VISVESVERAYA TECHNOLOGICAL UNIVERSITY

Jnana Sangama, Belagavi-590 018

A Project Report on
“Low-cost Dysmenorrhea (menstrual pain) Management Device”

Project Report Submitted in partial fulfillment for the award of the degree of

Bachelor of Engineering
in
Medical Electronics Engineering
Submitted by
TANUSHA M 1MS17ML054
GIANNE REGO 1MS19ML018
SUVARANA M 1MS19ML050
DEVIKA SANJEEV 1MS19ML017

Under The Guidance Of

Dr. Y S Sumathy, Assistant Professor

Department of Medical Electronics Engineering

Ramaiah Institute of Technology, Bangalore 560054
(Autonomous Institute, Affiliated to VTU)
2022-23

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 RAMAIAH INSTITUTE OF TECHNOLOGY
(Autonomous Institute, Affiliated to VTU)

Department of Medical Electronics Engineering

CERTIFICATE

Certified that the project work entitled “LOW-COST DYSMENORRHEA (MENTRUAL

PAIN) MANAGEMENT DEVICE” carried out by Ms. Tanusha M (1MS17ML054), Ms
Gianne Rego (1MS19ML018), Ms. Suvarna M (1MS19ML050), Ms. Devika Sajeev
(1MS19ML017), are the bonafide students of Ramaiah Institute of Technology in partial
fulfilment for the award of Bachelor of Engineering in Medical Electronics Engineering
department of the Visvesvaraya Technological University, Belgaum during the year 2022-
2023. It is certified that all corrections/suggestions indicated for Internal Assessment have
been incorporated in the Report. The project report has been approved as it satisfies the
academic requirements in respect of Project work prescribed for the said Degree.

Dr. Y S Sumathy Dr. C K NARAYANAPPA Dr. N V R Naidu

Signature of Guide Signature of HOD Principal

External Viva

Examiner Signature with date

1.
2.

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 RAMAIAH INSTITUTE OF TECHNOLOGY
(Autonomous Institute, Affiliated to VTU)

Department of Medical Electronics Engineering

DECLARATION

We, the students of VIII semester of Medical Electronics Engineering, Ramaiah Institute of
Technology, Bangalore-560054 declare that the work entitled “LOW-COST
DYSMENORRHEA (MENTRUAL PAIN) MANAGEMENT DEVICE” has been
successfully completed under the guidance of Assistant Professor Dr. Y S Sumathy,
Professor of Medical Electronics Department, Ramaiah Institute of Technology, Bangalore.
This dissertation work is submitted Visvesvaraya Technological University in partial
fulfilment of the requirements for the award of Degree of Bachelor of Engineering in
Medical Electronics Engineering during the academic year 2022 - 2023. Further the matter
embodied in the project report has not been submitted previously by anybody for the award
of any degree or diploma to any university.

Place: Bangalore

Date:

Team members:

1. TANUSHA M [1MS17ML054]
2. GIANNE REGO [1MS19ML018]
3. SUVARANA M [1MS19ML050]
4. DEVIKA [1MS19ML017]

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 ACKNOWLODGEMENT
We take this opportunity to express our gratitude to the people who have been instrumental in
the successful completion of this project. We would like to express our profound gratitude to
the Management and Dr. N.V.R Naidu, Principal, M.S.R.I.T, Bengaluru for providing us
with the opportunity to explore our potential.

We extend our heartfelt gratitude to our beloved Dr. C K Naryanappa, HOD, Medical
Electronics Engineering, for constant support and guidance.

We whole-heartedly thank our project guide Dr. Y S Sumathy, for providing us with the
confidence and strength to overcome every obstacle at each step of the project and inspiring
us to the best of our potential. We also thank her for her constant guidance, direction and
insight during the project.

This work would not have been possible without the guidance and help of several individuals
who in one way or another contributed their valuable assistance in preparation and
completion of this study.

Finally, we would like to express sincere gratitude to all the teaching and non-teaching
faculty of Medical Electronics Engineering Department, our beloved parents, seniors and my
dear friends for their constant support during the course of work.

Tanusha M
Gianne Rego
Suvarna M
Devika Sajeev

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 TABLE OF CONTENTS

Abstract
CHAPTER 1.............................................................................................................................................7
1.1 History of TENS.............................................................................................................................7
1.2 Introduction.................................................................................................................................7
1.3 Need of study...............................................................................................................................9
1.4 Project Objectives......................................................................................................................10
CHAPTER 2...........................................................................................................................................11
2.1 Literature Review.......................................................................................................................11
CHAPTER 3...........................................................................................................................................13
3.1 Methodology..............................................................................................................................13
3.2 Characteristics............................................................................................................................14
CHAPTER 4.........................................................................................................................................16
4.1 Specifications.............................................................................................................................16
4.2 Circuit.........................................................................................................................................17
4.3 Hardware Components..............................................................................................................19
CHAPTER 5...........................................................................................................................................20
5.1 Comparison................................................................................................................................20
CHAPTER 6...........................................................................................................................................23
6.1 Expected Outcome.....................................................................................................................23
6.2 Result.........................................................................................................................................23
6.3 Limitations..................................................................................................................................24
6.4 Cautions.....................................................................................................................................25
CHAPTER 7...........................................................................................................................................26
7.1 Conclusion..................................................................................................................................26
7.2 Future Scope..............................................................................................................................26
CHAPTER 8..........................................................................................................................................31

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 ABSTRACT

Transcutaneous electrical nerve stimulation (TENS) is a non-invasive and drug-free method

of pain management that uses electrical impulses to stimulate the nerves and reduce pain.
TENS is commonly used for various types of pain, including menstrual pain.

Menstrual pain, also known as dysmenorrhea, is a relatively common condition that affects
many women of reproductive age. It is characterized by cramping, lower abdominal pain, and
discomfort during menstruation.

TENS works by delivering low-level electrical impulses to the nerves, which can interfere
with the transmission of pain signals to the brain and promote the release of endorphins,
which are the body’s natural painkillers.

In the market currently there exists various TENS devices that are considered to be expensive
to the general public. Hence, we aim to make a low-cost TENS device by simplifying the
design and at the same time using lower-cost components which can help cut down
the costs significantly. Developing a low-cost TENS device can help increase access to this
form of pain management device for those women who otherwise may not be able to afford
expensive devices or treatments.

While there are many treatment options available for menstrual pain, including over-the-
counter pain relievers and hormonal therapies, some women prefer non-pharmacological
options, such as TENS.

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CHAPTER 1: Introduction, History, Need of Study and
Objectives of TENS
1.1 INTRODUCTION
Dysmenorrhea, or painful menstruation, affects a significant number of women worldwide.
The condition can be debilitating and affect a woman's quality of life, causing missed work or
school days and interfering with daily activities. While there are pharmacological treatments
available for dysmenorrhea, some women may prefer non-pharmacological approaches to
managing their pain. One such approach is the use of a transcutaneous electrical nerve
stimulation (TENS) machine.

TENS stands for Transcutaneous Electrical Nerve Stimulation, which is a non-invasive

method of pain relief that involves the use of electrical currents. It works by sending low-
voltage electrical impulses through the skin to stimulate the nerves and block pain signals
from reaching the brain. These impulses stimulate the nerves, which can help to reduce pain
signals sent to the brain. TENS machines are commonly used to relieve pain in conditions
such as back pain, arthritis, and migraines, but they can also be effective in managing
menstrual pain.

A TENS device typically consists of a small battery-operated device connected to electrodes

that are placed on the skin near the site of pain.

The Pain Gate Theory:

The Gate Control Theory of Pain is a mechanism, in the spinal cord, in which pain signals
can be sent up to the brain to be processed to accentuate the possible perceived pain, or
attenuate it at the spinal cord itself.
The 'gate' is the mechanism where pain signals can be let through or restricted. One of two
things can happen, the gate can be 'open' or the gate can be 'closed':
 If the gate is open, pain signals can pass through and will be sent to the brain to
perceive the pain.
 If the gate is closed, pain signals will be restricted from travelling up to the brain,
and the sensation of pain will not be perceived.
If someone experiences a painful (noxious) stimulus, the application of a non-noxious
(soothing or light rubbing) stimulus can help activate the gate control mechanism, and
reduce the pain.

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In conclusion, dysmenorrhea can be a challenging condition to manage, but the use of a
TENS machine can provide safe and effective pain relief. TENS machines are non-invasive,
portable, and have minimal side effects, making them a convenient option for managing
menstrual pain. While TENS machines are generally safe, it's important to use them under the
guidance of a healthcare professional to ensure their safe and appropriate use. Overall, the use
of TENS machines for dysmenorrhea is a promising approach to managing this common
gynecological condition.

Gate open
Gate close

The pain gate mechanism is located in the dorsal horn of the spinal cord, specifically in
the Substantia gelatinosa. The interneurons within the Substantia gelatinosa are what
synapse to the primary afferent neurons, and are where the gate mechanism occurs. Thus,
the substantia gelatinosa modulates the sensory information that is coming in from the
primary afferent neurons.

Primary neurons come in three different types:

 A-β fibers, large diameter fibers, have a quick transmission of impulses, due to
their myelination - these types of fibers are activated by non-noxious stimuli,
such as light touch, pressure, and hair movement.

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  A-δ fibers, a smaller diameter fiber - they are thinly myelinated, and are
stimulated by noxious stimuli, such as pain and temperature, specifically sharp,
intense, tingling sensations.
 C fibers, similar to A-δ fibers, have the slowest transmission of impulse since
they are not myelinated - these type of fibers are activated by pain and
temperature, namely prolonged burning sensations.
If the interneurons in the substantia gelatinosa are stimulated by the non-noxious large
diameter A-β fibers, an inhibitory response is produced and there are no pain signals sent
to the brain, and in this instance the 'pain gate' is closed.

When the interneurons are stimulated by the smaller diameter A-δ or C fibers, an excitatory
response is produced. In this case, pain signals are sent to the brain, these can be
modulated, sent back down through descending modulation, and perceived as varying
amounts of pain.

The activation of the large diameter A-β fibers also can help reduce and inhibit the
transmission of the small diameter A-δ and C fibers.

The usage of TENS activates the pain gate mechanism to inhibit pain signals going up to
the brain, and thus reduces the sensation of pain. Similar to as described above, the TENS
activates non-noxious afferent fibers, which in turn activates the 'pain-inhibiting'
interneurons in the spinal cord, and thus minimizes/reduces perceived pain as an output.
This is because TENS can activate A-β fibers, which helps facilitate the gate control
mechanism. The activation of the A-β fibers will inhibit the input from the noxious A-δ
and C fibers.

The Interferential Current (IFC) modality, also commonly used in Physiotherapy practices,
inhibits pain through the gate control mechanism, and other neural mechanisms.

Patients can self-administer TENS and titrate dosage as required because there is no potential
for overdose and there are few side effects or drug interactions. Maximal analgesia occurs
when TENS generates a strong but non-painful electrical paraesthesia beneath the electrodes.
Effects are generally rapid in onset and offset so patients are encouraged to administer TENS
as needed

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and throughout the day. TENS is cheap when compared to long term drug therapy and TENS
devices can be purchased over the counter and without medical prescription in the UK.

1.2 HISTORY OF TENS:

According to research by the Roman historian Sribonus, Egyptians used electric eel to
apply pain therapy. Then, the first electrical current was used to induce narcosis in the
patient in 1850, in America.
TENS devices, which produce short-term stimuli in direct current, were first used in 1919.
Wall and Sweet observed that chronic pain decreased shortly as a result of electrical
stimulation of the peripheral nerves via electrodes placed on the skin.
Transcutaneous electrical nerve stimulation (TENS) is a non-pharmacological method of
labour analgesia that has been used for over 30 years in European countries (Santana et al.,
2016). Since 1965, more and more electric current is being used to treat pain. TENS has
become a recognized treatment option and has continued its development up to day-to-day.
It helped patients reduce the use of pain medication. Among the preferred types of
treatments on this scale are the literature.
Today, there are various forms of heat therapy available for those who suffer from
dysmenorrhea, including heat patches, hot water bottles, and electric heating pads. These
methods are safe, non-invasive, and can provide quick and effective relief for menstrual
cramps.

BACKGROUND:
Dysmenorrhea is a common condition affecting many women during their reproductive years,
with estimates suggesting that up to 90% of women experience menstrual pain at some point
in their lives.
Primary dysmenorrhea (PD) is the most common gynaecological disorder during menarche. It
is a pain caused by menstrual cramps, located in the lower abdomen, extending to the lower
back of the spine and radiating to the medial region of the thighs.
It affects about 50% of women of reproductive age, and between 10 and 15% the presence of
pain is strong enough to interfere with the activities of daily living.
In the United States, dysmenorrhea has been the main reason for school and work
absenteeism. In the United Kingdom, 45 to 97% of the female population reports
dysmenorrhea

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The pain lasts for about 8 to 72 h, which begins during or a few days before the menstrual
period and tends to disappear after about 2 days or with the end of menstruation.
Transcutaneous Electrical Nerve Stimulation is a non-pharmacological method for pain relief
that has been shown to be effective for dysmenorrhea. TENS involves the use of a small
device that delivers electrical impulses to the nerves through electrodes placed on the skin.
While TENS machines are available on the market, they can be expensive and require a
prescription in some countries. This can make them inaccessible to women in low-income
who may not have access to healthcare or cannot afford the cost.
A low-cost approach to using TENS machines for the treatment of dysmenorrhea is necessary
to make this treatment option accessible to a wider range of women.

1.3 Need of study:

Dysmenorrhea is a condition characterized by painful menstruation, which affects a

significant number of women worldwide. Transcutaneous Electrical Nerve Stimulation
(TENS) is one of the non-pharmacological interventions that have been used to manage
dysmenorrhea. Here are some reasons why the study of TENS in dysmenorrhea is needed:

1. To determine its effectiveness: The use of TENS for dysmenorrhea is based on the
premise that electrical stimulation can activate the body's natural pain relief
mechanisms. However, the effectiveness of TENS in managing dysmenorrhea
needs to be studied in well-designed clinical trials to determine its efficacy.
2. To identify the optimal parameters: The optimal parameters of TENS, such as,
intensity, and duration, need to be determined for dysmenorrhea management. The
parameters may vary depending on the individual patient's pain threshold and
menstrual cycle phase.
3. To determine the safety: The safety of TENS needs to be studied in the management
of dysmenorrhea to determine its side effects and contraindications. If women have
conditions like epilepsy or have a pacemaker implanted then they may not be ideal
candidates for TENS.

Overall, the study of TENS in dysmenorrhea is necessary to determine its effectiveness,

identify optimal parameters and determine safety.

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1.4 Project objectives:

1. Develop a TENS machine that is effective in reducing the symptoms of primary

dysmenorrhea, including menstrual cramps, back pain, and pelvic pain.
2. Design a TENS machine that is easy to use and portable, so that women can use it
at home as well as at work.
3. Low-cost TENS machine as low as possible to make it accessible to women who
may not have access to expensive medical treatments.
4. Conduct clinical trials to check the safety of the TENS machine in reducing primary
dysmenorrhea symptoms.

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CHAPTER 2: Literature Review

2.1 Literature Review

1. Effectiveness of transcutaneous Electrical Nerve Stimulation and Interferential current
in primary Dysmenorrhea
A thesis by Nazan Tugay, Turkan Akbayrak, Funda Demirturk(Nov 2020) This
review paper presents compression between the effectiveness of transcutaneous
Electrical Nerve stimulation and interferential current in primary Dysmenorrhea. It
summarizes the research progress in hardware design. This paper aims to provide IFC
and TENS are both effective in reducing menstrual pain , referred lower limb pain,
and low back pain.
2. Transcutaneous Electrical Nerve Stimulation (TENS) for Primary Dysmenorrhea: An
overview
A thesis by Michal Elboim-Gabyzon, and Leonid Kalichman (2020) This review
paper presents the positive effects of TENS in reducing pain. The advantage of TENS
are that is it is an easy –to –use , safe, portable, battery-operated, and inexpensive
device. This paper aims to provide TENS is sufficiently associated with improvement
on multiple outcome variables in addition pain relief, for those who using it for quite
long time and also who tried conventional pain relief method.
3. Effect of high frequency transcutaneous electrical nerve stimulation at root level
menstrual pain in primary dysmenorrhea
A thesis by Uttam Manisha, Lehri Anuradha (2021)this review paper presents the
present study indicated that application of high frequency TENS (root level) was
effective at different menstrual pain sites.
4. Efficacy of high Transcutaneous Electrical Nerve stimulation (TENS)Application
with Relaxation Breathing in Primary Dysmenorrhea
A thesis by Swapneela Jacob, Lim Fung Mei (6th June 2022) this review paper
presents to determine the efficacy of high TENS in combination with relaxation
breathing and compare between the efficacy of high TENS and relaxation breathing
with placebo TENS and relaxation breathing. both are showed effective pain relief in
primary dysmenorrhea.
5. Using TENS for pain control: the state of the evidence

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 A thesis by Carol G T Vance, Dana L Dailey, Barbara A rakel,Kathleen A Sluka
(2018) this reviews paper presents the TENS has effects specific to mechanical
stimuli and beyond reduction of pain and will improve activity levels, function and
quality of life. This paper aims to provide TENS will continue to be used for pain
control, with or without efficacy data.
6. Transcutaneous Electrical Nerve Stimulation (TENS) for Primary Dysmenorrhea
An Overview: A thesis by Michal Elboim-Gabyzon and Leonid Kalichman (2020).
The evoked results of previous studies demonstrated the positive effects of TENS in
reducing pain and related PD symptoms, the improvement of the quality of life, and
the decreased use of additional analgesics.
7. Diagnosis and management of dysmenorrhea
A thesis by Michelle Proctor, Cynthia Farquhar (2019). Dysmenorrhea is a common
gynaecological condition that is underdiagnosed and undertreated. Simple
analgesics and non-steroidal anti-inflammatories are effective in up to 70% of
women. Oral contraceptives can be considered for women who wish to avoid
pregnancy. For women seeking alternative therapies heat, thiamine, magnesium,
and vitamin E may be effective.
8. Effect of transcutaneous electrical nerve stimulation (TENS) on primary
dysmenorrhea in adolescent girls
A thesis by Parisa Parsa, Saeed Bashirian (2013). TENS method seems to be
effective in managing primary dysmenorrhea. It is free from the adverse effects of
analgesics, gives immediate pain relief and had no adverse effects.

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CHAPTER 3: Methodology and Characteristics of TENS

3.1 Methodology:

Patient Selection

TENS placement

TENS parameters

Treatment duration

Outcome measures

Primary dysmenorrhea is a common gynaecological condition characterized by painful

menstrual cramps that can significantly impact a woman's quality of life. TENS has been
used as a non-pharmacological treatment for primary dysmenorrhea, and several studies
have investigated its effectiveness.

The methodology for TENS in primary dysmenorrhea typically involves the following
steps:

1. Patient selection: Patients with primary dysmenorrhea are typically selected for
TENS therapy. The diagnosis is made based on a history of painful menstrual
cramps.

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 2. TENS placement: TENS electrodes are typically placed on the lower abdomen,
lower back, or both. The placement of electrodes may vary depending on the
location and severity of the pain.
3. TENS parameters: The TENS parameters including frequency and electrode
placement are typically done based on the patient’s tolerance. Usually, a high
frequency is used for TENS i.e., 80-120 Hz which is a strong, but a comfortable
sensation is commonly used for primary dysmenorrhea.
4. Treatment duration: The treatment duration varies depending on the study design,
but typically ranges from 20-60 minutes per session. The treatment frequency also
varies, but most studies have used TENS for 2-3 times per day for several days,
starting from the onset of menstrual pain.
5. Outcome measures: The primary outcome measure is typically the reduction in pain
at the site of complain. Secondary outcomes may include changes in pain duration.

Overall, the methodology for TENS in primary dysmenorrhea involves the selection of
appropriate patients, electrode placement, TENS parameters, treatment duration, and
outcome measures. Future studies are needed to determine the optimal TENS parameters
and treatment duration to maximize the effectiveness of TENS in managing primary
dysmenorrhea.

3.2 Characteristics:

1. Location of electrodes:

Electrodes are placed in the lower abdomen or lower back, targeting the areas that
feel the most pain. The electrodes have a gel that provide maximum conductivity.
These patches can be used 5-6 times and should be stored carefully.

2. Regularity:

The frequency is usually set at 80-100 Hz, which is a high frequency that relieves
pain and this is the frequency that is most commonly used.

3. Intensity:

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 The intensity is set to a level comfortable for the patient, usually between 10 and
50 mA. Intensity varies from patient to patient.

4. Treatment time:

The recommended treatment duration is between 30 and 60 minutes per session,

with several sessions per day as needed. As TENS is relatively safe to use, and it
has no side effects, it can be used multiple times per day depending on the patient’s
requirement.

5. Safety:

TENS is generally considered safe, but it should not be used on certain areas of the
body, such as the head, neck, or heart. It should also be avoided in patients with
pacemakers or other implanted devices.

The characteristics of different TENS techniques:

Physiological Intention Clinical Technique

Conventional TENS To selectively activate Low-intensity / high-

large diameter non-noxious frequency TENS at site of
nerve fibres to elicit pain to produce “strong but
segmental analgesics. comfortable TENS
paraesthesia”. Administer
whenever in pain

Acupuncture like TENS To produce muscle twitches High-intensity / low-

to activate small diameter frequency. TENS over
motor afferents to elicit muscles, acupuncture
extra segmental analgesia. points or trigger points to
produce “strong but
comfortable muscle
contractions”. Administer
for 15–30 minutes at a time.

Intense TENS To activate small diameter High-intensity/high-

noxious afferents to elicit frequency TENS over
peripheral nerve blockade nerves arising from painful
and extra segmental site to produce “maximum
analgesia tolerable (painful) TENS

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18
CHAPTER 4: Specifications, Circuit and Hardware
Components of TENS

4.1 Specifications:

1. Frequency:
The frequency of a TENS device is the number of electrical pulses it delivers per
second. The most common frequency range for TENS devices is between 80 and 100
Hz.

2. Channel:
TENS devices can have one or two channels. Single-channel TENS devices allow
users to process one zone at a time, while dual-channel devices can handle two zones
simultaneously.

3. Timer:
The timer allows the user to set the duration of each TENS session, which can range
from 5 minutes to an hour or more.

4. Battery life:
TENS devices are typically battery operated, and battery life may vary depending on
usage and the type of battery used.

5. Size and Portability:

TENS devices can vary in size and portability, with some models designed for easy
use at home or on the go.

It is important to note that specific TENS specifications may vary by device model and
manufacturer. You should always consult your instruction manual or medical professional
before using the TENS device.

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4.2 Circuit:

Power source: The power source can be a 9V battery or a DC power supply is used.

Waveform generator: The waveform generator produces the electrical signal that will be
delivered to the electrodes.

Electrodes: The electrodes are the interface between the electrical signal and the body.
They are typically made of conductive gel or adhesive and placed on the skin over the area
where pain is felt. The electrodes are connected to the waveform generator through wires.
An LED is also used in the circuit.

Here, R1, R2 and R3 are the resistors used with values 6.8kΩ, 167kΩ and 233kΩ. C1 and
C2 are the low-pass filter capacitors.

2 electrodes, E1 and E2 are taken, which are placed on the surface of the skin.

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Circuit designed on a springboard

Circuit soldered on a PCB board

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4.3 Hardware components:
PCB Board-

A printed circuit board is a non-conductive material with conductive lines printed. The circuit
boards used in most electronic devices.

Resistors:

A device having resistance to the passage of an electric current that regulates the flow of the
electrical current in an electronic circuit.

6.8kΩ – provide lower noise, and are generally better for high frequency or radiofrequency
applications.

233Ω – used to resist the flow of electricity in a circuit.

1.67kΩ – used in a variety of electronic circuits, such as in voltage dividers, current limiting
circuits, and as pull-up or pull-down resistors in digital circuit.

47nF – flashing circuits, smoothing, circuits

10nF – used for power decoupling, ensuring smooth power in your circuit, and timing circuits

Capacitors:

A device used to store an electric charge in the form of an electrostatic field.

IC:

An integrated circuit, sometimes called a chip, semiconductor on which thousands of millions

of tiny resistors, capacitors, diodes and transistors are fabricated.

555- by using three 5kΩ resistors to divide the supply voltage in three

LED:

A light emitting diode is a semiconductor device, which can emit light when an electric current
passes through it.

Battery:

A battery is a device that stores chemical energy and converts it into electrical energy.

Electrode patches:

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TENS units work by delivering small electrical impulses through electrodes that have
adhesive pads to attach them to a person’s skin.

Switch:

A switch responds to an external force to mechanically change an electrical signal.

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CHAPTER 5: Comparison of the cost of TENS devices
5.1 Comparison of the cost of devices that are currently available in the
market vs the device that we made
Devices in the market:

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Device made at low-cost:

Components Prices
6.8kΩ resistor Rs. 35
233kΩ resistor Rs. 35
167kΩ resistor Rs. 49
47nF capacitor Rs. 49

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 10nF capacitor Rs. 49
IC 555 Timer Rs. 22
9V battery Rs. 20
Switch Rs. 10
PCB Board Rs. 30
Electrode pads Rs. 100

Total Price: Rs. 399

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CHAPTER 6: Expectation Outcomes, Results, Limitations and
Cautions of TENS
6.1 Expected Outcomes:
1. Many women have menstrual cramps just before and during their menstrual periods.
Menstrual cramps can be severe enough to interfere with everyday activities for a few
days every month.

2. As we know the pain relief product are expensive and many can't afford it. So we
have developed a product which is low cost pain relief with the same settings that is
more affordable.

3. This device can be easily portable and has very minimal side effects.

6.2 Result:

TENS Circuit with Electrode pads

27
 TENS device used on a patient

Basic scientific evidence suggests that there are peripheral and central nervous system
mechanisms underlying the analgesic action of TENS. Generally, TENS provides initial relief
of pain in 70-80% of patients. You can safely use a TENS machine as often as you like. You
can safely use a TENS machine as often as you like usually for 30-60 minutes up to 4 times
daily. TENS can provide relief for up to four hours.
Useful features of this study are practical, side effect is very low, battery operated and low
cost. Of course, this treatment should be done with a doctor's recommendation. Patients
should apply their doctor's recommendations and treatment plans recommended by
doctors. TENS is the most basic definition of electrical nerve stimulation with the help of
the skin tract. This method has been applied to many patients and is used as a reliable
method.
The TENS application stimulates the nerves that produce the painkillers in the brain and
spinal cord. As a result, natural substances secreted by the body itself are used for pain
treatment. Thus, the drug use of the patients is reduced and the patients are protected from
the side effects of the drugs. The handy features of the TENS therapy are practical, side-
effect, battery-powered, small devices. Of course, this therapy should be done with a
doctor's recommendation. Patients should apply their doctor's recommendations and
treatment plans prescribed by the doctors.
TENS is considered a low-cost therapy as it requires simple components to build the device
which are available at minimal prices. However, it is important to note that productiveness of

28
TENS will vary depending on the individual factors such as the extent of dysmenorrhea, the
duration of TENS treatment given, and the placement of the electrodes.
TENS may not be suitable for those individuals who have pacemakers, epilepsy or any
history of seizures.

(a) (b)

(d) (c)
Figure:

(a) Circuit diagram

(b) Circuit designed on springboard
(c) Circuit on PCB Board
(d) Final outcome

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6.3 Limitations:

1. Limited effectiveness: TENS may not provide sufficient pain relief for all the women.
The effectiveness of TENS may vary on individuals pain tolerance.
2. Limited duration of effect: TENS is not a permanent solution, and its pain relief effect
may only last for a short period of time. TENS can be used on a regular basis.
3. Availability and cost: TENS machine may not be readily available at all healthcare
centres and they might be expensive for personal use.
4. User compliance: Active participation and cooperation is required to achieve the needed
effect

Application of the project:

Pain management: TENS machines can be used to relieve pain caused by conditions such as
arthritis, back pain, sciatica, and fibromyalgia. The electrical impulses stimulate the nerves
and can interfere with pain signals, providing relief.

Sports injuries: TENS machines can be used to manage pain caused by sports injuries such as
muscle strains, sprains, and contusions.

Labor pain: TENS machines can be used to manage pain during labor and delivery. The
electrodes are placed on the back and send electrical impulses to the nerves that transmit pain
signals from the uterus and cervix.

Postoperative pain: TENS machines can be used to manage pain after surgery, reducing the
need for opioids and other pain medications.

Chronic pain: TENS machines can be used to manage chronic pain conditions such as
neuropathy, phantom limb pain, and chronic back pain.

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6.4 Cautions:
1. Consult a healthcare professional: Before using a TENS machine, it is important to
consult a healthcare professional, such as a doctor or physical therapist, who can advise
on the appropriate settings and usage for your specific condition.
2. Avoid using on certain areas: TENS machines should not be used on or near certain
areas of the body, such as the eyes, head, chest, or neck.
3. Do not use on open wounds or broken skin: TENS machines should not be used on open
wounds or broken skin, as it can interfere with the healing process.
4. Do not use while driving or operating heavy machinery: TENS machines can cause
drowsiness or dizziness in some people, so it is important to avoid using them while
driving or operating heavy machinery.
5. Avoid using during pregnancy: TENS machines should not be used during pregnancy
unless advised by a healthcare professional.
6. Do not use if you have a pacemaker or other electronic implant: TENS machines can
interfere with pacemakers or other electronic implants, so it is important to consult with
a healthcare professional before using a TENS machine if you have an electronic
implant.
7. Follow the manufacturer's instructions: Always follow the manufacturer's instructions
for the TENS machine, including the appropriate placement of electrodes and duration
of use.

In summary, while TENS machines can be a useful tool for managing pain, it is important to
use them with caution and under the guidance of a healthcare professional to ensure their safe
and effective use.

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CHAPTER 7: Conclusion and Future Scope of TENS
7.1 Conclusion:
Primary dysmenorrhea is a common menstrual disorder affecting a significant proportion of
women worldwide. The pain associated with primary dysmenorrhea can be debilitating,
leading to missed work or school and reduced quality of life. Transcutaneous electrical nerve
stimulation (TENS) is an inexpensive, non-invasive therapy that has shown great promise in
the relief of pain associated with primary dysmenorrhea.

TENS therapy works by delivering electrical impulses to the nerves in the affected area,
which can help relieve pain. This therapy is usually done using a small battery-powered
device that can be attached to the skin using electrodes. TENS therapy is relatively easy to
use and can be done at home, making it a convenient option for women with menstrual pain.

The future scope of TENS for primary dysmenorrhea is quite promising. Wearable TENS
devices have been developed and can be a discreet and convenient option for women with
dysmenorrhea. Additionally, as our understanding of the mechanisms underlying primary
dysmenorrhea improves, it may be possible to develop personalized TENS therapy tailored to
the specific needs of each individual.

Combining TENS therapy with other treatments, such as medication or acupuncture, may
further improve pain relief in women with primary dysmenorrhea. TENS therapy is also
relatively inexpensive, making it a potentially attractive treatment option in resource-
constrained settings where other options may not be available or too expensive.

In summary, TENS therapy provides a safe, non-invasive, and inexpensive way to manage
pain associated with primary dysmenorrhea. Although more research is needed to fully
understand its effectiveness and the underlying mechanisms involved in its pain-relieving
effects, TENS therapy offers a promising option for those looking for an alternative. A safe
and cost-effective way to manage primary dysmenorrhea. With continued research and
development, the future of TENS therapy for primary dysmenorrhea looks quite promising.

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7.2 Future Scope:
The future scope of TENS for primary dysmenorrhea is quite promising. Here are some
potential areas for growth:

1. TENS Wearables: With the growing popularity of wearables, TENS devices can be
integrated into clothing to provide a discreet and convenient option for women with
pain menstrual abdomen.
2. Personalized TENS Therapy: Currently, TENS therapy is typically delivered in a one-
size-fits-all approach. However, as our understanding of the mechanisms underlying
primary dysmenorrhea improves, it may be possible to develop personalized TENS
therapy tailored to each individual's specific needs.
3. TENS and Other Therapies: TENS therapy can be used in combination with other
therapies, such as medication or acupuncture, to further improve pain relief in women
with menstrual pain.
4. TENS in resource-constrained settings: TENS therapy is relatively inexpensive and
non-invasive, making it a potentially attractive treatment option in resource-
constrained settings where other options may not be available or expensive.

Overall, TENS therapy holds promise as an inexpensive and effective treatment option for
primary dysmenorrhea, and continued research and development in this area could lead to
more exciting innovations. more in the near future.

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 CHAPTER 8: REFERENCES

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