressure and heart rate in stage 2 hypertensive

patients (Kotruchin, 2021). One study found that the

procedure had beneficial effects of improving hair

and skin-related dysfunction in people with type 2

diabetes (Magalhães da Silva, 2015). Furthermore, a

study of primiparous women indicated that treatments

reduced anxiety and the duration of labor, and

increased Apgar scores (Moghimi-Hanjani, 2015).

Other studies have shown changes in the frequency of

defecation among female university students.

Although the results were not significant, reflexology

effects were suggested (Nakahashi, 2011).

Results of these studies imply that reflexology is

effective for improving PMS symptoms, but few

researchers have examined its effects for PMS

symptoms. Those few reported studies have been

qualitative, short-term evaluations.

For this study, we examined the long-term effects

of reflexology quantitatively by continuously

obtaining physical data such as bowel sounds and

blood pressure. As an introduction to the study, this

502

Inoue, A., Majima, Y., Masuda, S. and Matsuda, T.

Effectiveness of Reﬂexology for Premenstrual Syndrome (PMS) and Other Health Difﬁculties Speciﬁc to Women.

DOI: 10.5220/0011774600003414

In Proceedings of the 16th International Joint Conference on Biomedical Engineering Systems and Technologies (BIOSTEC 2023) - Volume 5: HEALTHINF, pages 502-506

ISBN: 978-989-758-631-6; ISSN: 2184-4305

 2023 by SCITEPRESS – Science and Technology Publications, Lda. Under CC license (CC BY-NC-ND 4.0)

paper presents a comparison of data indicating

reflexology effects on women's bodies before and

after a single treatment.

2 EXPERIMENT TECHNIQUES

2.1 Experiment Summary

For this experiment, three women in their 20s to 40s

affected by constipation and menstrual pain

underwent reflexology treatment for 20 min per leg,

for a total of 40 min.

Prior to conducting this experiment, we have been

approved by the University's Ethics Committee.

2.2 Participants

The participants with consent were three women with

PMS symptoms and difficulties such as uterine

fibroids: one was in her 20s; one was in her 30s; and

one was in her 40s. The participants’ health

difficulties and self-care status are shown with

interview data.

2.3 Experiment Flow and Acquired

Data

The experiment flow and data acquired from this

experiment are described below. This experiment

included the following steps: 1. preliminary survey; 2.

body data acquisition – 1; 3. reflexology treatment;

and 4. body data acquisition – 2. For participants

scheduled to receive multiple treatments, the pre-

survey content after the second treatment changed to

inquiries about continued effects of reflexology.

1. Preliminary Survey

Questions about defecation and menstruation

were asked, with contents mainly as follows.

(Contents of the first survey)

• Diarrhea, constipation, and abdominal pain

• Days since last menstrual period

• Menstrual cycle

• PMS symptoms other than defecation

• Self-care for symptom relief

• Other concerns about body condition

(Details of the second and subsequent surveys)

• Bowel difficulties and PMS symptoms

improved by reflexology

• Other difficulties improved by reflexology other

than those described above.

2. Acquisition of Physical Data (1)

We obtained the following data.

• Blood pressure

• Heart rate

• Blood oxygen level

Table 1: Data acquisition equipment.

Ite

Equipment name

Bowel soun

JPES-01 (Mitorika Co., Ltd.)

Blood pressure UA-651BLE (A&D Co. Ltd.)

Heart rate 〃

Blood oxygen

level

Onyx Model 9500 (Star

Product Inc.)

3. Reflexology Treatment

Participants were treated by a practitioner who

had attended a reflexology course for at least one year

and who held a private certification. The left leg was

treated for 20 min, followed by the right leg for 20

min, for a total of 40 min. The practitioner applied

treatment using the hands and sticks, when necessary,

using a cream. Both the participant and the

practitioner sit on a chair during the treatment.

Figure 1: Experimental environment.

4. Body Data Acquisition (2)

We obtained the data obtained in step 2 again.

3 RESULTS OF EXPERIMENTS

The following describes results obtained from data

acquired during the experiment. For this experiment,

data of the first group were obtained after the

participant sat in a chair for 5 min of rest. Data of the

second group were obtained immediately after the

treatment of both legs, but the participant remained

seated.

3.1 Bowel Sound Data

The electronic stethoscope used for this experiment,

JPES-01, can acquire information related to

frequency and decibels. To date, the state of the

Effectiveness of Reﬂexology for Premenstrual Syndrome (PMS) and Other Health Difﬁculties Speciﬁc to Women

503

intestines has been determined fundamentally by the

number of times per minute that the intestines move,

called intestinal peristalsis. For this study, we

analyzed bowel sounds not only by sound counts but

also by frequency, decibels, and changes in time-

series data.

3.1.1 Before Treatment

1. Frequency Data

The following graph shows approximately one

minute of bowel sound data obtained before the

procedure. The vertical axis shows decibels. The

horizontal axis shows the frequency in hertz. This

graph shows how much of which frequency sine wave

is contained in the sound wave for one minute.

Figure 2: Frequency spectrum of three participants (before

treatment).

The curves are similar for all three participants,

but the concavo-convexity shapes differ. Also, the

frequency bands that contain many sine waves differ.

2. Waveform data

As with the frequency data, one minute of data

obtained before the procedure are shown below. This

graph shows the amplitude of the intestinal acoustic

waveform on the vertical axis and time on the

horizontal axis. Data for one participant are shown here.

Figure 3: Time series waveform data (before treatment).

3.1.2 After Treatment

1. Frequency Data

The data for approximately 1 min are shown

below, as they were before the treatment.

Figure 4: Frequency spectrum of three participants (after

treatment).

The data here show that the curves of the three

participants have been consolidated into a single

curve. Two of them seem to have less unevenness in

their curves, although one of them does not change

much.

2. Waveform Data

The waveform data of about 1 min are shown here

as they were before the treatment. The amplitude was

smaller than before the treatment. The amplitudes of

the other two participants also decreased or remained

almost identical.

Figure 5: Time series waveform data (after treatment).

3.2 Blood Pressure, Heart Rate, Blood

Oxygen Levelssure

This section presents a description of data other than

bowel sounds obtained before and after reflexology.

3.2.1 Blood Pressure

A comparison of blood pressure before and after

treatment showed an average of 106.8 (131.0/82.7)

before the treatment and 104.1 (126.3/82) after

treatment. Although an earlier study showed that

blood pressure had decreased, the present results

differed from those of an earlier study (Machi, 2000)

in that the three participants respectively showed a

decrease, maintenance, and increase in blood pressure.

Some participants reported that they felt sleepy

during the treatment, which implies a relaxing effect.

Reflexology reportedly improves blood circulation.

Therefore, future studies should provide increased

HEALTHINF 2023 - 16th International Conference on Health Informatics

504

data collection and better examination of reflexology

effects on blood pressure.

3.2.2 Pulse Rate

Comparison of the heart rate before and after the

treatment showed that the average heart rate was 76.3

beats per minute before the treatment and 68.3 beats

per minute after the treatment, indicating that the heart

rates of all three participants decreased. Results are

consistent with those of earlier studies (Machi, 2000).

Then, we couldn’t find significant difference in blood

pressure and blood oxygen concentration, but the

paired t-test detected significant differences between

before and after the procedure groups(P=0.049).

3.2.3 Blood Oxygen Concentration

Blood oxygen concentrations before and after the

procedure were increased in all participants by 1%.

The results resembled those of an earlier study

(Machi, 2000), which suggested that oxygen

concentrations increased in some participants.

3.3 Interview Data

The following are contents of interviews about PMS

symptoms conducted with the participants before the

experiment.

3.3.1 Interview Items

The interview items are presented below.

Table 2: Interview items.

Item

number

Detail

Difficulties related to defecation (diarrhea,

constipation, abdominal pain, etc.)

Number of days elapsed since the last

menstrual period at the time of data

acquisition, Number of days elapsed since last

menstrual period

Usual menstrual cycle (is the cycle stable?)

Presence of PMS symptoms other than

defecation

Details of 4

What we are doing to solve 1 and 5

Other body-related concerns

3.3.2 Approaches to Symptom Relief

Because data obtained from this study were of only

three participants, relating characteristics of the

physical data to the interview data is difficult. For this

reason, this report presents only responses obtained

from interviews as examples.

Table 3: Sample response.

Item

number

Response

Menstrual pain, constipation, heavy

bleeding during physiological periods

Yes

Not very stable.

(Menstruation might last about a week)

Yes

Overeating, irritability, sleepiness, rough

skin

Warm the body (e.g. at a hot spring)

Uterine fibroids, rhinitis, asthma

Future experiments will investigate how these

concerns change during the course of multiple

reflexology treatments.

4 CONSIDERATIONS

This chapter presents results obtained from

experiments described in Section 3 and a discussion

of them.

4.1 Bowel Sound Data

From this experiment, data were obtained before and

after reflexology treatment to assess how the state of

the intestine changes. Reportedly, reflexology relaxes

and regulates the body. The difference in bowel

sounds before and after the treatment assessed by this

study indicate some effect on the bowel. Because the

data were obtained from only three people, the

frequency graphs of the three people converged to a

single graph after treatment. Future research must be

undertaken to clarify whether many people converge

similarly, and to elucidate the meaning of this shape.

4.2 Blood Pressure, Heart Rate, Blood

Oxygen Level

The results obtained for blood pressure, heart rate,

and blood oxygenation resembled those of earlier

studies. Results for blood pressure differed slightly

from those of earlier studies. However, because

earlier studies had fewer participants, the number of

participants in future studies must be increased; the

reliability of future data must be improved.

Effectiveness of Reﬂexology for Premenstrual Syndrome (PMS) and Other Health Difﬁculties Speciﬁc to Women

505

4.3 Interview Data

Interviews were conducted mainly to clarify the

participants’ characteristics. Because the interviews

revealed the participants to be women with various

difficulties, we believe that future experiments with

women with various difficulties will lead to deeper

analyses. Correlating these interview data with

physical data is expected to be important when

conducting multiple treatments with more data.

5 SUMMARY AND FUTURE

ISSUES

This paper presents results and discussion of data

obtained from an experiment conducted to verify the

effectiveness of reflexology as treatment for PMS

symptoms and other health difficulties women face.

Future investigations will be done to obtain data over

a longer period, such as one or two months, to clarify

the durability of reflexology effects and the number

of treatments necessary to sustain them. Additionally,

an analytical model will be constructed based on

intestinal sound data to elucidate the state of

intestines during illness and to propose methods to

alleviate symptoms.

ACKNOWLEDGEMENTS

This work was supported by JSPS KAKENHI Grant

Number JP19K10808.

REFERENCES

The Japan Society of Obstetrics and Gynecology. (2018).

Obstetrics and Gynecology Diseases (PMS). Retrieved

May 10, 2022, from https://www.jsog.or.jp/modules/

diseases/index.php?content_id=13

Hitachi Consulting. (2021). Report on the Effects of

Changes in Working and Living Styles on the Future

Japanese Economy and the Challenges Ahead

(Summary Version)

Nurul Haswani Embong, Yee Chang Soh, Jong Chiau Ming,

TinWui Wong. (2015). Revisiting reflexology: Concept,

evidence, current practice, and practitioner training.

Journal of Traditional and Complementary Medicine,

vol.5(4), pp.197-206.

Praew Kotruchin, Supap Imoun, Thapanawong

Mitsungnern, Patcharin Aountrai, Maneenuch

Domthaisong, Kazuomi Kario. (2021). The effects of

foot reflexology on blood pressure and heart rate: A

randomized clinical trial in stage-2 hypertensive

patients. The Journal of Clinical Hypertension

(Greenwich), vol.23(3), pp.399–400.

Natália Chantal Magalhães da Silva, Érika de Cássia Lopes

Chaves, Emilia Campos de Carvalho, Leonardo César

Carvalho, Denise Hollanda Iunes. (2015). Foot

reflexology in feet impairment of people with type 2

diabetes mellitus: randomized trial. Revista Latino-

Americana de Enfermagem, vol.23(4), pp.603–610.

Soheila Moghimi-Hanjani, Zahra Mehdizadeh-Tourzani,

Mahnaz Shoghi. (2015). The Effect of Foot

Reflexology on Anxiety, Pain, and Outcomes of the

Labor in Primigravida women. Acta Medica Iranica,

vol.53(8), pp.507-511.

Atsuko Nakahashi, Tatsuko Kobayashi, Kumiko Iguchi,

Chiho Gomi, Kikumi Tanaka, Miyuki Senba, Ayako

Mochizuki, Takahide Taniguchi, Miyuki Kobayashi.

(2011). Reflexology-induced Changes in Defecation

Status in Healthy Female College Students with

Constipation Tendency. Bulletin of the Faculty of

Nursing, University of Yamanashi, vol.13.

Yoshio Machi, Chao Liu, Maki Fujita. (2000).

Physiological Measurements for Reflexology Foot

Massage. Journal of International Society of Life

Information Science, vol.18(2), pp.502-510.

HEALTHINF 2023 - 16th International Conference on Health Informatics

506